Ankle fractures in Tunisia
Definition of ankle fractures
A broken ankle is also known as an ankle "fracture." This means that one or more of the bones that make up the ankle joint are broken. A fractured ankle can range from a simple break in one bone, which may not prevent you from walking, to multiple fractures, which forces your ankle out of place and may require you not to put weight on it for several months. In other words, the more bones that are broken, the more unstable the ankle becomes. There may also be damaged ligaments. The ankle ligaments hold the ankle bones and joint in position. Broken ankles affect people of all ages. Over the past 30 to 40 years, doctors have noted an increase in the number and severity of broken ankles, partly due to an active, older "baby-boomer" population.
Ankle anatomy
Three bones make up the ankle joint:
Tibia - shinbone
Fibula - smaller bone of the lower leg
Talus - a small bone that sits between the heel bone (calcaneus) and the tibia and fibula
The tibia and fibula have specific parts that make up the ankle:
Medial malleolus - inside part of the tibia
Posterior malleolus - back part of the tibia
Lateral malleolus - end of the fibula
Doctors classify ankle fractures according to the area of bone that is broken. For example, a fracture at the end of the fibula is called a lateral malleolus fracture, or if both the tibia and fibula are broken, it is called a bimalleolar fracture. Two joints are involved in ankle fractures:
Ankle joint - where the tibia, fibula, and talus meet
Syndesmosis joint - the joint between the tibia and fibula, which is held together by ligaments
Multiple ligaments help stabilize the ankle joint.
Orthopedic treatment of ankle fractures in Tunisia
You may not need surgery if your ankle is stable, meaning the broken bone is not displaced or only slightly displaced. A stress X-ray may be done to see if the ankle is stable. The type of treatment required may also be based on where the bone is broken. Several different methods are used to protect the fracture while it heals, ranging from a high-top tennis shoe to a short leg cast. Some doctors let patients put weight on their leg right away, while others have them wait 6 weeks. You will see your doctor regularly to repeat your ankle X-rays to make sure the fragments of your fracture have not moved during the healing process.
Surgical treatment of ankle fractures in Tunisia
If the fracture is out of place or your ankle is unstable, your fracture may be treated with surgery. During this type of procedure, the bone fragments are first repositioned (reduced) into their normal alignment. They are held together with special screws and metal plates attached to the outer surface of the bone. In some cases, a screw or rod inside the bone may be used to keep the bone fragments together while they heal.
Syndesmotic injury treatment
The syndesmosis joint is located between the tibia and fibula and is held together by ligaments. A syndesmotic injury may only involve the ligament - this is also known as a high ankle sprain. Depending on the ankle's instability, these injuries can be treated without surgery. However, these sprains take longer to heal than the normal ankle sprain. In many cases, a syndesmotic injury includes both a ligament sprain and one or more fractures. These are unstable injuries and they do very poorly without surgical treatment. Your doctor may do a stress test X-ray to see if the syndesmosis is injured.
Recovery after ankle fracture
Because there is a wide range of injuries, there is also a wide range of ways people heal after their injury. It takes at least 6 weeks for the broken bones to heal. Healing of the involved ligaments and tendons may take longer. As mentioned above, your doctor will most likely monitor the bone healing with repeated X-rays. This is usually done more often during the first 6 weeks if surgery is not chosen.
Pain management after ankle fracture
Pain after an injury or surgery is a natural part of the healing process. Your doctor and nurses will work to reduce your pain, which can help you recover faster.
Medications are often prescribed for short-term pain relief after surgery or an injury. Many types of medicines are available to help manage pain, including opioids, non-steroidal anti-inflammatory drugs (NSAIDs), and local anesthetics. Your doctor may use a combination of these medications to improve pain relief and minimize the need for opioids.
Be aware that although opioids help relieve pain after surgery or an injury, they are a narcotic and can be addictive. It is important to use opioids only as directed by your doctor. As soon as your pain begins to improve, stop taking opioids. Talk to your doctor if your pain has not started to improve within a few days of your treatment.
Rehabilitation after ankle fractures
Rehabilitation is very important regardless of how an ankle fracture is treated. When your physician allows you to start moving your ankle, physical therapy programs and home exercise programs are very important. Doing your exercises regularly is essential. Eventually, you will also start doing strengthening exercises. It may take several months for the muscles around your ankle to get strong enough for you to walk without a limp and to return to your regular activities.