The ankle joint is a durable, workhorse joint that accommodates a wide variety of vigorous activities such as running, jumping and contact sports. When the ankle becomes injured, especially when fractured, or broken, treatment options are varied and often are dependent upon the type, location and severity of the fracture and its relationship and proximity to the joint surfaces.
Restricted Weight Bearing
In instances where a fracture is considered nonsurgical, minor and nondisplaced, treatment can be as minimal as restricting weight bearing by the use of crutches or a walker. Limiting weight bearing on a broken ankle allows the fracture(s) to heal without the aggravation of repeated forces being exerted on the fracture site(s) by repeated weight bearing. As the fracture heals, a gradual increase in the amount of weight placed upon the ankle can be closely monitored and controlled with devices such as crutches and walkers.
Bracing
Another form of treatment for an ankle fracture can come in the form of bracing. Bracing has some distinct advantages over casting in that these supportive devices can be removed, if applicable, for bathing and general hygiene as well as skin care and observation for signs of pressure. Braces can be static, or immovable, thus keeping the desired body part motionless for healing and alignment purposes. Some braces have adjustable levels of motion and functionality which can be changed as healing progresses. Braces can be rigid, such as padded hard plastic as in cases of fracture braces which require maximum rigidity and support, or fabricated in combination with other materials such as canvas, foam or leather for support, but with improved comfort. Some braces can be made of nylon or neoprene rubber for an easy slide-on application. This type of brace is typically for use as a maintenance support well down the road of healing and where increased function and motion is desired. One example of this brace type would include a neoprene slide-on knee support or knitted slide-on ankle sleeve. One of the most popular forms of ankle immobilization for fracture is the cast boot. This device fits and operates similar to a short leg case, but with the added benefit of removability and, in some brands, selective ankle positioning adjustments.
Casting
If an ankle fracture is of a type and severity that requires circumferential support and immobilization for an extended period of time, the application of a cylindrical cast may be the best treatment option for that scenario. Many times after ankle surgery, immobilization of the ankle is desired to prevent accidental loss of position and alignment of the fracture from unintended movement. The application of a cast eliminates the risk of unwanted motion from loose-fitting braces whose material may stretch out after time, or may become loosened with swelling reduction. Some casts can be worn for walking and others can be applied with weight bearing forbidden, depending upon conditions such as type and severity of injury. Casts are typically made from plaster or fiberglass.
Surgery
In cases where there is significant damage to the bones of the ankle, the congruity of the joint surfaces has been grossly altered, or there is significant displacement of the fracture components, thus rendering normal healing impossible, surgical intervention may be warranted. Various surgical procedures exist which involve repositioning displaced fracture fragments, restoring joint surface anatomy and congruity, and stabilizing the fracture in general, all of which promote healing and return to normal function. Procedures can involve the use of a wide variety of fixation devices, from small pins, to plates and screws. These devices secure the fractured bone(s) in proper position and hold them during healing.
