■ COMMUNITY NEWS
ANKLE FRACTURES (BROKEN ANKLE)
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By Dr. Michael M. Cohen, DPM, FACFAS
nkle fractures, oth- regardless of how well the ankle was repaired. erwise known as Many of these patients will inevitably require broken ankles are additional surgery in the future to eliminate common injuries in people of all ages and pain. The procedures may include fusion lifestyles. They may occur during any sport where the bones are welded together or an involving a twisting or jumping motion such ankle replacement. as football, basketball, ballet, and running. X-rays of the ankle and knee are required They may also occur as a result of a motor to diagnose an ankle fracture. More advanced vehicle accident, slip or fall from a height. imaging such as CT or MRI is often necessary to People (particularly post-menopausal women) determine the extent of the injury. With modern with osteoporosis may be susceptible. When imaging techniques, a three-dimensional one breaks an ankle, they have fractured one recreation of the fracture can be obtained or more of three bones which make up the with a CT scan allowing the surgeon to fully ankle. If treated improperly the injury could assess the fracture. Treatment is based on lead to long-term disability. The ankle joint the alignment and stability of the ankle with is made up of the tibia (shin bone) the larger the goal being to heal the fracture(s) as close of two bones in the lower leg and flares out to perfect as possible. A fracture displaced at its lower end forming a knob on the inside 2 or more millimeters can result in long term of the ankle called the medial malleolus problems and often necessitates an operation. and another flare in the back known as the Unfortunately, arthritis may develop even posterior malleolus. The smaller of the two when the ankle has been placed in good bones in the leg is the fibula and flares out alignment because of the irreparable damage on the outside of the ankle to form the lateral done to the bone and cartilage at the time of malleolus. The tibia and fibula rest on the injury. Not all fractures require surgery. Simple talus, a wedge-shaped bone connecting nondisplaced fractures may be treated with the foot to the leg. We think of the ankle as a cast or walking boot. More severe injuries a room with three sides and a roof. The tibia however require surgical reduction using forms the roof, the medial malleolus (inside specialized plates and screws. A foot and wall), and the posterior malleolus (backside ankle specialist may wait one to three weeks wall). The lateral malleolus forms the outside for swelling to resolve before the ankle is wall of the room. Ligaments connect these surgically repaired. After surgery, patients structures together to guide movement and must remain non-weight bearing for a period assure stability. If a major ligament such as of anywhere from 4-6 weeks to a few months the Deltoid or Syndesmotic ligament is torn depending on the severity of the fracture. A the ankle is generally considered unstable. graduated rehabilitative period is prescribed A syndesmotic tear may involve a fracture during the postoperative period to allow the of the fibula near the knee (Maisonneuve patient to regain movement, strength, and fracture). The lateral malleolar ankle fracture balance. Risk factors for poorer outcomes is the most common, and bimalleolar (lateral in proper healing of ankle fractures include and medial) the second most common. When smoking, diabetes (especially if under poor all three sides are fractured (medial, lateral, control), age, and peripheral neuropathy. and posterior) the injury is referred to as a Michael M. Cohen, DPM, is a Board-Certified Foot and Ankle Surgeon and Diplomate of the American trimalleolar fracture. As the number of fractures Board of Foot and Ankle Surgery. He is a Fellow of or level of impact increases so does the risk the American Board of Foot and Ankle Surgeons of long-term damage to the ankle joint. Ankle and Board Certified and Diplomat of the American fractures may be nondisplaced (in correct Board of Podiatric Medicine. He practices with the position) or displaced (misaligned). High velocity Foot, Ankle and Leg Specialists of South Florida fractures are known as Pilon fractures and specializing in lower leg injuries and reconstructive have the worst long-term prognosis because surgery of the foot and ankle. The South Florida of the extensive comminution and damage Institute of Sports Medicine in Weston is located to the joint. These fractures inherently pose at 1600 Town Center Blvd., Suite C, (954) 389the worst long-term prognosis because the 5900 and in Pembroke Pines at 17842 NW 2nd ankle shatters in many pieces and quite Street, (954) 430-9901. The practice website is www.SOUTHFLORIDASPORTSMEDICINE.org. often lead to chronic disability and arthritis
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34 / Our City Pembroke Pines / August 2022 / OurCityMedia.com
