1Where is the ankle on the leg of a man
- 1.1Interesting historical facts
- 1.3Anatomy of an ankle
- 1.4Biomechanical features of the ankle and ankle
- 1.5Pathological physiology of the anatomy of the anatomy of the ankle
- 1.6Why the ankle swells during pregnancy
- 1.7Injuries to the ankle
- 1.9Dislocation of the ankle
- 1.10Ankle bruise
2Structure and Diseases of the Ankle
- 2.1general characteristics
- 2.2Causes of pathologies
- 2.3Common injuries
- 2.7Fracture: degree of damage
- 2.8How to treat
- 2.9Preventing problems
3Where is the ankle (ankle) in a person and what is it?
- 3.1Injury of ankle
- 3.2Assisting with trauma and pain
4Fracture of the ankle: causes, symptoms and treatment
- 4.1A few words about anatomy
- 4.2In which case does an ankle injury occur?
- 4.3How to classify such fractures
- 4.4Classification of Weber
- 4.5Variants of specific indirect fractures of the ankle
- 4.7Therapeutic tactics
- 4.8Non-surgical treatment
- 4.9Operative treatment
- 4.10Rehabilitation process
Where is the ankle on the leg of a man
The ankle or ankle (malleolus) is the bone formation of the lower third of the shin, consisting of the distal part of the epiphysis of the tibia and fibula.
The man's ankle is a "fork" that tightly holds the body of the talus bone on both sides.
The talus bone is a bone structure that is located directly in front of the ankle joint and forms the so-called lift of the foot.
Interesting historical facts
For the first time a detailed sketch of the structure of the lower limb was drawn by Leonardo da Vinci. His drawings are still popular among modern anatomists.
He represented the human leg as a mechanical formation, having its laws in motion and structure.
This allowed us to open our eyes to the features of the articular surfaces of the ankle and knee joint.
All names of anatomical structures Leonardo described in Latin. The artist made inscriptions in Latin even near the smallest area, described its shape and structure, which shows on his great knowledge in human anatomy, scrupulousness and attentiveness in work.
He believed that the description of the anatomy of any part of the human body without pictures and illustrations is incorrect.
It is better to see once than hear or read hundreds of times.
The image of the artist's foot is so detailed and natural that with the help of them one can easily see the structure and biomechanics of the foot.
Even modern photos are not so detailed can characterize the location of the ankle in man, as the artist's drawings.
The ankle is the basis for fixing the ligaments that hold the ankle joint to the shin. It is attached to the talus bone, which has three articular surfaces that ensure the maneuverability of the foot.
Due to the large number of small ligaments, joints and bones, the ankle is quickly restored and well suited for rehabilitation. Negative moment in this case is a large number of small articular surfaces that can be affected by arthritic changes.
The function of the ankle and foot for a person is very important.
The peculiarity of the structure of the lower third of the limb allows you to keep the vertical axis when walking and running. A powerful Achilles tendon, ligaments of the ankle joint and muscular apparatus of the shin keep the body weight when walking and ensure its movement.
Anatomy of an ankle
Anatomy of an ankle
Ankle joint has three articular surfaces. This allows him to move in several planes:
- Anteroposterior direction is the movement of the joint around the talus bone, which plays the role of a block in the uppermost position of the foot.
- Plantar flexion is the supination of the foot, which means a helical turn of the foot inside.
- Back bending or pronation of the foot - a screw-like turn of the foot outward.
In traumatology and orthopedics, two ankles are distinguished:
- The medial malleolus formed by the protrusion of the lower part of the tibia.
- Lateral ankle formed by the protruding lower part of the fibula.
In the anatomy of the ankle, two internal surfaces are distinguished:
- Outer, which is posterior to the ankle joint of the foot.
- Internal, located anterior to the joint in the frontal plane (plane parallel to the frontal bone).
The ankle has a capsule, which is strengthened by a large number of small ligaments:
- Lateral ligaments of the ankle joint start from the tops of the ankles and are arranged in a fan-shaped manner. Their end is attached to the periosteum, the lower tarsal ossicles of the foot (navicular, 3 wedge shaped, cuboid).
- Anterior and posterior intercellular ligament and interosseous membrane. These structures retain the distal intercellular articulation.
Movement in the ankle is quite large:
- Plantar flexion is 40-50 °.
- The back folding is 20-30 °.
These indicators are very individual and depend on a large number of factors (for example, the flexibility of the gastrocnemius muscles of the shin), therefore the mobility of the ankle in the anteroposterior direction can range from 60 to 140 °.
The nervous system of the ankle is represented by two nerves:
- Tibial nerve.
- Deep peroneal nerve.
When ankle injuries and ankle joint diseases are sometimes required, the blockade of the tibial and peroneal nerves of the lower third of the shin is required. For this, Brown's technique is most often used.
To perform it at a distance of 100-120 mm from the ankle, subcutaneously in the tibia, an anesthetic solution is injected along the path to the circle.
In places where the visual ring of anesthesia intersects with the Achilles tendon, inject an anesthetic 2-4 cm deep into the fibula.
This provides a blockade of the tibial nerve.
Biomechanical features of the ankle and ankle
Pain when the foot is tucked
For a better understanding of where the ankle is and its biomechanics, you can see the illustrations and photos in the medical literature. This topic is best described in the book "The Atlas of Fractures and Their Treatment" edited by A.Shabanov. and Sartan V.A.
In this book, the ankle is represented in the form of several axes that are arranged to each other at a certain angle and form complex triangles. It is the violation of the correlation of angles and planes in these figures that leads to dislocation and fracture of the ankle or ankle joint.
- Axis A is a vertical line located in the middle of the tibia and going down to the heel bone.
- The B axis is the line that lies at an angle of 3-10 ° from the A axis laterally.
When changing the ratio of axes, there are different types of violation of integrity of the ankle:
- As the angle between the A and B axes decreases, the center of gravity shifts inwards, which leads to a break in the small distal part of the condyle of the tibia and fragmentation fracture of the lower part of the fibula.
- As the angle between the A and B axes increases, the cent of the weight shifts outward, which leads to a fracture of the tibia in the area of the epimetaphysis and a fracture or fracture of the fibula.
To better understand the mechanism of such fractures, you can imagine a girl who goes on high heels. If her leg is turned inwards, the first variant of the fracture appears. If outside, the second one.
Of course, with the turn of the foot, the determination of the fracture mechanism for treatment does not play a significant role. But sometimes the pathogenetic mechanism of ankle fracture plays an important role in investigative measures of various violations of the law.
Pathological physiology of the anatomy of the anatomy of the ankle
Redness of ankle in a damaged place
When the integrity of the bone, ligaments, joints and soft tissues is disturbed, a whole cascade of biomechanical reactions arises in the lower leg, leading to edema, impaired blood circulation, and infection of the foot. All this can lead to disruption of the main function of the foot - walking.
In the network, you can find a lot of photos with cones, swelling, rashes, redness of the ankles. At first glance, the cause of all these changes may be mechanical damage or allergy (for example, for mascara for a tattoo), but this is a completely deceptive opinion.
Why the ankle swells during pregnancy
Swelling of the ankle in pregnancy
During pregnancy, the body weight of the girl is increased by at least 12 kg. These pounds are important for the safe flow of childbirth and breastfeeding.
In the initial period of pregnancy, it is correct to practice walking or swimming, in this case excess fluid and calories that pregnant women use, will be used properly and the risk of gaining extra weight is not will be.
In the last trimester of pregnancy, the woman's mobility drops sharply, which leads to accumulation of fluid in the lower limbs. There is swelling and numbness of the legs. This worries the pregnant woman and can affect her health.
To correct the condition, it is necessary to slightly limit the consumption of tea, water and products containing a large amount of liquid (watermelons, apples, cherries). It is best to drink before, liter of water per day.
Injuries to the ankle
Often a person podvarachivaet or striking a leg while playing sports, running or just walking on the street.
At this moment, he feels pain, burning, bursting in the area of injury.
In this case, it is necessary to distinguish a fracture from a sprain, a bruise or a dislocation, because the regimens for treating these conditions have some differences.
When you strike or tuck the foot, there is a crunching or a feeling of raspiraniya in the leg. Pain is sharp, persistent for a long time. It is very painful to step on foot and move it.
With a fracture, you can see the displacement of the bone fragments or joint in an unnatural direction.
If the fracture with the displacement between the bone fragments will be located soft tissue, so the restoration of integrity can only be after the operation.
Dislocation of the ankle
Dislocation - a violation of the correct location of articular surfaces and ligaments in the joint.
This condition is accompanied by swelling, soreness of the foot when moving. When the leg is dislocated, the leg hurts much less.
Fingers move without effort, there is no feeling of bursting and a foreign body in the leg.
How does an ankle bruise look like?
A bruised ankle is a blow to the leg, which is accompanied by a subcutaneous hemorrhage, edema and soreness. In the place of impact there may be a lump or edema, visually it looks like an increase in soft tissue in volume.
At palpation this formation is soft and sharply painful.
Treatment of this condition consists in applying local anti-inflammatory drugs to the patient leg (Diclofenac, Indovazin, Venarus, Indomethacin) and its restriction in movement and support on -2 of the week.
The ankle is a complex biomechanical device that is an important functional component of the lower limb.
It is formed by the external bone processes of the tibial and fibular bones.
With the help of the ankle, the foot is held in the required position and is maximally mobile when moving.
A source: https://NogoStop.ru/golenostop/lodyzhka/lodyzhka.html
Structure and Diseases of the Ankle
The functions of the right-hand man are provided by a special structure of his skeleton. Most of the load when traveling is on foot. And the role of the transmitter between working muscles of the lower leg and the foot is performed by the ankle, also known as the ankle.
This is a complex connection between the ankle and the bones of the foot, distributing the load and assuming almost the entire weight of the human body.
This part of the skeleton is very vulnerable, so a lot of injuries and pathologies of the musculoskeletal system fall on it.
A pin is not a joint or a muscle. This is a complex construction, formed by the heads of the shin bones, connected with the talus bone.
They are attached to the muscles and tendons, distributing the load on the foot, ensuring the work of the ankle joint and maintaining balance. It is due to the presence of such a connection that the foot can freely move in three planes.
But the special structure of the ankle limits the amplitude of such movements, stabilizing the ankle joint.
Almost everyone has heard of the existence of such a part of the body, but some do not realize where the ankle is. Although in fact it is very easy to find.
At the bottom of the shin, in the place where it joins the foot, you can not only grope, but also see the ledges on the sides. They are not the same in size, but represent the heads of the tibial and fibular bones that connect with the talus bone of the foot.
In accordance with this, the lateral ankle located on the outside and the medial lobe are isolated.
Various injuries and diseases in this area are quite common. In this case, there is a sharp pain that hinders the movement of a person.
A large number of blood vessels and nerve fibers pass through the ankle.
Therefore, the pain can become very strong, which negatively affects not only the performance, but also the overall quality of life.
Another symptom of various pathologies of the ankle is swelling. It develops both in trauma and in other diseases.
The puppy grows in size, the skin changes color, it can become shiny and thin. Edema can spread both above and below the ankle.
In addition, with some injuries, ankle deformation is also possible. And the mobility of the foot in this place is disturbed in any pathology.
Pain and swelling in the ankle may appear due to trauma or degenerative-dystrophic diseases
Causes of pathologies
The scallop is a rather complex structure providing a movable joint of the tibia with the foot. It is this place that provides the functions of depreciation and reduces the load on the foot.
Therefore, various pathologies and injuries occur frequently here. To injure an ankle it is possible at running, jumps or at walking. Particularly susceptible to this athletes and people who spend a lot of time on their feet.
Uncomfortable shoes, high heels and excess weight several times increase the risk of injury.
But not always the pain in the ankle is associated with traumatic injury.
Sometimes regular loads or various diseases cause the appearance of other pathologies.
These can be joint diseases: arthritis, arthrosis, synovitis, chronic inflammation in muscles or ligaments, gout or osteoporosis.
The most common cause of pain in the ankle are various injuries. And, people are affected at any age. This place is very vulnerable, so even people who are not exposed to heavy loads, the trauma can happen at any moment.
The most common of these are:
- dislocation of the ankle.
Even a small bruise in the ankle region leads to the appearance of swelling and bruising
This is the most common ankle injury. It can occur when it strikes a hard surface, a heavy object falls on its leg or when it falls.
The protruding ankle bones are a vulnerable place for such influences.
A bruised ankle can be very painful, since many nerve fibers pass through this place, and the load on it is high even when standing.
In the ankle region there are several large ligaments that withstand a high load. Therefore, they are susceptible to various injuries.
Most often, an ankle is stretched.
It can occur with increased stress, non-compliance with safety regulations while playing sports, and also because of wearing uncomfortable shoes.
After such an injury, swelling develops rapidly, there is a sharp pain when walking or palpating. Basically, it is located slightly below the ankle.
Ankle dislocation often happens when walking on heels
With sudden unsuccessful movement, jumping, and also because of the tug of the foot when stepping on a hummock or pebble, an ankle dislocation may occur. In this case, the ankle is injured. Most of the swelling and redness in this case occur on its outer side, and the heel turns inside.
The difference between dislocation and subluxation of the joint is that the latter accompanies various chronic articular pathologies: arthritis or arthrosis.
Suffered such a trauma full people, as well as those who lead a sedentary lifestyle. After all, the ligamentous apparatus is weakened by them and can not hold the joint under increased loads.
In such cases, the leg can turn even when walking normally.
Fracture: degree of damage
The most difficult ankle injury is a fracture. It represents the detachment of the bones of the shin along with the tendons from the place of their attachment. Both sides of the ankle are usually injured.
In addition, blood vessels, soft tissues, nerve plexuses can be damaged. It is accompanied by a fracture of severe pain localized in the ankle or below it.
In addition, there is often swelling, joint deformity, soft tissue damage, up to ligament ruptures.
But more often there is a so-called stress fracture of the ankle. Constant increased loads, as well as strong pressure on the ankle area due to excess weight causes the appearance of microcracks on the bones. This condition causes aching pain, which eventually become permanent.
Cold compress will help relieve pain and swelling after trauma
How to treat
Any pathology in the ankle region requires immediate treatment. After all, in advanced cases, the functions of the ankle joint may be completely disrupted.
Therefore, the treatment of diseases and injuries in this place should begin as early as possible. The choice of therapeutic methods is carried out only by a doctor after examination and diagnosis.
To detect a trauma, most often an X-ray is done, it is possible to administer an MRI and a biochemical blood test.
You can also read: richiny edema of the feet and ankles
When you have severe pain, you must first of all give the person first aid. Immediately after the injury, you need to carefully disengage from the shoes, so that the growing swelling does not cause deterioration.
It is recommended to apply cold as soon as possible to the sore spot. This will help reduce pain, as well as prevent the appearance of swelling. In addition, it is very important to limit the load on the damaged limb.
The patient needs to sit or lie more, and, the leg should be on the dais.
All other methods of treatment depend on the cause of discomfort in the ankle. If a fracture is necessary, the surgeon needs help, which combines the damaged bones and impose a plaster bandage.
A complete exception, and sometimes even just a restriction of the load, accelerates the recovery.
To accelerate bone splicing, calcium preparations, vitamin D, mummies, biologically active additives that improve metabolic processes can be prescribed.
When stretching ligaments or a dislocation, there is usually no serious tissue damage. But swelling is always present.
To reduce it, except for cold compresses and NSAIDs, you can use ointments based on heparin or troxevasin. Diuretics are often prescribed as well.
As with a fracture, it is necessary to immobilize the ankles for at least a few days. But instead of gypsum, an elastic bandage is used for this.
The ankle should be bandaged so that the foot is at a right angle to the tibia. With such injuries, warming compresses should not be done in the first few days, as this can cause an increase in swelling.
To treat abnormalities of the ankles caused by inflammatory or dystrophic processes in the joints, it is necessary with the use of non-steroidal anti-inflammatory drugs.
Most often, these drugs are based on diclofenac, ketoprofen or ibuprofen. They are available in the form of tablets, ointments or injections.
As an auxiliary method of therapy, physiotherapeutic procedures are necessarily used: magnet, UHF, laser therapy, mud applications, mineral baths.
To prevent injury to the ankles, you need to choose comfortable shoes with a low heel
With frequent dislocations or other joint damage, development of degenerative diseases is possible. Therefore, you should try to avoid injuries. For this, wear comfortable shoes with a steady heel. Before a sports load, it is necessary to do a warm-up.
To prevent pain and develop edema in various pathologies of the ankles, it is very important to pay attention to shoes. It should be soft, with a supinator or special orthopedic insoles.
Every day it is recommended to do gymnastics to strengthen the muscles and ligaments of the ankle. Such simple exercises as the rotation of feet, walking on socks and on the heels, flexion of the fingers, can be performed several times a day.
You also need to do foot massage, walk on massage mats. In the evenings it is useful to take foot baths or a contrast shower.
A pinch is one of the most vulnerable places in the human skeleton. But its normal functioning depends on its working capacity. In order not to lose the opportunity to move normally, you need to protect it from damage.
A source: http://MoyaSpina.ru/info/stroenie-funkcii-shchikolotki
Where is the ankle (ankle) in a person and what is it?
Where is the man's ankle? The orthopedist can answer this question. Most people know that the ankle is part of the foot, but where exactly it is, can not show.
Another name for this part of the leg is an ankle that consists of three bones:
- Big tibia.
- Small tibia.
Bones are connected to each other by tendons, creating a block-like formation. Thus, when answering the question of where the ankle is located, it is worthwhile to show the site of the articulation of the shin and foot. Very well know where the ankle is located, athletes, dancers, tourists.
It is they who often injure this leg. If you put carelessly on the foot, turning it out, then the ankle bone moves in the ankle.
As a result, there is severe pain, which affects another area of the ankle - a large tibia and a foot.
Functionality of the ankle is depreciation of the body during exercise, walking, running, active movements. This is the place most often on the foot becomes the object of injuries, bruises, fractures, sprains.
Ankle or ankle is where? Even knowing where the ankle is, not many people can avoid her trauma, or describe the anatomical structure, for example, that the foot is fixed below the tibia and tibia.
Around the joint and an ankle is formed, consisting of such parts as:
- Inner or distal - this is the lowest part of the tibia.
- External - at the bottom of the peroneum.
- Distal surface - tibial at the top.
Tendons are attached where there is a site with a deepening of the external ankle. From here the tendons go to the peroneal muscles - short and long. To the outside of the external ankle, joint ligaments and fasciae consisting of cases are attached. Their function is to cover nerves, vessels and tendons.
What does the ankle look like? It is much easier for people to imagine the ankle structure. Thus, the lower edge of the tibia is similar to an arc, on its inner side there is an appendix. On the tibia and in front are the anterior and posterior ankles.
Small tibia is located on the outside of the tibia, on the sides should be located bumps.
The outer ankle, partially located on the tibia, creates an intercostal syndrome. The following parts of the ankle are arranged in this order:
- The surface of the anterior joint is divided into the inner and outer, and between them is a crest;
- the inner ankle is formed by the anterior and posterior tubercles, which are separated by a pit, the first tubercle is larger than the second;
- the heel and shin bones are joined to each other by a talus bone, which consists of three parts - the body, the block and the neck, namely, the block located here is responsible for the connection with the shin;
"Fork" is formed between the bones - large and small tibia, between which is the block of the talus bone.
Above - convex, where there is a depression, and there enters the crest of the epiphysis of the tibia.
The block, located in the front part, is wider, gradually passes into the neck and head, and behind it is located the tubercle and groove. On it, and passes the fold of the thumb of the foot.
For the flexion of the foot, these structural parts of the ankle are responsible, such as:
- Long flexors of fingers.
- Hind tibia.
- Plantar bone.
- Muscle of the lower leg, which is called the triceps.
- The opposite function, i.e. Extension of the cheek is provided by the front tibia and the extensors of the toes.
The movement is answered by:
- Anterior long bones.
- Third small tibia.
These are the so-called pronators, and for the inner turns are the insteps; long extensor of the big toe and anterior tibia muscle.
For feeding the tissues in the ankle, the arteries, called the tibia, the anterior and posterior tibia, respond. Near the joint capsule, ligaments, ankles and arteries, various vessels form a branched network.
Thanks to this structure, the ankle can perform its functions, helping a person withstand the load of the body, evenly distributing it from feet to feet. Such depreciation is very important, because it provides a person with the ability to move.
Injury of ankle
Symptoms of ankle damage cause pain of varying intensity and are manifested as follows:
- When there is a sprain of the ligaments, an edema develops in the ankle area, provoked by a hemorrhage. It is impossible to touch the damaged place, since the leg is very sore.
- Fracture of the external ankle provokes severe swelling, as well as severe pain in the ankle and slightly lower.
- When there is a fracture and a dislocation, then the joint begins to grow instantly in size. Walking becomes impossible, since the foot is strongly shifted to the side - the outer, the inner, the back. Quite often there is a crepitation of fragments, which are located between the bones. Exterior examination is difficult due to severe pain.
With a fracture of the calcaneus, a thickening of the heel will occur, which will turn outward. It is very difficult to step on it, so you need to rest your leg.
The appearance of a large hematoma from the back of the foot indicates another fracture - the diaphysis of the metatarsal bones. During the examination, the patient is asked to stand on his toes, and if he can not do this, then a fracture is diagnosed.
When a dislocation or subluxation occurs, the ankle becomes very painful, the foot suffers from deformities, a hematoma is formed from the back side.
Often it is the pain that causes the ankle to accidentally "find" a person on the leg.
If the pain is constant and intense, then the person goes to the hospital, where the doctor says that the ankle is damaged.
She starts to hurt because of injuries to the feet or ankles, which is caused by the following reasons:
- There was a fall or a jump from a height.
- Hit a heavy object on the leg.
- Turning the foot.
- Soreness demonstrates dislocation of the foot or sprain of the ligament.
- The development of arthritis.
- Deforming osteoarthritis.
Such symptoms become the basis for a visit to a rheumatologist or surgeon who sends a patient to an X-ray to detect a trauma of one kind or another.
Assisting with trauma and pain
If there was a trauma, then do not worry and panic. The patient should take a horizontal position, providing the foot with a resting state, then remove the shoes, so that nothing presses on the damage.
In place, which causes anxiety, you must apply a tight bandage or elastic bandage. Top of the ice or something cold.
After providing the first therapeutic measures, the patient must be taken to a medical institution.
In the emergency room, the doctor first examines the leg, if the pain is severe, and the leg swollen and blue, then the x-ray of the ankle is made. Additional methods of examination are:
- biochemical research;
They are prescribed if the pain has a long or moderate character. The basis for the treatment of fractures, dislocations, tears and stretching of the ankle is the application of gypsum.
In severe injuries, when there is a shift, you need to perform a surgical procedure. To remove the swelling, you need to take special medications that help splice the bones.
At the same time, you can drink vitamin D and calcium, mummies.
If the cause of soreness is arthritis or arthrosis, then the course of treatment changes. The main thing is to take nonsteroidal preparations of an anti-inflammatory nature.
You can remove pain with gels and ointments, for example, Diclofenac, Ibuprofen. Chondroprotectors are excellent for tissue repair, but they need to be taken with a long course.
A source: http://legsgo.ru/anatomy/gde-naxoditsya-lodyzhka.html
Fracture of the ankle: causes, symptoms and treatment
So, do you imagine an ankle fracture?
The article will consider fractures, the frequency of which takes up to 80% of all fractures of the ankle area and requires additional attention from people to understand the mechanism of injury, a clinic that can develop for a given type of damage, as well as options for it treatment.
A few words about anatomy
Fracture of the ankle brings not only considerable painful sensations, but also difficulties in walking and movement of the affected limb. Why is this happening?
The ankle, as is known to many, is medial and lateral. The medial is in turn a distal extension of the tibia, and the lateral, respectively, is peroneal.
On the one hand, seemingly at first glance, the common man is a meaningless bone, which only hinders, because It is not once in life strikes everyone about the corner of a bed or a table, plays a really considerable functional role. We will try to understand further which.
The medial process of the epiphysis of the tibia, referred to as the ankle or ankle (the common name is popular in the people) is covered with the articular surface of the ankle joint (GSS). He as part of this joint plays a role in the movement of the lower limb, for example, when running, climbing stairs and walking normally.
The lateral, which is the distal part of the fibula, in turn is also covered with the articular surface of the same articulation. Both ankles have a stabilizing function in the ankle, thus preventing unwanted trauma of the tendon-ligament apparatus of the GSS.
How does the joint stabilize? The lateral ankle in its position limits the anterior anterior displacement of the talus, and the medial ankle plays the role of a support for this bone from the inside. More clearly about this function is described in the video in this article.
In which case does an ankle injury occur?
In any fracture, the mechanism of injury plays an important role, since it is necessary to know that the doctor can assume the type of damage and conducted the appropriate diagnostics to confirm it, or, conversely, exceptions.
Fracture of the foot in the ankle, in turn, is quite trivial in the way it is formed.
The patient who applied for help at a traumatic point with this kind of fracture, will inform the staff about how he walked on an even or not and his leg slipped and turned up, after which he felt a sharp pain and could no longer stand on the damaged limb.
Trauma is a low-energy fracture, which puts older people at risk for this damage, especially older women. In addition to age-related patients, skiers, climbers and football players, known for frequent injuries of this anatomical area, are at risk.
The photo shows a standard fall, in which there is a fracture of the ankles.
Also, such a fracture can occur if a person stumbles and falls when walking.
In such a situation, the foot does not move with respect to the ground, since it was it that caught on ground or asphalt, but the body continues its movement forward for the first milliseconds.
In this case, the area of the ankle joint is tilted due to a mismatch between the position of the foot and the body, the talus bone in the turn is forcibly rotated or deflected in the joint, resulting in trauma to the lateral or medial ankles.
How to classify such fractures
The division of the ankle fractures into different groups differs depending on the purpose of their grouping. So one of the first classifications was developed in the middle of the twentieth century under the names Lauge-Hansen (English, Lauge-Hansen) in order to determine the method of fracture reduction. It was based not only on the position of the foot in the fracture of the ankle, but also the direction of the strength of the traumatic factor.
Its task is to simplify the choice of surgical intervention.
However, given some confusion of this classification, few doctors found it useful for their work.
A more simplified division of fractures used to this day is the classification of Weber, which focuses on the fracture of the fibula, therefore it is suitable for the separation of injuries lateral ankles.
Classification of Weber
Fractures of the lateral ankle are subdivided according to their level relative to the interdental syndesmosis (dense joint of the distal ends of the tibia due to fibrous tissue).
|Type of fracture||Radiographic image||Description|
|Type A||Fracture of the distal part of the ankle.||The fracture line is located below the gap between the tibia and the tibia. Occurs when a combination of internal rotation and adduction occurs;|
|Type B||Excessive external rotation is the reason for such a break.||The oblique fracture of the lateral ankle with an orientation from its anterior to the posterior surface;|
|Type C||The fracture is located much higher than the ankle.||An oblique fracture of the fibula with damage to the intercellular membrane.|
Variants of specific indirect fractures of the ankle
- Fracture of Dupuytren. This combined trauma of the ankle joint area is characterized by a double-arm fracture in combination with a rupture tibiofibular ligaments located between the tibial and fibular bones and subluxation in the GSS due to the disposition of the talus bones. Its second name is Pott's fracture. The complexity of this lesion leaves no room for conservative treatment.
- Volkman Fracture. Combines the fracture of the medial malleolus, fibula and metaepiphysis of the tibia. The latter feature distinguishes this type of injury from the fracture of Dupuytren. In this case, the fragment of the latter has usually a triangular shape.
- Masonryn fracture. It is more a copy of Dupuytren's fracture, having only one difference - the localization of the fracture of the fibula, where in this case the fracture line passes in its middle or upper third.
On the X-ray diffraction chart, Dupuytren's fracture, or Potta.
In each case, the signs of fractures may be slightly different, but more generally have a general picture:
- edema at the site of the fracture;
- severe pain syndrome;
- impossibility to stand on the affected limb;
- increased sensitivity of the damaged area.
Many patients who have applied for help in the trauma department are interested in why the ankle is turning blue at the fracture of the ankle. The explanation for this is simple - a bone fracture is accompanied by blood loss.
Blood in the case of closed trauma flows out of the bone and spreads between the muscles, connective tissues.
Over time, it folds, acquiring a bluish tinge of the skin above the site of the hematoma.
Sometimes patients are wondering whether it is possible to soar after an ankle fracture, but a high local temperature can trigger vasodilation and worsening of the leg.
In order to understand how the leg looks after an ankle fracture, it is necessary to realize the degree of edema that accompanies this fracture. Imagine that one of the extremities takes the form of a high-growth boot about to the middle of the shin. Approximately in this form is the affected leg.
Among the most frequent complaints of patients with this type of injury is a complaint that the leg does not bend after an ankle fracture. This is due to both the fracture itself and the edema in the damaged area.
A thorough diagnosis is very important for determining the type of fracture - its severity and degree of displacement if any, the complications, if any, play a decisive role in the choice of the approach in treatment. Whenever possible, always try to conduct the most minimally invasive treatment, for example conservative fracture management, but this is not always possible.
In turn, for the patient, only time is important - when stepping on the foot after fracture of the ankle and how to speed up the process of restoring the injured limb.
Before talking about how the patient is conservatively guided with a fracture of the ankles - consider the testimony for this:
- the transverse orientation of the fracture of the inner or outer ankle is below the level of the interarticular gap;
- Isolated fracture of the lateral ankle with a displacement of less than 3 mm;
- fractures with bias in the case where anatomical reduction can be achieved without the use of repeated manipulations;
- the presence of general somatic contraindications, which make it impossible to conduct surgical treatment.
The frequency of conservative treatment prevails over the operative in the fracture of the ankle.
Langget on the leg with an ankle fracture is used everywhere, and in the presence of rotationally unstable injuries, the leg is placed in a position at an angle of 90 ° in the ankle articulation and fix.
Many ask how to put a foot in the fracture of the ankle - it is worth betraying an elevated horizontal position, and for the first time to limit its vertical position with the direction of the foot down.
Surgical intervention is usually carried out by carrying out a metalosynthesis, for example, by fixing a metal plate. However, first you need to understand the testimony for him.
- fracture of the medial malleolus, the localization of which is higher than the level of the ankle joint ankle joint;
- ineffectiveness of conservative treatment;
- fractures with a displacement of more than 3 mm or the presence of subluxation in the ankle.
The price during the performed operation, if necessary, is a full movement in the ankle joint.
Surgical treatment with screws and mataloosteosynthesis in the case of a fracture of type C according to Weber.
The goal of the operation is not only to restore the length of the fibula in case of a fracture in it, but also to restore the joint surfaces of the ankle joint, which will restore the function in this joint and make possible full movement in German.
It is important to remember that the patient's activity with conservative treatment and operational is somewhat different. About that, for what day and how to walk around the leg after a fracture of the ankle will inform the specialist.
In addition to fixing fractures with displacement using metal plates, internal fixation is also used. In this case, the needles in the leg are set in case of an ankle fracture, so as to achieve all of the above surgical intervention goals.
Depending on the type of injury - the very approach to its treatment changes. So, in the presence of a rupture of syndesmosis between the tibial and fibular bones, special screws are installed.
Subsequently, the removal of the positioning screw with an ankle fracture occurs only if there is an x-ray confirmation of the fusion of the damaged fibrous interosseous plate. The load on the leg after fracture of the ankle is allowed only after the removal of this screw.
In this case, some orthopedists choose the option of starting loads on the limb even before the positioning screw is removed, however, in this case, the possibility of its fracture is not ruled out.
An experienced physician knows that in one operation or the imposition of gypsum as an option for nonoperative treatment, the matter does not end.
Recovering is a complex process, which requires mutual understanding between the doctor and the patient and the fulfillment of all prescriptions of the attending physician, both about activity, and up to such details, for example, how to keep a leg in a fracture ankles.
Recovery of lost functions takes time and effort of the patient.
Rehabilitation is an important step towards a full recovery.
Properly selected program to restore the affected limb will not only help you get back on your feet, but also prevent complications associated with early walking.
The physiotherapist will tell you not only how to stand up after an ankle fracture, but also what exercises to give preference to, how they must be properly performed to simultaneously stabilize the fracture, but not to damage the lower limb yet more. All exercises are selected individually, taking into account general somatic pathology and its complications.
A source: https://travm.info/patologii/perelomy/perelom-lodyzhki-547