Trimalleolar fracture is considered a very common injury. Excessive force impact on the integrity of the bone apparatus of the lower limb is the only cause of the pathology. The consequences of a fracture in the majority of cases do not go unnoticed, pursuing the victim for the rest of his life.
Who is at risk for broken ankles?
"Peak" statistics on the largest number of injuries falls, as a rule, in the winter season. The risk group includes not only the elderly, but also lovers of outdoor activities, rock climbing, ice skating. The recovery process most often drags on for several months.
Injury to the ankle is often accompanied by displacement of bone fragments, subluxations and torn ligaments. Self-treatment for a fracture is not the most suitable way, it is unlikely that you will be able to quickly get on your feet in the literal sense, and therefore, if you get injured, you need to seek professional medical help as soon as possible.
Ankle Fracture: Types of Trimalleolar Injuries
When damagedankle fractures are of several types. With a force impact on the limb from top to bottom and squeezing the ankle inward, a supination-adduction fracture occurs. A pronation-abduction type of injury occurs when the ankle bones are excessively forced to twist outwards. In the case of a deep, thorough eversion of the foot, a rotational fracture at the level of the joint will be a natural result. Injuries affecting the integrity of the tibia - isolated flexion and extension injuries, for which a triangular bone fragment is a characteristic feature.
In the most severe cases, combined fractures occur, which are a number of signs of previous types of damage. These include the three-malleolar type of fracture - the most dangerous, since it concerns both ankles and the tibia. Its characteristic features are ruptures of the ligamentous apparatus, rupture of blood vessels and damage to nerve endings.
Injury factors: Why do ankles break?
Trimalleolar fracture with displacement and subluxation is a complicated form of limb injury that affects the choice of treatment and the duration of rehabilitation.
Causes of broken ankle bones in most cases are:
- knuckle twisting;
- tucking the foot;
- excessive stress on the ankle joint;
- intense extension and flexion of the joint.
Another very common reasonof a three-malleolar fracture is not so much their forceful effect on bone tissue as fragility due to a reduced content of calcium, useful trace elements. Deficiency of valuable substances that provide strength to the human bone is the result of poor nutrition, coffee and alcohol abuse. It is rare enough to cause a fracture of the ankle joint rotting, provoked by osteomyelitis. The disease occurs, as a rule, in childhood, and inevitably leads to the patient's disability.
Main symptoms of limb injury
To provide competent medical care for an ankle injury, it is first of all important to learn how to identify a fracture. There is no time for reflection, but it is necessary to act urgently, therefore, it is up to the one who happened to be with the victim at the time of the injury to diagnose the nature of the injury.
Recognizing a trimalleolar fracture is not an easy task for them, but everyone can cope with it. The first signs of such a serious injury to the limb are:
- sharp pain that doesn't recede even for a moment;
- when you try to step foot pain intensifies;
- rapid development of puffiness;
- appearance of bruising;
- blue limb in the area of the entire ankle.
Other signs of ankle injury in three places
Internal hematomas occur after some time, spreading throughout the foot, toes. Other symptoms indicating the presencetrimalleolar injury, the following manifestations can be called:
- tightness of the skin over fragments of broken bones;
- changing the correct shape of the ankle joint;
- obvious foot deformity;
- severe limitation of movement in the fingers.
If the above symptoms coincide with the patient's feelings, it is urgent to provide him with complete rest and immobilization of the broken ankle joint.
The faster the patient is taken to the emergency room, the higher his chances of a detailed diagnosis and appropriate treatment.
Displacement and subluxation: a complication of fracture
If a displaced trimalleolar fracture is difficult to visually recognize even for a traumatologist, subluxation may be suspected by a specialist long before the results of an MRI study are obtained. By the way, this diagnostic procedure is mandatory for such a complex fracture of the ankle. This type of injury is characterized by a significant rupture of the deltoid ligaments of the ankle joint.
Getting a fracture with subluxation is much easier than most readers think. The most common "scenario" of injury is a fall on the ice, during which:
- foot tucked outward;
- there is a tension of the deltoid ligament with its subsequent breakage;
- due to high pressure, the lateralankle;
- excessive mobility of the talus leads to increased force on the tibia and fibula.
How is the ankle treated, how long does rehabilitation take?
Trimalleolar fracture with subluxation is one of the most “popular” reasons for surgical intervention in the internal tissues of the lower limb. With the displacement of bone fragments and the impossibility of their manual reposition, the patient is also prescribed an operation. A trimalleolar fracture can be cured in only one way - by bringing the ankle into an anatomically correct form. For this, for more than 2 months, patients are prescribed to wear plaster casts. The doctor fixes the injured leg, leaving it motionless - a prerequisite for ensuring bone fusion. After 4-5 days, special stirrups are applied to the patient, allowing them to move around. During the first 2-3 months, the patient's performance is gradually restored and soon the patient will be able to return to his usual way of life.
In order for rehabilitation after a trimalleolar fracture to be successful in a short period of time, doctors reposition the broken parts of the bone, put all the fragments together and fix them tightly. The procedure can be performed for both closed and open fractures.
Intervention of surgeons in the treatment process
It is impossible to independently engage in the reduction of a damaged part of a limb, since unprofessional actions can only lead to a worsening of the situation. procedureperformed under local anesthesia, and upon completion, final x-rays are taken and the broken leg is fixed in a plaster cast.
In the case when it is not possible to set the bone in place, an operation is performed. In order to prevent improper fusion of the ankle and tibia (fibula) bones, it is impossible to delay the surgical intervention, so the operation is most often done 3-4 days after the injury. For effective fixation of the posterior and anterior ankles, surgeons use various instruments (knitting needles, screws, nails, etc.). At the end of the procedure, a drain is inserted into the patient's leg and a cast is applied.
Recovery and rehabilitation after broken ankle
Treatment of a trimalleolar fracture, in fact, is a prolonged immobilization of the limb, accompanied by the administration of appropriate medications. A doctor should choose drugs for the speedy fusion of damaged bones, restoration of sinewy and soft tissues. After surgery, the patient is also prescribed a course of antibacterial agents to prevent the inflammatory process. As a rehabilitation for a trimalleolar fracture, the patient is prescribed physiotherapy, massages and sets of special exercises that help restore the limbs to their previous mobility, relieve the haunting pain syndrome.
A couple of words should also be given to the consequences of an ankle fracture, awaiting the injured. The risk of developing deforming arthrosis remains sufficienthigh even with qualified treatment and persistent rehabilitation. In some cases, patients never fully recovered, resulting in permanent disability.
