Injuries to the foot and ankle are very common. Ten per cent of all emergency hospital visits are for foot and ankle fractures and sprains. Due to its size, shape and function, the ankle receives more stress than any other joint in the body and is prone to injury.
Causes
Ankle fractures are most often caused by a twisting injury of the ankle with the ankle “rolling” inwards or outwards.
In addition, there are several bones in the foot which are prone to fracture as a result of “twisting” the ankle. The bones on the outside of the foot are particularly at risk and therefore the whole foot has to be examined thoroughly after what may appear to be a sprain.
A large proportion of foot and ankle injuries take place during sport. One large study of 12,000 sporting injuries showed that a quarter of all injuries involved the foot or ankle. We work to prevent these injuries before they occur. However receiving treatment at The Foot Clinic – 905-684-5953 as soon as possible after an injury is important to recovery.
Diagnosis
Assessment starts with a precise history of the injury. This often allows an accurate prediction of the structures likely to have been damaged. All bones, large and small joints, ligaments, tendons and peripheral nerves must be examined before imaging takes place and to determine which, if any, images should be ordered.
X-rays may be required along with CT and MRI scanning. Types of foot and ankle injuries:
Ligament injuries
Bone and ankle fractures
Cartilage and tendon damage
Tendon injuries
Summary
As there are so many structures in the foot and ankle that are at risk of being injured, it is important to seek early specialist advice. Often, the worst thing one can do with a significant “sprain” is to ignore it. Walking off the pain usually just doesn’t work and can reduce long term healing. With appropriate treatment, following foot and ankle injuries, it is possible to return to normal activities faster and long term problems can be prevented.
Ligament Injuries
Ligament Injuries
Ligament injuries to the ankle are the most common sports injury. There are three ligaments on the outside and one on the inside of the ankle. The ligaments on the outside are regularly injured in a typical ankle sprain. Fortunately, surgery is rarely necessary, as these injuries heal without surgical intervention.
The mainstay of treatment for ligament injuries is correct stretching and sometimes an ankle brace may be needed for four to six weeks followed by custom made orthotics. It can however take months to recover fully from an ankle sprain.
In addition to the ligaments mentioned above, there are ligaments which join the two long bones of the ankle (tibia and fibula). This ligament is called the syndesmosis. If this ligament is injured, pain is felt slightly higher than with conventional ligament injuries, hence the expression “the high ankle sprain”.
These injuries can be severe, take longer to heal and are frequently missed. It is therefore important that they are diagnosed properly by a specialist. Some of these sprains need to be repaired in order to avoid long term damage. In addition to ligament injuries, there are other structures that are at risk of injury when the ankle is ‘sprained’ such as tendons and the cartilage of the joint.
Summary
As there are so many structures in the foot and ankle that are at risk of being injured, it is important to seek early specialist advice. Often, the worst thing one can do with a significant “sprain” is to ignore it. Walking off the pain usually just doesn’t work and can reduce long term healing. With appropriate treatment, following foot and ankle injuries, it is possible to return to normal activities faster and long term problems can be prevented.
Bone and Ankle Fractures
Bone and Ankle Fractures
Bone and ankle fractures (breaks) are a risk when there is a trauma, or injury. The ankle bones are commonly fractured and may need surgery to restore the anatomical alignment if they are displaced. Fractures can range from less serious avulsion injuries (small piece of bone pulled off) to severe shattering-type fractures of the bones and dislocations.
There are many foot fractures which are easily missed when they occur and careful assessment is mandatory if long term consequences are to be avoided. Probably the best example of this is the “Lisfranc” injury of the midfoot. This is essentially a ligament injury but often associated with a tiny fracture not seen on conventional x-rays. A failure to detect this injury at the outset can lead to severe pain and deformity in the long term.
When a bone is broken, there is usually severe pain and the individual has great difficulty bearing weight and often can not put the foot to the ground. Sometimes, however, patients are able to bear weight or even walk with a broken ankle or foot. This is why all foot and ankle injuries seen by a specialist in disorders of the foot and ankle.
As a general rule, broken bones tend to heal well. Most simple fractures do not require surgery but there are many foot and ankle injuries where surgery is necessary to enable a patient make a full recovery and avoid devastating long term consequences.
Summary
As there are so many structures in the foot and ankle that are at risk of being injured, it is important to seek early specialist advice. Often, the worst thing one can do with a significant “sprain” is to ignore it. Walking off the pain usually just doesn’t work and can reduce long term healing. With appropriate treatment, following foot and ankle injuries, it is possible to return to normal activities faster and long term problems can be prevented.
Cartilage Damage
Cartilage Damage
Cartilage and tendon damage are common foot and ankle problems. Cartilage is flexible, rubbery connective tissue that cushions bones at joints. Cartilage can be damaged by a trauma, such as an injury, or by conditions such as osteoarthritis which cause the loss of cartilage.
Ankle fractures can result in severe cartilage damage, but even a simple sprain can lead to significant damage to the cartilage. Treatment for cartilage damage depends upon the degree of damage and loss.
Tendons consist of small fibres of a material called collagen. Tendons connect the ends of muscles to bones and play a vital role in movement. Unlike muscles, tendons regenerate very slowly, depending upon the degree of damage and are inelastic. Cartilage and tendon damage can normally be identified with an expert examination and scans if needed.
Summary
As there are so many structures in the foot and ankle that are at risk of being injured, it is important to seek early specialist advice. Often, the worst thing one can do with a significant “sprain” is to ignore it. Walking off the pain usually just doesn’t work and can reduce long term healing. With appropriate treatment, following foot and ankle injuries, it is possible to return to normal activities faster and long term problems can be prevented.
Tendon Injuries
Tendon Injuries
Tendon injuries can be caused by a sudden stress or trauma and also by untreated inflammation and degeneration.
The tendons perform a very important function within the body, connecting the ends of the muscles to the bones. Unlike the muscles, the tendons degenerate very slowly and if severely damaged, may not degenerate at all.
Of the numerous tendons in the foot, the Achilles tendon is the most frequently ruptured.
Other tendons such as the peroneal tendons can be injured but unlike the Achilles they are more prone to splitting than rupturing completely. Such injuries often require surgical repair.
Summary
As there are so many structures in the foot and ankle that are at risk of being injured, it is important to seek early specialist advice. Often, the worst thing one can do with a significant “sprain” is to ignore it. Walking off the pain usually just doesn’t work and can reduce long term healing. With appropriate treatment, following foot and ankle injuries, it is possible to return to normal activities faster and long term problems can be prevented.
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