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Dr. Belongie

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Ankle Sprain or Fracture?

Ankle pain

Ankle Sprain or Fracture?

You stepped off the curb and rolled over on your ankle or came down hard, twisting your ankle while running.   All of a sudden you now have pain over the outside of your ankle.  What do you do? The best advice is to sit down and get your weight off the injured ankle.  For some, swelling will develop rapidly.  If your pain resolves when you get your weight off the injured foot, then it is likely that you have sprained your ankle. Although it is possible to still have a fracture.   If the ankle continues to be painful, it is more likely that you have a fractured bone.  A severe sprain of the ankle may also continue to hurt even when you do not have pressure on it.

If your ankle does looked deformed, your pain level is high, and you suspect that you did more than just sprain your ankle, it is advised that you make an appointment right away with an orthopaedic surgeon to evaluate your injury.  In most cases, an x-ray will be performed to rule out a fractured ankle.  An ankle fracture also tends to be more painful with palpation directly over the bony prominence on the inside or outside of the ankle, rather than over the surrounding ligaments and soft tissues.  Another sign of fracture is a palpable movement or crepitance of the bony prominence with palpation.

If your symptoms are tolerable and are alleviated at rest, it is advised that you begin self-treatment using the R.I.C.E. method. This involves Rest, Ice to reduce inflammation and pain, Compression and Elevation to control swelling.  You should try and avoid putting weight on the injured ankle. Crutches or another assistive device may be helpful if you need to be up on your feet. If symptoms do not improve significantly or worsen during the next 7 to 10 days, it is advisable to you see a doctor.

Simple sprains result in a stretching of some of the fibers of the supportive ligaments.  Patients usually recover uneventfully from this type of injury using the R.I.C.E method described above.  More advanced sprains can cause a partial or complete tear of the ligaments that requires bracing, casting, or in some cases surgery to fix. Physical therapy is often indicated following a more advanced ankle sprain.  Normal recovery ranges from 4 to 6 weeks on average.

A fractured ankle is a break in one of more of the bones that forms the ankle joint. After x-ray confirmation of a fractured ankle, treatment may consistent of an immobilization boot, splint, cast or surgery. Treatment is dependent on the nature and severity of the injury. In some cases, you may need to avoid putting weight on the injured ankle for at least 6 weeks. Recovery can be prolonged with an unstable fracture in which one or more of the ligaments are torn in addition to a fracture.

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