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Ankle Pain, Injury and Surgery

The ankle acts as a hinge allowing upwards, downwards and sideways movement of the foot. There are three bones within the joint:

  • The tibia – runs down the front of the leg
  • The fibula – a thinner bone which runs parallel to the tibia
  • The talus – slots into the tibia and fibula

These are held together by strong bands of collagen fibre known as ligaments.

Ankle pain

Pain in the ankle can be caused by arthritis and there are five types which typically affect this joint. These are: ankle arthritis, rheumatoid arthritis, psoriatic arthritis, gout and septic arthritis.

The other causes of pain can be due to injury which results in a sprain or fracture.

Injuries – ligaments

The most common ligament injuries happen when the foot twists and the full body weight is placed on the lateral ankle ligament. Although the result is normally a sprain or strain sometimes small pieces of bone tear off. Other mechanisms of injury can also result in this, but the twisting action can cause pieces of the cartilage lining to chip and the tendons around the ankle may also be damaged.

What to do if you sprain your ankle

Although the majority of sprains are minor and can be treated by resting, applying a bandage and ice, severe injuries may require a visit to hospital and further treatment.

Severely damaged ligaments can cause lasting instability. Physiotherapy or orthotics and a range of treatments can vastly improve this. However, a ligament reconstruction is possible in some cases.

Injuries – fractures

Fractures can sometimes be confused with a sprain as the symptoms are similar. The following may indicate a fracture:

  • Acute pain in the bones around the ankle
  • Inability to put any weight through the ankle
  • A cracking noise when the injury occurs
  • The ankle is deformed
  • Swelling gets worse over three to four days
  • The skin is broken over the ankle

Surgery

There are a range of treatments which include ankle arthroscopy, ankle replacement and ankle fusion.

A simple fracture can be treated with a plaster cast which is typically left on for between six and eight weeks. After four weeks of non-weight bearing, the plaster may be replaced by a removable cast or a special boot which will allow for some weight to be put through the joint.

Severe fractures often require surgery to realign and fix the bone. It is usual for a general anaesthetic to be used but in some cases a nerve block or epidural is an option. Plates and screws or wires are used in a procedure known as open reduction and internal fixation (ORIF). The metalwork is rarely removed unless it causes problems.

Recovery

After an operation, physiotherapy/orthotics is generally encouraged. It takes around 12 weeks to recover and longer to regain full movement of the lower leg and foot, but this depends on the severity of the fracture.

 

This page is intended for information purposes only and should not replace advice that your relevant health professional would give you.

 

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