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Broken Ankle Causes, Differences, Symptoms and Treatments

The ankle is a hinged synovial joint made up of three bones: the tibia (shin bone), the fibula (outer ankle bone), and the talus (between the heel and leg). These three bones are bound, supported, and stabilized by strong, fibrous bands of tissue called ligaments.

A break in an ankle bone can be either traumatic or stress related. This injury may be referred to as a break or fracture. A traumatic fracture can result from tripping, twisting or rolling the ankle, falling, or by blunt impact to the ankle. These traumatic ankle breaks usually occur during sporting activities or accidents. Stress fractures, however, occur over time and are the result of repetitive stress to the ankle. These fractures sometimes occur when a new activity that engages the ankle is introduced, or when the level of activity is abruptly increased or intensified. 

There are various symptoms that accompany an ankle break. The most significant symptoms are pain and swelling that occurs in the ankle and sometimes spreads up from the foot to below the knee. Bruising or discoloration may develop eventually. It will be difficult or even impossible to put weight on the affected foot, and in severe cases there may be a visible deformity or even exposed bone.

It is very important to seek immediate treatment when an ankle break occurs or is suspected to have occurred, in order to allow the bone to properly heal and to avoid future complications such as stiff joints, limited range of motion, and osteoarthritis.

To diagnose a broken ankle, your podiatrist will first ask you to explain how the injury occurred and what your symptoms are. They will perform a thorough examination, checking for damage to nerves, blood vessels, and other structures around the injury site. They will also test your range of motion. An X-ray will need to be reviewed and, in some cases, an MRI or CT scan may be necessary.

Proper treatment of a broken ankle will depend on where and how severe the break is, how stable the ankle is, and whether the bone is displaced (misaligned or separated) or non-displaced (broken yet still aligned properly). 

Mild fractures (where the bone is non-displaced) may be treated by resting, icing, and elevating the ankle at first, followed by immobilization with a cast or walking boot. Pain and inflammation may be treated with acetaminophen. More severe or complicated fractures where bones or joints are displaced may require surgery. 

Recovery time will also vary, and it may take 4-6 weeks or longer for a broken ankle to heal. Your podiatrist will most likely order progressive X-rays or stress tests to be taken in order to monitor the healing process.

Wound Care

Diabetics must be wary of all wounds, regardless of depth or size. Diabetes, a chronic disease in which the body cannot properly use glucose the way it normally would, causes various complications that make wounds difficult to heal. Nerve damage or neuropathy will cause diabetics to have trouble feeling the pain of a blister or cut until the condition has significantly worsened or become infected. A diabetic’s weakened immune system can make even the most minor of wounds easily susceptible to infection. Diabetics are also more prone to developing narrow, clogged arteries, and are therefore more likely to develop wounds.

Wounds should be taken care of immediately after discovery, as even the smallest of wounds can become infected if enough bacteria build up within the wound.  To remove dirt, wounds should be first rinsed under running water only. Soap, hydrogen peroxide, or iodine can irritate the injury and should be avoided. To prevent infection, apply antibiotic ointment to the wound and cover it with a bandage. The bandage should be changed daily. The skin around the wound may be cleaned with soap.

To prevent further exacerbation, see a doctor—especially if you have diabetes. Minor skin conditions can become larger problems if not properly inspected. As the wound heals, make sure to avoid applying pressure to the affected area.

Plantar Fasciitis

Plantar fasciitis is one of the most common causes of heel pain. The plantar fascia is the thick band of tissue that connects the heel bone to the toes. When this band of connective tissue becomes inflamed, plantar fasciitis occurs. Fortunately, this condition is treatable.

There are several factors that may put you at a greater risk for developing plantar fasciitis. One of the biggest factors is age; plantar fasciitis is common in those between the ages of 40 to 60. People who have jobs that require them to be on their feet are also likely to develop plantar fasciitis. This includes factory workers, teachers, and others who spend a large portion of their day walking around on hard surfaces. Another risk factor is obesity because excess weight can result in extra stress being placed on the plantar fascia.

People with plantar fasciitis often experience a stabbing pain in the heel area. This pain is usually at its worst in the morning, but can also be triggered by periods of standing or sitting. Plantar fasciitis may make it hard to run and walk. It may also make the foot feel stiff and sensitive, which consequently makes walking barefoot difficult.

Treatment for plantar fasciitis depends on the severity of the specific case of the condition. Ice massage applications may be used to reduce pain and inflammation. Physical therapy is often used to treat plantar fasciitis, and this may include stretching exercises. Another treatment option is anti-inflammatory medication, such as ibuprofen.

If you suspect that you have plantar fasciitis, meet with your podiatrist immediately. If left untreated, symptoms may lead to tearing and overstretching of the plantar fascia. The solution is early detection and treatment. Be sure to speak with your podiatrist if you are experiencing heel pain.

Ingrown Toenails

An ingrown toenail is a nail that has curved downward and grown into the skin.  This typically occurs at either the nail borders or the sides of the nail.  As a result, pain, redness, swelling, and warmth may occur in the toe.  If a break in the skin forms due to the ingrown nail, bacteria may enter and cause an infection in the area; this is typically characterized by a foul odor and drainage.

Ingrown toenails have multiple reasons for developing.  In many instances, the condition is a result of genetics and is inherited.  The most common cause, however, is improper trimming; cutting the toenails too short forces the skin beside the nail to fold over.  An ingrown toenail can also develop due to trauma, such as stubbing the toe, having an object fall on the toe, or participating in activities that involve repeated kicking or running.  Wearing shoes that are too tight or too short can also cause ingrown toenails.

Treatment for an ingrown toenail varies between patients and the severity of the condition.  In most cases, it is best to see your podiatrist for thorough and proper treatment.  After examining your toe, your podiatrist may prescribe oral antibiotics to clear the infection if one is present.  Surgical removal of either a portion of the nail or the entire nail may also be considered.  In some cases, complete removal or destruction of the nail root may be required.  Most patients who undergo nail surgery experience minimal pain afterward and can return to normal activity the following day.

Ingrown toenails can be prevented with proper nail trimming and by avoiding improper-fitting shoes.  When cutting the toenails, be sure that you are cutting in a straight line and avoid cutting them too short.  Shoes should not be too short or tight in the toe box.

Plantar Fibroma

A plantar fibroma is a knot in the arch of the foot. It can cause pain when repeated pressure is applied by walking barefoot or wearing tight shoes. While plantar fibromas can appear in anyone, men who are middle-aged or older are said to be more susceptible. The main symptom of a plantar fibroma is a firm lump on the arch of the foot. If there is pain, it can be intensified by putting pressure on the nodule. The lump can stay one size or grow larger. You may have one or more fibromas in the feet and there tends to be a high incidence of recurring plantar fibromas.  Generally, a plantar fibroma can be treated without surgery. Treatment might include steroid injections to help shrink the lump, orthotics to help redistribute weight away from the nodule, plantar fascia stretching, or physical therapy to help use anti-inflammatory medication on the lump. If a lump grows larger or more painful, a podiatrist can be consulted to confirm the diagnosis. The doctor will palpate the lump and this may cause pain that can be felt all the way to the toes. An X-ray, MRI, or biopsy might be done if further evaluation is necessary. A lump in the arch of the foot might be something other than a plantar fibroma, such as cysts, nerve or fatty tumors, swollen tendons, or an infection in the foot. It is important to see a podiatrist for proper diagnosis and treatment of plantar fibromas.

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