Ankle Injury

Injuries of the ankle while indulging in sports or some other activity can be termed as ankle injury. The most common ankle injury is an ankle sprain and occurs due to an injury i.e. either a tear, twist or overstretch of the ligaments. The most often sprained joint is the ankle joint. A stretch of the ligament causes a minor sprain and a severe sprain is a result of tearing of the ligament itself. Common causes for an ankle sprain:

• Ankle sprain occurs when the foot or heel twists inwards when compared to the lower leg thereby causing a stretch for the ligaments outside the ankle. This is termed as inversion sprain. If the foot or heel twists outwards, which is uncommon that condition is referred to as eversion sprain.
  
• People who have weak muscles in the lower leg
  
• People who have loose ligament in the ankle
  
• People who have sprained their ankle earlier and did not let it heal completely have chances of spraining the same ankle yet again.
  
• Sprains are common while climbing the stairs or while walking on uneven surfaces.
  
• People who wear high heeled shoes or slippers have more chances to sprain if they slip off their footwear while walking.
  
• While running, jumping, during a game of football or tennis, ankle injuries are common.

Symptoms of ankle sprain include severe pain at the site of the injury and inflammation and possible bruising. There is trouble in moving the joint. Other than cases of severe ankle sprains where professional help is required, an ankle sprain can be treated by self care. The most common method followed for ankle sprain is RICE:

• R: Rest. Rest the injury by limiting moving around and keeping weight off the affected place at least for 24-48 hours from when the injury has occurred.
  
• I: Ice. Place ice in a bag and apply on the affected area, this will bring down the inflammation, pain and bruising of the area. Apply ice once in two hours for twenty minutes.
  
• C: Compression. Compress the joint by applying a bandage; take care to apply the bandage firmly and not tightly.
  
• E: Elevation. Put up the injured leg right above the level of the heart, this brings a lot of relief, particularly during the nights.

Medications prescribed by the doctor would include non-steroidal anti-inflammatory drugs such as ibuprofen. The physician will ask for a x-ray and according to the extent of the injury advice for physical therapy and recommend support for the ankle through taping or bracing of the ankle. Very severe damage to the ligament might call for a surgery to repair the same.

Prevention from ankle injury

• Wear right fitting shoes or slippers.
  
• Warm up before getting into vigorous sports activities.
  
• Eat a healthy diet to keep your muscles and bones strong.
  
• Maintain a healthy weight and balance your weight appropriately while you walk, run or jump.
  
• Watch out while you walk on uneven surfaces and slippery surfaces.
  
• Wear the right shoes and use the right sports equipment while you practice a sport.
  

Talus fracture

The talus is a turtle-shaped small bone that sits between the heel bone calcaneus and the two bones of the lower leg, the tibia and fibula. Over half of the talus is covered with cartilage. The talus is an important connector between the foot and the leg and the body. It helps to transfer weight and pressure across the ankle joint. Therefore any injury to the talus affects the ankle and the subtalar joints and multiple planes of movement of the foot and ankle are also affected. It is interesting to note that the first series of talus fractures was described in men injured in the British Royal Air Force in early 1900, when the old war planes made crash landings. The term aviators astragalus was used to describe what we now call talus fracture. Typically causes for talus fracture include fall from heights, motor vehicle collisions and injuries of the lower back.

Persons suffering from talus fracture experience acute pain and considerable swelling and tenderness in the affected area. There is inability to bear weight. Often this type of fracture is mistaken for ankle sprain. A physician relies on x rays of the foot and the ankle to ascertain the nature and kind of talus injury. In some cases, if x ray does not reveal the nature of the fracture, a CT scan is requested. Fractures in the talus can occur:

• Through the neck of the talus
  
• Through the dome of the talus
  
• Aviators fracture which occur through the neck of the talus with dislocation of the body of the talus out of the ankle joint.

Fractures of the talus are rare but when they occur they are highly complicated. Since talus has no muscle attachment and peculiar blood supply, high morbidity in the form of non-union and mal union can occur. Avascular necrosis, which means partial death of the bone, leading to a painful arthrosis condition is another common complication.

Immediate first aid has to be rendered to patients from talus fractures. A well-padded splint around the back of the foot and leg from the toe to the upper calf is placed. Foot must be elevated to the level of the heart to prevent further edema. Ice packs can be applied every twenty minutes till the physician arrives. Care should be taken not to put weight on the injured foot. Untreated talus fractures can create problems later. The foot may get impaired and the patient is at risk of developing arthritis and chronic pain. The bone may even collapse in certain cases.

Often talus fractures require surgery to minimize the complications from arising later. The surgeon realigns the bones surgically and uses metal screws to hold the pieces in place. Small fragments of bone can be removed by bone grafts which are used to restore the structural integrity of the joint.

Even after a good correction surgery, there is always the danger of deformity, arthritis and other conditions like lack of blood supply to the talus bones. The ability of the ankle to move can be affected if ankle arthritis occurs. Subtalar arthritis that is arthritis in the subtalar joint beneath the talus bone is another complication. Deformity of the foot is another problem of talus fracture. When the fracture is fixed, it becomes difficult to reposition the bone correctly and deformity may occur.