A three-ankle fracture is considered a very common injury. Excessive force on the integrity of the bone apparatus of the lower limb is the only cause of the pathology. The consequences of the fracture in the predominant number of cases do not go unnoticed, pursuing the victim for the rest of his life.
Who is at risk for an ankle fracture?
The “peak” of statistics on the greatest number of injuries falls, as a rule, in the winter season. The risk group includes not only the elderly, but also lovers of outdoor activities, climbing, ice skating. The recovery process most often drags on for several months.
Damage to the ankle is often accompanied by displacement of bone fragments, subluxation and tearing of ligaments. Self-medication for a fracture is not the most suitable way, it is unlikely to be able to quickly get on its feet literally, and therefore, having been injured, it is necessary to seek professional medical help as soon as possible.
Fracture in the ankle: types of three-ankle lesions
If the ankle bone is damaged, there are several types of fractures. When a limb is exerted by force from top to bottom and the ankle is squeezed inward, a supination-adduction fracture occurs. The pronational abduction type of injury occurs when the ankle bones are excessively violently turned outward. In the case of a deep thorough inversion of the foot, a logical result will be a rotational fracture at the joint level. Damages affecting the integrity of the tibia are isolated flexion and extensor injuries, for which a triangular bone fragment is a characteristic feature.
In severe cases, combined fractures occur, which are a number of signs of previous types of damage. These include the three-ankle type of fracture - the most dangerous, since it concerns both ankles and the tibia. Rupture of the ligamentous apparatus, rupture of blood vessels and damage to nerve endings are considered its characteristic features.
Damage factors: why do the ankles break?
A three-ankle fracture with displacement and subluxation is a complicated form of limb damage that affects the choice of treatment and the duration of rehabilitation.
The reasons for the violation of the integrity of the ankle bones in most cases are:
- twisting the joint;
- tucking the foot;
- excessive load on the joint in the ankle;
- intensive extension and flexion of the joint.
Another very common cause of a three-ankle fracture is not so much their forceful effect on bone tissue, but rather fragility due to the reduced content of calcium and beneficial microelements. Deficiency of valuable substances that provide strength to the human bone is the result of malnutrition, abuse of coffee and alcohol. Rarely enough to cause an ankle fracture is able to rot the joint, provoked by osteomyelitis. The disease occurs, as a rule, in childhood, and inevitably leads to disability of the patient.
The main symptoms of limb injury
In order to provide competent medical care for ankle localization injury, it is first of all important to learn how to determine a fracture. There is no time for reflection, but it is urgent to act, therefore, the one who was at the time of the injury with the victim has to diagnose the nature of the damage.
Recognizing a three-ankle fracture is not their lungs, but everyone can cope with it. The first signs of such a serious limb injury are:
- sharp pain that does not recede for a moment;
- when you try to step with your foot, the pain syndrome intensifies;
- the rapid development of puffiness;
- the appearance of bruising;
- blue limb in the entire ankle.
Other signs of ankle damage in three places
Internal hematomas occur after some time, spreading throughout the foot, toes. Other symptoms indicating the presence of a three-ankle lesion include the following:
- skin tightness over fragments of broken bones;
- change in the correct shape of the ankle joint ;
- pronounced deformation of the foot;
- severe limitation of movement in the fingers.
If the above symptoms coincide with the patient’s sensations, it is urgent to provide him with complete rest and immobilization of the affected ankle joint.
The faster the patient will be delivered to the emergency room, the higher his chances of a detailed diagnosis and the appointment of appropriate treatment.
Displacement and subluxation: complication of a fracture
If a three-ankle fracture with an offset is visually difficult to recognize even for a traumatologist, a specialist may suspect subluxation long before the results of an MRI scan. By the way, this diagnostic procedure is mandatory for such a complex ankle fracture. For this type of injury, a significant rupture of the deltoid ligaments of the ankle joint is characteristic.
A subluxation fracture is much easier than most readers think. The most common “scenario” of injury is a fall on ice, during which:
- the foot is tucked out;
- tension of the deltoid ligament occurs, followed by its break;
- due to high pressure, the lateral ankle breaks;
- excessive mobility of the talus leads to an increase in the force of action on the tibia and fibula.
How is the ankle treated, how long does the rehabilitation take?
Three-ankle fracture with subluxation is one of the most “popular” causes of surgical intervention in the internal tissues of the lower limb. With the displacement of bone fragments and the impossibility of their manual reduction, the patient is also prescribed an operation. A three-ankle fracture can be cured in only one way - bringing the ankle into the anatomically correct form. For this, for more than 2 months, patients are prescribed wearing plaster bandages. The doctor fixes the damaged leg, leaving it motionless - a prerequisite for ensuring bone fusion. After 4-5 days, special stirrups are applied to the patient, allowing them to move. During the first 2-3 months, the patient’s working capacity is gradually restored and soon the patient will be able to return to his usual lifestyle.
In order for rehabilitation after a three-ankle fracture to be successful in a short period of time, doctors reposition the broken parts of the bone, make up all the fragments together and tightly fix them. The procedure can take place both with closed and open fractures.
Intervention of surgeons in the treatment process
It is impossible to deal with the repair of the damaged area of the limb on its own, as unprofessional actions can only lead to a worsening of the situation. The procedure is performed with local anesthesia, and upon its completion, final x-rays are taken and the broken leg is fixed in a plaster cast.
In the case when it is not possible to straighten the bone into place, an operation is performed. In order to prevent improper splicing of the ankle and tibia (fibula) bones, it is impossible to delay the performance of surgical intervention, therefore, the operation is most often done 3-4 days after the damage. To effectively fix the back and front ankles, surgeons use various tools (knitting needles, screws, nails, etc.). At the end of the procedure, a drainage is introduced into the patient's leg and gypsum is applied.
Recovery and rehabilitation after ankle fracture
Treatment of a three-ankle fracture, in fact, is a prolonged immobilization of the limb, accompanied by the use of appropriate drugs. A doctor should choose drugs for the speedy healing of damaged bones, restoration of sinewy and soft tissues. After surgery, the patient is also prescribed a course of antibacterial agents to prevent the inflammatory process. As a rehabilitation for a three-ankle fracture, the patient is prescribed physiotherapy, massages and special exercise complexes that help restore limbs to their previous mobility and relieve the haunting pain syndrome.
A few words should also be given to the consequences of an ankle fracture awaiting an injured person. The risk of developing deforming arthrosis remains quite high even with qualified treatment and persistent rehabilitation. In some cases, patients could not fully recover, which led to a final disability.