What is a Closed Fracture of Ankle & How is it Treated?|Causes, Symptoms, Diagnosis of Closed Fracture of Ankle

What is a Closed Fracture of Ankle?

A broken bone is medically termed as a Fracture. A fracture can occur in any bone of the body but are generally caused due to trauma or accidents. Fractures generally are of two types, open and closed. A closed fracture occurs when the bones just break and the fragments of the bone do not penetrate through the skin surface such that it protrudes through the skin surface and become exposed to environmental pollutants.

A Closed Fracture of Ankle can occur when there is complete or partial break in the bones of the ankle. The major bones present in the ankle are the distal ends of the tibia and fibula. In a Closed Fracture of Ankle either of these two bones, and in some cases both, can break but does not protrude through the skin surface.

Closed Fracture of Ankles can vary from as mild as an avulsion injury in which tiny fragments of bones pull away to severe fractures where there is complete break of the bone. In some cases a Closed Fracture of Ankle can also cause injuries to the surrounding structures like the ligaments and other soft tissues. Closed Fracture of Ankle is mainly caused by a twisting type of an injury or an accident in which an individual is run over by a vehicle on the ankle causing the ankle to twist awkwardly resulting in a Closed Fracture of Ankle.

What is a Closed Fracture of Ankle & How is it Treated?

What are the Causes of Closed Fracture of Ankle?

Twisting injuries are the primary cause for a Closed Fracture of Ankle. This can happen either due to a severe slip and fall from a height landing directly on to the ankle and twisting it forcefully or an accident where the ankle gets twisted after coming under the wheels of a moving vehicle. Closed Fracture of Ankle can also be caused due to sporting injuries like basketball and football where the ankle can get twisted causing the bone to break. Ballet dancers can also twist their ankle while dancing resulting in a Closed Fracture of Ankle.

What are the Symptoms of Closed Fracture of Ankle?

Some of the symptoms of Closed Fracture of Ankle are:

  • Immediate swelling and severe pain in the ankle area immediately after the injury.
  • Presence of an obvious deformity can also be seen with Closed Fracture of Ankle.
  • An individual with Closed Fracture of Ankle will not be able to stand up or ambulate to any degree.
  • An individual with Closed Fracture of Ankle will have reduced range of motion of the ankle and will experience severe intense pain with any motion of the ankle.
  • There might also be discoloration at the injury site.

How is Closed Fracture of Ankle Diagnosed?

To diagnose Closed Fracture of Ankle, the treating physician will first examine the injured area looking for any signs of tenderness, discoloration, and swelling. The physician will then try to move the patient’s ankle to see if there is a reduction in range of motion and if the patient feels any pain with it. Once a fracture is suspected, the physician will order radiological studies to pinpoint the location of the fracture and the extent of the fracture so as to formulate a treatment plan.

The radiological studies done for diagnosing Closed Fracture of Ankle are x-ray, MRI, and CT scans. These radiological studies give a comprehensive view of the inner structures of the ankle and the surrounding areas which gives the physician a fair idea as to the type of fracture and whether any adjoining structures have been affected by it as well. In cases where a fracture is so minute that it is not clearly seen on these images, then a bone scan may be done to have a better insight as to the location of the Fracture. These are usually done for very minor avulsion type injuries where the chances of a major fracture are quite minimal.

How is Closed Fracture of Ankle Treated?

Closed Fracture of Ankle can be treated both conservatively as well as surgically depending upon the degree of the fracture and the extent of the injury. Conservative approaches are used for those fractures which are mild and in which the bones have not displaced from their normal anatomical position. Surgery is done for type of fractures in which there is significant displacement of the bones from their normal position.

Conservative Treatment of Closed Fracture of Ankle: The patient needs to follow the RICE protocol which is to completely rest the affected ankle and not put any weight on it. The patient can ice the area for 15-20 minutes two to three times a day to calm down the swelling. The patient also needs to keep the leg elevated to keep the swelling down. Once the swelling has subsided then the patient will be put in a splint or cast depending on the severity of the fracture for immobilization for a period of about six to weight weeks to allow the fracture to heal.

During the healing phase of Closed Fracture of Ankle, the patient is not allowed to put any weight on the ankle and is kept as nonweightbearing. The patient is given crutches to move around to carry out basic activities. Once the fracture is shown to have healed on radiological studies then the patient will be sent to physical therapy to work on strengthening the ankle and work on range of motion. The patient will then be slowly asked to bear weight on the injured ankle for a few days and once he is able to do it without pain or discomfort then the patient is allowed to gradually return back to normal activities.

Surgical Treatment of Closed Fracture of Ankle: In cases where the bones of ankle gets displaced from their alignment then surgery may be required to align them in their normal position. This is usually done in cases where the Fracture is severe. This is done by using metal screws and rods to align the bones and hold them in their normal places and allowing the bones to heal. This procedure is called internal fixation if the rods and screws are inserted within the body and external fixation if it is done outside the body.

Postsurgery, the patient will be nonweightbearing for a period of about four weeks. Once the fracture is confirmed healed on x-rays then the plates and screws are removed and the patient is sent to physical therapy for strengthening and range of motion exercises. Once the patient is through with rehab, then he or she will be asked to put some weight on the affected extremity and once the patient is able to do so pain free then gradually the patient will be sent back to normal activities after post a Closed Fracture of Ankle.

What is the Recovery Period For Closed Fracture of Ankle?

The recovery period for Closed Fracture of Ankle varies from individual to individual and depends on the age and overall health and the extent of the injury. For cases where the fracture was mild and nondisplaced the patient can get back to normal activities within six to eight weeks postinjury but in cases where the degree of fracture was significant and required surgery to correct it then it takes almost four to six months before an individual can get back to full activities after sustaining a Closed Fracture of Ankle.

The recovery rate can be expedited if the patient diligently adheres to what the physician has recommenced in terms of activity, rest, weightbearing status, and participating in exercises. It is very vital for the patient to not stress the fractured site too soon after recovery for fear of refracturing it again and undergoing the same process of treatment.

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Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:October 17, 2018

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