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.
  

Metatarsal fracture

A fracture is called a metatarsal fracture when one of the long thin bones of the foot is fractured. It is also known as broken foot, and can be classified as Jones fracture, stress fracture of the foot, Lisfranc fracture dislocation, marcher's fracture, tennis fracture and dancer's fracture. Human foot has five metatarsal bones. Depending on the extent of injury and displacement, metatarsal fractures can be classified as minor or severe injuries. When this fracture occurs in an area of the foot where there is poor blood flow, the healing is more difficult. Jones Fracture is of this type and requires surgery to position the bones.

Twisting and dropping a heavy object on the foot are the two major causes for most of the metatarsal fractures. Direct impact of the falling object will result in a metatarsal fracture. Since the symptoms of this type of fracture may be similar to an ankle sprain, a metatarsal fracture may be missed at times. Though X-rays will help to confirm the fracture, a CT scan or MRI is needed only when there are other injuries.

Keeping the injured foot at an elevated position will help to reduce the pain. One can use crutches to avoid pressure on the foot. Stiff soled shoe or a walking cast can be used as part of the treatment. A non-weight bearing cast for several weeks is prescribed for more severe fractures.If a metatarsal fracture has occurred in an area of the foot that has poor blood supply or if the bones are very much out of place, surgery is recommended. Maintaining good balance, good coordination and strength of the foot are some tips one should remember to avoid metatarsal fractures.

Avulsion fracture

A fracture is called an avulsion fracture when the injury occurs in a place where a tendon or ligament that attaches to the bone pulls off a piece of the bone. It is common to notice avulsion fractures occur around the pelvis area, though they can occur anywhere in the body. More than adults, children are more prone to avulsion fracture, because a child's bone may give away before the ligament or tendon is injured whereas in adults, ligaments get injured more. Children have an area of bone that grows faster. This area in the skeleton is known as a growth plate. When an injury occurs in children near a growth plate, the tendons or ligaments can pull very hard and it will lead to a fracture of the growth plate. Growth plates are necessary for normal skeletal development of a child and so, avulsion fractures must be treated with utmost care. Surgery is the only option, to align the growth plate and stabilize it. If there is no danger of lasting growth problems and if the avulsion fracture is well aligned, then surgery is not necessary.

Normally, avulsion fractures can be treated without surgery since it is treated as a soft-tissue injury. An avulsion fracture of the hamstring attachment on the pelvis can be treated in the same way as a hamstring tear. Surgery is considered only when the bone is pulled too far from its original position. Some ankle sprains where the damaged ankle ligaments pull off a tiny piece of a bone from the joint are treated like an ankle sprain. Avulsion fractures in children are more complicated.

Avulsion fracture of the pelvis

Teenagers and sports persons are susceptible to a type of pelvic fracture. Often some of the pulled muscles may end in an avulsion fracture not detected earlier. The muscle in the pelvic area tears away a small piece of bone from the top of the hip bone and there may be sudden muscle contractions. The entire pelvic ring is not involved and there is no injury to the internal organs. Avulsion fractures experienced by athletes are stable fractures and will heal without surgery. Elderly persons with osteoporosis are also at a risk for pelvic fracture. It can occur during a fall or when descending stairs. Normally the pelvic ring is not damaged but any of the individual bones of this ring may be fractured. Mostly these pelvic fractures involve high-energy forces. Motor vehicle accident, crush accident and fall are the major causes for this type of fracture. Pelvic fractures can be life-threatening depending on the amount of force involved.

Acute pain, swelling and bruises are symptoms of pelvic injuries. To avoid aggravating the pain, a patient may walk with a bent knee. There may be injuries to other parts of the body like head, legs or the chest, if the injury is due to trauma. Heavy bleeding can lead to shock should be arrested immediately. The doctor will request for X-rays from different angles to find out the exact degree of displacement to the bones. A CT scan will reveal the extent of other injuries. It is routine to examine the blood vessels and nerves to the legs for any damage due to the injuries.