Our bodies are strong, but delicate. Once a part of our body is injured it has the potential to affect the rest of the body. The ankle is an essential part of everyday movement, and it helps support the weight of our entire body.
The ankle is the joint that connects the bones in the lower leg to the foot bones. There are three separate bones that make up our ankle:
- the tibia: the main wide bone on the inside of the lower leg.
- the fibula: a second, thinner bone on the outer side of the lower leg.
- the talus: the foot bone that makes up the bottom part of the ankle joint.
Ankle injuries are a common type of sports injury. You don't necessarily have to be an athlete to get a serious ankle injury. You can get a debilitating sprain or fracture by simply walking on uneven pavement. Ankle injuries can happen to anyone at any age!
The most common ankle injuries are sprains and fractures, which involve the ligaments and bones in the ankle. You can also tear or strain a tendon. A strain refers to damage to muscles and tendons as a result of being pulled or stretched too far.
Diagnosing Ankle Pain
As there are many structures in and around our ankles, getting a proper diagnosis and treatment plan is important. At your first visit at our office, you can expect a thorough physical exam and x-rays taken in our office.
Depending on the situation, a CT scan or MRI might be necessary.
Possible causes of ankle pain may include:
- Ankle fracture
- Ankle sprain
- Achilles tendonitis or rupture
- Peroneal tendonitis or rupture
- Posterior tibial tendonitis or rupture
- Tarsal tunnel syndrome
- Osteochondral defect
- Avulsion fracture
- And many other possibilities
Chronic or Acute Ankle Sprain
The three bones that comprise the ankle joint (the tibia, fibula and the talus) are held together by ligaments, which are strong elastic bands of connective tissue that keep the bones in place while allowing normal ankle motion. A sprain is a term that describes damage to ligaments when they are stretched beyond their normal range of motion. Each subsequent sprain will lead to further weakening of your ligaments. Certain foot types can also be more prone to getting ankle sprains or repetitive micro-trauma. If this occurs, your ankle may become unstable and at greater risk of additional ankle problems.
Ankle ligament reconstruction or internal ligament bracing may be considered. It is a surgery that will tighten and firm or replace one or more ankle ligaments. This surgical procedure is frequently done as an outpatient surgery, so you are able to go home the same day. Depending on the degree of injury, there are possible minimally invasive surgical techniques to repair and tighten the ligaments.
A fracture describes a break in one or more of the bones. It could be a partial or a complete break. Fractures in the ankle can range from the less serious avulsion injuries to severe shattering-type breaks of the tibia, fibula or both. Ankle fractures are most often caused by the ankle rolling inward or outward. Do not mistake an ankle fracture for an ankle sprain; an accurate and early diagnosis is very important. X-rays would be an excellent recommendation in order to determine the full scope of the injury.
In cases when an ankle bone is broken and displaced (moved out of alignment), a surgical procedure called Open Reduction and Internal Fixation is performed to put the bone back into place. This is accomplished by using screws, plates, sutures, or rods to hold the broken bone fragments together and allow the bones to heal jointly.
Achilles Tendon Rupture
An Achilles tendon rupture is often described by patients as a painful popping sensation in the back of the calf. It can be a complete or partial tear that occurs when the tendon is stretched beyond its capacity. Possible causes may be from vigorous jumping or pivoting, or sudden acceleration while running.
The Achilles is the largest tendon in your body. It runs down the back of the lower leg and connects the calf muscle to the heel bone. Also called the heel cord, the Achilles tendon facilitates walking by helping to raise the heel off the ground.
Various surgical techniques are available to repair Achilles tendon ruptures. The surgeon will select the procedure best suited to the patient and degree of rupture. For some ruptures, our surgeons have to make a large enough incision to repair the tendon. Sometimes, other tendons or grafts are needed for more severe ruptures.
Another technique called the Percutaneous Achilles Repair System (PARS) involves repairing the damaged tendon without disrupting the blood supply to the tendon, while minimizing scar-tissue. It is a minimally invasive surgical procedure.
During the PARS, a 2 cm horizontal incision located about 4-6 cm above the heel is made in order to insert the PARS device. This device has four prongs: two that go inside the leg to hold the tendon in place, and two that go outside the leg. All four prongs have 8 small holes that allow the surgeon to place a suture throughout the tendon, including healthy non-injured tendon. When the Achilles tendon is injured, it does not usually tear evenly. It shreds so that the ends appear to resemble a mop head, which is why it is imperative to suture the entire tendon to get a stronger repair.
Once the top of the tendon is secure the surgeon will pull the threads tight and secure the two ends of the tendon together. Held in this position, the Achilles tendon will mend and heal properly.
Post Surgery – Stay Positive
Having damage to our body that restricts our activities can have a significant effect on our emotional well being. Maintaining a positive outlook is a major component of your recovery period! Be sure to follow your doctor’s orders and instructions for a successful healing process. It is important that you maintain as normal life as your injury allows. There are a number of devices to help you stay mobile while you are recovering from whichever type of ankle surgery you have received. Our surgeons also work closely with physical therapists throughout the recovery period.
Reach out to our surgeons for help with your ankle fracture
Reach out to our surgeons for help with your ankle and foot injury