Symptoms & Treatments

Acute Ankle Injuries

An ankle sprain is the most common injury seen in sports. It is usually caused by a rolling-in or inversion of the ankle resulting in a stressing of the ligaments on the outside of the ankle. These are known as the lateral ligament complex. Simple ankle sprains usually only damage one of the three major ligaments. These can be treated with a standard program known as R.I.C.E. (Rest, Ice, Compression, Elevation). Swelling will resolve quickly following the R.I.C.E. program. Usually an individual can return to sports within a few days provided the ankle is taped or braced.

More severe ankle sprains are known as Grade II or Grade III, depending whether or not two or all three of the ligaments are disrupted. Significant ankle injuries require functional bracing, physical therapy, and restriction from athletic activities for several weeks. Surgery is rarely necessary for the acute injury, but may be necessary for the repeated ankle sprain if the athlete develops chronic instability.

Often, repeated ankle sprains result in damage of the cartilage lining of the ankle joint, which causes a secondary post-traumatic arthritic condition. The long-term result of this can be chronic pain, swelling, and loss of normal functional activities.

The most common ankle fracture occurs on the fibula bone, which is also located on the outside of the ankle. Both conditions have a similar mechanism of injury. What determines whether an ankle will be sprained or fractured is the magnitude of the initial force of how far the foot or ankle is displaced. A fracture of the fibula bone occurs at the level of the ankle joint. A non-displaced fracture can be treated non-operatively with a brace, protected weight-bearing, and the R.I.C.E. program. Whereas most ankle sprains allow an individual to return to sports within a few days, a distal fibula fracture may take several weeks. Displaced fibula fractures usually require surgery for placement of a metal plate or screws to secure the fracture in position. The metal implant will preserve the normal alignment of the bone and provide for rigid fixation that allows early range of motion exercise. This type of injury also requires several weeks to months for complete healing.

The reason people refer to the ankle sprain as being a more severe injury is that chronic ankle sprains result in long-term problems with instability. Ankle fractures, once healed, usually allow a full return to normal function. Secondary procedures are rarely necessary following ankle fractures, whereas they may be fairly common ankle sprains which were not initially treated properly.