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Malleolar Fractures: Symptoms, Diagnosis, and Treatment

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The malleoli are two bony prominences on the sides of the ankle joint. The lateral malleolus is located on the outside of the ankle, and the medial malleolus is located on the inside of the ankle. The malleoli help to stabilize the ankle joint and prevent it from rolling in or out.

Anatomy of the malleoli

The lateral malleolus is the larger of the two malleoli. It is the expanded lower end of the fibula, which is the smaller of the two bones in the lower leg. The medial malleolus is the lower end of the tibia, which is the larger of the two bones in the lower leg.

Function of the malleoli

The malleoli work together to stabilize the ankle joint. The lateral malleolus prevents the ankle from rolling in, and the medial malleolus prevents the ankle from rolling out. The malleoli also help to distribute weight evenly across the ankle joint.

Malleolar fractures

A malleolar fracture is a break in one or both of the malleoli. Malleolar fractures are most commonly caused by a twisting injury to the ankle, such as an ankle sprain. They can also be caused by a direct blow to the ankle.

Types of malleolar fractures

There are four main types of malleolar fractures:

  • Lateral malleolar fracture: This is a break in the lateral malleolus.
  • Medial malleolar fracture: This is a break in the medial malleolus.
  • Bimalleolar fracture: This is a break in both the lateral and medial malleoli.
  • Trimalleolar fracture: This is a break in all three malleoli (the lateral malleolus, medial malleolus, and posterior malleolus).

Symptoms of malleolar fractures

The symptoms of a malleolar fracture can vary depending on the severity of the fracture. Common symptoms include:

  • Pain in the ankle
  • Swelling around the ankle
  • Bruising around the ankle
  • Difficulty walking
  • Inability to bear weight on the ankle

Diagnosis of malleolar fractures

The diagnosis of a malleolar fracture is usually made by a doctor based on a physical examination and X-rays. In some cases, the doctor may also order a CT scan or MRI to get a better look at the fracture.

Treatment of malleolar fractures

The treatment of a malleolar fracture depends on the severity of the fracture. Non-surgical treatment may be an option for some patients with minimally displaced fractures. This may involve wearing a cast or brace for several weeks. Surgical treatment is usually necessary for patients with displaced fractures or fractures that involve the joint surface. Surgical options include open reduction and internal fixation (ORIF) or arthroscopic surgery.

Complications of malleolar fractures

Complications of malleolar fractures can include:

  • Infection
  • Nonunion (failure of the fracture to heal)
  • Malunion (misalignment of the bones)
  • Arthritis

 

Recovery from malleolar fractures

Timeline for recovery

The timeline for recovery from a malleolar fracture varies depending on the severity of the fracture and the type of treatment. Patients who have non-surgical treatment typically need to wear a cast or brace for 6-8 weeks. They may also need physical therapy to help them regain range of motion and strength in their ankle. Patients who have surgical treatment typically need to wear a cast or brace for 8-12 weeks after surgery. They will also need physical therapy to help them regain range of motion and strength in their ankle.

Rehabilitation exercises

Physical therapy is an important part of the recovery process for malleolar fractures. Physical therapy can help to:

  • Reduce pain and swelling
  • Increase range of motion
  • Improve strength
  • Restore function to the ankle

The specific exercises that are prescribed will vary depending on the severity of the fracture and the type of treatment. However, some common exercises include:

  • Range of motion exercises
  • Strength exercises
  • Proprioceptive exercises
  • Balance exercises

Tips for a smooth recovery

Here are some tips for a smooth recovery from a malleolar fracture:

  • Follow your doctor’s instructions carefully.
  • Wear your cast or brace as directed.
  • Do your physical therapy exercises as instructed.
  • Elevate your ankle and apply ice for the first 24-48 hours after the injury.
  • Avoid putting weight on your ankle until your doctor tells you it is safe to do so.
  • Be patient. Recovery from a malleolar fracture takes time.

Frequently Asked Questions

Here are some common FAQs about malleolar fractures:

  • How long will it take for my ankle to feel normal again?

It can take several months for your ankle to feel completely normal again. However, most people are able to return to their normal activities within 6-12 months.

  • Will I have any permanent damage from my malleolar fracture?

In most cases, there is no permanent damage from a malleolar fracture. However, some people may experience residual pain or stiffness in their ankle.

  • What can I do to prevent malleolar fractures?

There are a few things you can do to help prevent malleolar fractures, such as:

  • Warming up before exercising
  • Wearing proper footwear
  • Avoiding activities that put stress on your ankles
  • Being aware of your surroundings and avoiding uneven surfaces

Conclusion

Malleolar fractures are common injuries that can occur as a result of a twisting injury to the ankle. The treatment for malleolar fractures depends on the severity of the fracture. Most people are able to make a full recovery from a malleolar fracture with proper treatment and rehabilitation.

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