Ankle pain, injury and surgery

The ankle is a joint which consists of three bones, two of which are in the leg, the tibia and fibula, and the third is a foot bone, the talus. The bones create a complex joint which goes beyond a simple hinge as it facilitates a range of movements. Ligaments hold the bones in place. 

What causes ankle pain?

Arthritis in the ankle is relatively common and can cause severe pain. There are five main types which are ankle arthritis, rheumatoid arthritis, psoriatic arthritis, gout and septic arthritis. 

There are several sorts of injuries which can cause ankle pain, but the most common are sprains and breaks. There are a number of procedures and treatments that can improve ankle pain which include ankle arthroscopy, ankle instability, ankle replacement and ankle fusion.

Types of ankle injury

Sprain – This is the most common ankle injury and can have a number of different causes. Ligaments can be damaged when the foot twists inwards. Small pieces of bone can tear off and the cartilage lining can chip. It is also possible to damage the tendon around the ankle. 

What to do – Most importantly, you must rest and not bear weight for around one to two days. As soon as the injury occurs, apply ice and a bandage as this will help to reduce the swelling. It is normal for the bruising to become more pronounced. However, if there is little improvement in pain levels or swelling, or if it gets worse then seek medical advice. 

Long term stability can be affected by badly damaged ligaments. Physiotherapy can help and it may be necessary to look into the possibility of a ligament reconstruction in the most severe cases.

Fractures – Initially it is easy to confuse a fracture with a sprain so it is important to look out for some important signs which may point to a break: 

Acute pain in the area around the injury, particularly in the bones
Deformity of the ankle
Skin which is broken over the injury
Cracking when the injury occurs
Swelling which gets worse three to four days after the injury occurs

Common treatment – A plaster cast is used to treat straight forward fractures. A normal cast is used for the first four weeks and it is sometimes replaced with a removable version or special boot.  At this point weight can be put through the injured ankle. In total it is usual to be in plaster for between six to eight weeks. 

A surgical procedure known as an open reduction and internal fixation is sometimes necessary. Plates, wires or screws are used to realign and fix the bone. These are rarely removed. 

Recovery – Rehabilitation differs depending on the injury but it normally takes around 12 weeks to recover from a fractured ankle. It is important to follow medical advice of when to rest and exercise when recovering. 


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