A broken ankle or ankle fracture is most commonly caused by trauma like that suffered in an automobile accident or a fall. The experienced Miami, Florida ankle fracture lawyers at Hannon Legal Group have handled many personal injury cases involving all types of ankle fractures.
Ankle fractures can range in severity from a minor break in one bone to numerous distinct fractures which move the bones out of alignment.ANATOMY OF THE ANKLE JOINT
The ankle joint is made up of three bones:
- The Tibia
- The Fibula
- The Talus
The tibia and fibula run from the knee joint down to the ankle joint. The parts of the tibia and fibula that compose the ankle joint are:
- The Medial Malleolus
- The Posterior Malleolus
- The Lateral Malleolus
Ankle fractures can actually involve two distinct joints; the ankle joint and the syndesmosis (the joint between the tibia and fibula).COMMON ANKLE FRACTURES
The most common types of ankle fractures are:
- Single bone fractures: lateral malleolus fracture, medial malleolus fracture or posterior malleolus fracture.
- Bimalleolar fractures: When two of the three parts or “malleoli” which make up the ankle are broken, the injury is referred to as a “Bimalleolar” fracture. The most common Bimalleolar fracture involves the lateral malleolus and the medial malleolus and often results in an unstable ankle joint. where the ligaments on the inside (medial side) of the ankle have been damages and this ligamentous injury occurs together with a fracture of one of the malleoli.
- Trimalleolar fractures: When all three of the malleoli of the ankle are broken, the injury is referred to as a Trimalleolar fracture. Trimalleolar fractures are unstable and are often accompanied by a dislocation.
- Any of the above fractures can be “comminuted.” A Comminuted fracture is one where the bone has been broken into more than two separate pieces or fragments. This usually renders the ankle joint unstable.
Ankle fractures may be treated without surgery if the fracture is non-displaced and the ankle joint is otherwise stable. If the fracture is “displaced” (out of alignment) or the ankle joint is unstable, surgery will usually be recommended.
- Medial Malleolar Fractures rarely occur in isolation. They usually occur in combination with a posterior malleolar fracture, a fractured fibula and/or ligament damage. These fractures are sometimes treated without surgery. In those cases, a short leg cast or a brace is usually recommended to immobilize the joint. When surgery is recommended, the joint may be immobilized by using either “internal fixation” (often referred to as Open Reduction Internal Fixation or ORIF) or “external fixation” and sometimes a combination of the two techniques. These surgical techniques involve the placement of fixation devices. These medical devices can include screws, a plate, wiring, use of a rod inserted into the bone or some combination of the above. They are utilized to stabilize the fracture in good alignment to allow for proper healing and/or to prevent “non-union.”
- Lateral Malleolar Fractures are fractures of the fibula. If surgery is not necessary, the ankle may be immobilized by using something as simple as a high-top athletic shoe like those worn for basketball. More often a brace or a short leg cast is utilized. If the fracture is displaced or the ankle joint is not stable, surgical intervention will usually be necessary.
- Posterior Malleolar Fractures are fractures of the back portion of the tibia bone where it meets the ankle joint. Like medial malleolar fractures, these rarely occur in isolation. They often occur in combination with a fracture of the lateral malleolus because of shared ligament attachments. This fracture can be treated without surgery if the fracture is non-displaced and the joint is stable. If the fracture is displaced or comminuted or the joint is unstable, surgery is usually necessary. Surgery will usually involve either the placement of screws from the front of the ankle to the back or the placement of a plate with screws on the back side of the tibia.
- Post traumatic arthritis is a complication associated with many intra-articular fractures and with fractures of the posterior malleolus in particular. In the case of a displaced posterior malleolar fracture, the cartilage which covers this part of the “shin bone” is often damaged. The risk of post-traumatic osteoarthritis is increased if the damaged cartilage doesn’t heal properly.
- Bimalleolar Fractures render the ankle joint unstable and surgery is usually recommended. When surgical intervention is necessary, open reduction internal fixation (ORIF) as described earlier for lateral and medial malleolus fractures is usually performed. Sometimes a technique referred to as external fixation is utilized either alone or in combination with ORIF. External fixation involves the placement of screws into the bone and attachment of a device called an external fixator to the screws from outside the skin where it can be adjusted to insure proper alignment.
- Trimalleolar Fractures also render the ankle joint unstable and surgical intervention is almost always recommended as long as the patient’s health is good enough to tolerate the procedure without significant added risk. The same surgical techniques utilized to treat Bimalleolar ankle fractures and the individual fractures discussed above are utilized in the treatment of trimalleolar ankle fractures. If complications arise or the surgery fails, ankle fusion may be recommended.
- Ankle Fusion surgery may be necessary in patients who encounter complications such as arthritis or severe ankle misalignment also called “mal-union.” In this procedure, the ankle bones are fused using internal or external fixation to compress the bones so that the bones fuse. This usually helps to alleviate pain but also usually results in a decreased range of motion. The increased work load placed on other joints which can compensate somewhat for the diminished ability to move the ankle, may eventually lead to arthritis in these surrounding joints.
- Syndesmotic Injury, also called a “high ankle sprain” when coupled with a fracture usually renders the ankle joint unstable making surgical intervention necessary. The syndesmosis is the joint between the tibia and fibula which is held together by ligaments.
Rehabilitation through a regimen of physical therapy and/or home exercise plays a very important role in attaining a good recovery of your ankle injury. At some point, when your injury is more stable, your doctor will permit you to begin “weight bearing” or putting weight on your injured ankle.
It generally takes a minimum of six weeks for the fractures to heal. Ligaments and tendons that suffer damage usually require more time than that. Some of the more severe ankle injuries may result in a permanent impairment or disability, especially if complications like post traumatic osteoarthritis or “mal-union” arise.
Mal-union occurs when the bone fragments become displaced and heal in poor alignment. This often leads to post traumatic arthritis and sometimes additional surgery which can include an ankle fusion.
If you or someone you know has suffered an ankle fracture as a result of someone else’s negligence, you may be entitled to substantial compensation. Contact a Miami personal injury lawyer today for a free, no-obligation consultation about your case. Our Miami, Florida injury lawyers handle serious injury cases all over the state of Florida.