Where there is a visible deformity, severe pain or inability to weight bear, medical assistance should be sought as soon as possible. Where there is no visible deformity in the ankle or foot and putting weight down through the foot is possible, initial treatment should involve:
- Ice – apply ice for 20 minutes at a time, taking care not to apply directly to the skin.
- Compression – applying light compression can help reduce swelling and provide support
- Elevation – will help minimse the swelling
If symptoms persist despite these measures a review by a doctor is required. The doctor will assess the injury to determine what additional medical treatment is required.
Treatment of ankle sprains
Ankle sprains do not usually require surgery. Non-surgical treatment include:
- Medication to control pain and inflammation
- Avoid weight bearing – this may require the use of aids such as crutches
- Immobilisation – a supportive bandage or in some cases an ankle brace, cast or “moon boot” may be required
- Physiotherapy – to assist with exercises that improve control, strength and balance and also prevent stiffness.
Occasionally ankle sprains do not heal with non-surgical treatment and your surgeon may recommend surgery.
Surgery may be required to repair or reconstruct the damaged ligaments to prevent ongoing pain and instability of the ankle. Arthroscopic or keyhole surgery may also be required in some cases. In this procedure a small camera is used to look into the ankle joint through a small incision and enables damage within the joint, such a loose pieces or cartilage flaps, to be repaired.
Treatment of fractures of the ankle and injuries to the midfoot
If a fracture has occurred at the ankle joint and the bones and joint are lined up perfectly (undisplaced fracture) surgery may not be required. Similarly fractures that involve the bones of the foot, if undisplaced, may not require surgery. Often these types of undisplaced fractures can be treated with a period of immobilisation in a cast, brace or moon boot. The type of cast or brace and length of time required in it will depend on the type and severity of the injury. Also there may be a period of time that placing weight through the affected limb is not allowed.
Ankle and midfoot fractures that are displaced (bone ends not aligned) or comminuted (bones in several pieces) will generally require surgery. Also injuries that involve fractures and dislocation of the bones and joints of the ankle and foot surgery.
Your surgeon will align the bones and fix them together using internal metal plates, screws and/or wires if necessary. Sometime it may be necessary to fix your bones with and external frame to help the soft tissues and swelling settle down. This is used in more severe injuries.
Your doctor may also recommend surgery if there is a risk of the fracture not healing (nonunion).