Compound Ankle Fracture: Causes, Symptoms, Treatment, and Recovery

A compound or an open fracture is a type of fracture in which the broken bone fragments protrude through the skin from the surface of the wound and gets exposed to the atmosphere and can be seen visibly. Such fractures occur mainly due to extremely high impact forceful motor vehicle collisions, severe assault, or severe injuries caused due to a gunshot or other sharp object. An example where a Compound Fracture can occur is when a pedestrian is hit by a moving car and the tire of the car moves over the pedestrian’s ankle. In such cases, the individual is likely to suffer a Compound Ankle Fracture where the bones fragments of the ankle may stick out of the surface of the skin through the wound.

A Compound Ankle Fracture is definitely a serious injury with the bone sticking out and exposed to the environment which makes it prone to infections which may complicate the injury further. Additionally, Compound Ankle Fracture may also result in injuries to other nerves or soft tissues in the adjoining areas. As Compound Ankle Fracture tends to damage surrounding tendons and ligaments, they have a higher risk for complications and take much more time to heal than closed fractures.

As stated, Compound Ankle Fracture occurs only because of some type of high energy collision such as an automobile running over the ankle. Falling from a good height on uneven surface on to the ankle may also result in Compound Ankle Fracture. A gunshot wound to the ankle region may also cause a Compound Ankle Fracture.

Elderly people may also suffer from Compound Ankle Fracture as their bones become brittle and weak with age and even a simple penetrating injury to the ankle may result in a Compound Ankle Fracture.

Another cause for a Compound Ankle Fracture is when an individual is assaulted and hit by a sharp object on the ankle region.

In a Compound Ankle Fracture, there will be a deep wound in the ankle through which bone fragments will be protruding out. The affected individual will be unable to move the ankle to any significant degree. There will be significant swelling and excruciating pain on the affected ankle. The ankle in Compound Ankle Fracture may also look deformed. There will be profuse bleeding from the wound due to Compound Ankle Fracture. The individual will also not be able to stand up or ambulate to any significant degree after sustaining Compound Ankle Fracture.

The diagnosis of a Compound Ankle Fracture is quite easy as there will be visible bone fragments jutting out through the skin when the individual presents to the emergency room. Radiological studies in the form of x-rays, MRI, and CT scans may be done to look at the extent of the fracture and also assess the damage that has been done to the surrounding structures.

Any type of Compound Fracture is best treated with surgery and same is the case with Compound Ankle Fracture. In fact the treatment for Compound Ankle Fracture begins as soon as the patient presents to the emergency room. The physician will first place the affected ankle in a splint so as to maintain alignment of the bones as much as possible. The patient will be given pain medications for pain relief. The next step towards treatment will be surgery to fix the fracture. The surgery performed to fix a Compound Ankle Fracture is called as External Fixation.

External Fixation for Compound Ankle Fracture: In this procedure, metal pins or screws are placed in the bone above and below the fracture site. These pins and screws are attached to a metal bar outside the skin to hold the pins and screws in place and keep the bones aligned so that they can heal. This is normally a temporary measure in cases of Compound Ankle Fracture and is done to align the bones while the patient recuperates and gets ready for the main surgery which is to permanently fix the fractures.

Plates and Screws: In this procedure, the bone fragments are first repositioned into their normal alignment and are held together with special screws and plates which are attached to the outer surface of the bone to fix the Compound Ankle Fracture.

Normally, for Compound Ankle Fracture, it takes roughly 6 to 8 months for an individual to recover and get back to normal activities. In some cases, it may even take longer depending on the severity of the injury and the complexity of the procedure to fix it. Postsurgery, the patient will be nonweightbearing on the affected leg for a period of at least six weeks to allow proper healing of the fracture.

The patient will then be sent to physical therapy for strengthening and range of motion exercises as prolonged immobilization will cause the ankle to become stiff. During physical therapy, the patient will be asked to put some weight on the affected leg to check for any chances of instability and once the patient is able to bear weight on the injured leg pain free then gradually the patient will be asked to weight bear with support of a crutch or cane.

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