An ankle fracture can be a painful and frustrating injury, but with the right treatment and care, most individuals can expect to regain full function of their ankle over time. In this article, we will discuss the typical recovery timeline for an ankle fracture, as well as the various factors that can impact healing time.
An ankle fracture is a common injury that can occur at any age. Together with traumatologist Olga Limorenko, we are looking into the dangers of such a fracture and whether it is possible to speed up recovery.
A sprained ankle, a fall due to an unnoticed step, a hole, or a slippery surface can all cause an ankle fracture. It is important to diagnose this injury in time in order to begin proper treatment and appropriate rehabilitation.
Classification of ankle fractures
There are many classifications of ankle fractures.
Classification of fractures of the external and internal ankles
The approach, which takes into account the mechanism of injury, is considered outdated and is not used today – this information does not affect further treatment tactics. The most widely used classification is the AO – Association of Osteosynthesis [2], which is based on the anatomy of the ankle joint and subsequent treatment approaches.
Classification of ankle fractures AO
According to this classification, there are 3 large groups:
1. Suprasyndesmotic injuries – those fractures that are localized above the tibiofibular syndesmosis – the junction of the tibia and fibula through three ligaments:
- simple fracture of the fibular diaphysis;
- comminuted fracture of the diaphysis of the fibula;
- fracture of the proximal fibula.
2. Fractures at the syndesmosis level:
- trans-syndesmotic isolated fracture of the fibula;
- trans-syndesmotic fracture of the fibula with damage to the tibia or deltoid ligament;
- trans-syndesmotic fracture of the fibula with damage to the tibia or deltoid ligament and fracture of the posterior edge.
3. Fractures below the level of syndesmosis:
- subsyndesmotic isolated fracture of the ankles;
- subsyndesmotic fracture of the tibia with a fracture of the medial malleolus;
- subsyndesmotic fracture of the tibia with a fracture of the posteromedial edge of the ankle.
It should also be noted that fractures can be closed or open.
The approach to treatment and rehabilitation depends on the type of fracture, the presence or absence of displacement and other features.
The most common signs of a broken ankle are:
- pain,
- edema,
- redness in the ankle area.
“You should pay attention to the presence of the very fact of injury: you twisted your leg, stepped unsuccessfully, stumbled, slipped, after which swelling, pain and redness appeared. These symptoms are very similar to damage to the ankle ligaments, and only a specialist can recognize whether it is a fracture or not. Their appearance is a reason to consult an orthopedic traumatologist,” notes Olga Limorenko.
Diagnosis of an ankle fracture
A doctor will help you accurately diagnose a fracture. He will prescribe the necessary examination: this will necessarily be an x-ray, computed tomography, MRI, and maybe a combination of methods.
1. Doctor’s examination
The specialist will find out under what circumstances the injury was sustained, examine the injured limb, and then conclude what examinations are necessary to clarify the diagnosis.
2. Radiography
X-ray is the first mandatory basic examination for fractures. X-rays of the ankle joint are performed in the lateral and anteroposterior projections, and sometimes in the oblique one. This is necessary in order to obtain the most objective picture of the damage.
3. CT and MRI
Computed tomography (CT) is needed to clarify the diagnosis in complex cases, and magnetic resonance imaging (MRI) for an ankle fracture is prescribed to assess the condition of the ligamentous apparatus in the damaged area.
Treatment of an ankle fracture
There are two main types of treatment for ankle fractures: conservative and surgical.
1. Conservative type of treatment
“The conservative method involves immobilization, that is, immobilization, in a plaster cast,” says the doctor. — It is applied for 4–6 weeks for fractures of one ankle, for up to 12 weeks for fractures of both ankles and the posterior edge of the tibia. It is important to understand that the conservative method is suitable if there is no displacement of the fragments or it is insignificant.
Plaster immobilization can be replaced with polymer plaster – one that can be wetted. Spending time in it until the fracture heals is much more comfortable than in a classic plaster cast. However, it is important to remember that this can only be done when the swelling has regressed, that is, no earlier than 10-14 days from the moment of injury.”
2. Surgical type of treatment
“The surgical type of treatment consists of osteosynthesis, that is, the comparison of fragments in the correct position and their fixation with plates and screws,” says Olga Limorenko. — The surgical method is considered optimal, since after the operation the patient is immediately allowed to move the foot and is prescribed physical therapy necessary to develop the ankle joint. By the time the fracture heals – and the time frame is the same as with conservative treatment, from 4 to 12 weeks – and the moment the patient gives up crutches, the patient can already begin to walk with normal biomechanics of movements and not waste time developing movements in the joint.”
3. Vitamin intake
The use of any supplements is not an independent method of treating fractures.
Taking vitamin complexes is only an additional measure that cannot affect the effectiveness and timing of fusion, but can improve blood supply and, accordingly, nutrition of the bone, which begins to heal. This process is facilitated by vitamins D , K, as well as vitamins B9 and B12. It is important to understand that taking these drugs must be under control and as prescribed by a doctor.
Timeframe for healing of the ankle after a fracture ;Ankle Fracture: How Long It Will Take to Recover
A fracture of one ankle heals in 4–6 weeks, but the process of bone healing after a fracture of both ankles can take up to 12 or even 16 weeks.
Rehabilitation after an ankle fracture
Treatment is not limited to just one method – applying a cast or performing surgery. It is important to pay attention to rehabilitation, without which it may be difficult or even impossible to restore normal gait after injury [3].
1. Physiotherapy
Physiotherapy is a good remedy both in the early period, when you need to relieve swelling, and in the later period – it helps improve blood supply to the tissues.
2. Massage
“Massage is contraindicated until the patient walks on two legs without additional support (crutches/cane). It can be prescribed in the late rehabilitation period, but only after an ultrasound scan of the veins of the lower extremities,” notes Olga Limorenko.
3. Restorative set of exercises
Exercise therapy (physical therapy) is required to develop movements in the ankle and foot joints for all patients with ankle fractures, regardless of the method of treatment. A specialist should prescribe and monitor their implementation; he will explain how to perform each exercise correctly and effectively. Only competent physical rehabilitation will help restore mobility as before the injury.
Consequences and complications after an ankle fracture
Common problems after an ankle fracture include:
- nonunion or malunion of a fracture;
- false joint;
- amyotrophy;
- persistent pain syndrome;
- gait disturbances.
Doctor’s recommendations
“The patient’s well-being after a fracture depends not only on the correct diagnosis and treatment, but also on how clearly the patient follows medical recommendations. Neglecting them can negate the results of even the most effective treatment,” says Olga Limorenko.
Questions and answers
Traumatologist Olga Limorenko answered the most common questions from patients about ankle fractures.
How long do you wear a cast for an ankle fracture?
From 4 to 12 weeks from the date of injury.
What is the ICD code for an ankle fracture?
According to ICD-10: a fracture of the lower leg, including the ankle joint, is coded S82.
How long can you walk with a plate in your leg after breaking your ankle?
If the implant does not interfere, then you can walk with it for the rest of your life. However, in young patients who lead an active lifestyle and are at higher risk of injury, it is recommended to remove the fixator 1.5–2 years after surgery. But situations are different, and only a specialist can set individual deadlines.
What should you do to help your ankle fracture heal faster?
There are no magic pills for healing a fracture; it requires time, good blood supply and following medical recommendations. It is important to eat right, it is extremely important not to exclude animal protein from the diet, because it is a building material for bones and affects the formation of callus.
Thoughtless use of calcium is contraindicated. If you imagine a house, then calcium is the bricks, and protein is the cement that binds these bricks. If the patient does not have osteoporosis, and the fracture occurred due to a twisted leg, a slip, or any other external reason, the use of calcium does not make sense from the point of view of fracture healing and may even be harmful to the blood vessels, kidneys and heart.
