Etiology: Tian Hongtao, Department of Orthopedics, Wuhan Union Medical College Hospital Mostly caused by indirect violence, mostly due to sprains during plantarflexion (i.e., direction of the tensed foot). Mostly seen in adolescents. Clinical manifestations: obvious ankle swelling, ecchymosis, inversion or eversion deformity (depending on the mechanism of injury), impaired mobility. Limited tenderness can be detected at the fracture site. Treatment: Plaster immobilization for 6-8 weeks: simple internal or external ankle fractures without displacement and without separation of the subtalar union. Fixation in an ankle inversion position for internal ankle fractures and an ankle outversion position for external ankle fractures. Surgical incisional reduction and fixation: simple internal or external ankle fractures with displacement, those with separation of the inferior tibiofibular union, and vertical compression fractures. RECOVERY: EARLY RECOVERY (6-8 weeks postoperatively) REDUCING SWELLING During the initial phase of recovery, one needs to concentrate on reducing swelling. Lie flat on your back or sit with your upper body in an upright position with your legs straight. Gently bend your ankle, bringing your toes closer to your knee, until you feel a slight stretch in your ankle and calf muscles. Slowly bend the injured ankle again, moving the toes away from you. Slowly return to the original position. Relax for 10 seconds and repeat 10 times. Use a couch as an exercise tool to strengthen the short peroneal tendon, which prevents your ankle from going into disuse. Standing on a couch, press the inside part of your injured foot against the bottom of the couch, press your foot into the couch and hold for 10 seconds. Relax for 10 seconds and repeat 10 times. Aquatic Exercises Some therapeutic exercises can be performed in water to reduce pain while increasing flexibility and strength. The buoyancy of the water supports most of the weight and reduces stress on the joints. Water also strengthens muscles through its natural resistance properties. To improve your ankle function, get into chest-deep, warm water and stand or sit on a step, with your back against the side of the pool. Begin some exercises by straightening your knees and slowly rotating your ankles. Gently and slowly move the ankle clockwise on the injured side. Rotate 5 times, return to the original position and relax for 10 seconds. Repeat 10 times, then do it counterclockwise 10 times. Towel Stretch Relaxing stiff muscles plays an important role in returning the ankle to its normal level. Sit on an exercise mat or the floor with your legs straight. Place the injured foot in the center of a towel. Pull on each side of the towel with one hand. Gently pull on the towel until you feel a slight stretch in your calf muscle. Keep your back straight. Hold for 20 seconds. Slowly return to the original position. Relax for 10 seconds and repeat 10 times. Post-recovery (after 8 weeks) Plantar Flexion and Dorsiflexion Stretching your ankle will help increase your range of motion after a fracture. Sit down and lift the leg on the injured side off the floor until your hand can touch your foot. Relax your foot. Place your hands on your toes and gently press them down so that the toes are pointing towards the ground, this is plantarflexion. Keep pushing until you have a stretching sensation in your ankle. Hold for 30 seconds and repeat 5 times. In dorsiflexion, place your hands on your heels and elevate your ankles with your toes pointing toward the ceiling. Do this until you feel the stretch in your ankles. Hold for 30 seconds. Relax and repeat. Repeat the full set 5 times. Inversion and eversion Sit down with your feet relaxed. Place your hands on your ankles and slowly move your ankles so that your feet face outward – pronation. You will feel a stretch on the inside of your ankle. Hold for 30 seconds. Relax and repeat 5 times. Next, move your ankle with your hand so that the ball of your foot faces inward – inversion. Do this until you get a stretch on the outside of your ankle. Hold for 30 seconds and repeat 5 times. Balancing Exercises If you don’t use your ankle for a long period of time, you may not be able to support your weight because you are weaker. Help keep your balance by keeping your injured leg upright, your healthy calf elevated to your knee, and your arms straight out on either side. Stand close to a wall or chair for support if needed. Attempt to maintain balance for 60 seconds. Repeat 5 times. If you can complete this exercise, try closing your eyes, standing on a pillow or keeping your hands pressed against the sides of your body. Gathering a towel Gathering a towel around your feet can improve flexibility and function after a broken ankle. Place a towel flat on the floor in front of a chair. Sit back in the chair. Remove your socks and shoes. Use your toes to gather the towel. Start at the end closest to you and work your way toward the other end. Once you’re done, unfold the towel with your toes. Relax and repeat 10 times. Stay tuned for video instruction. (Image from the Internet) Author: Tian Hongtao, Wuhan Union Orthopaedic Hospital Title: Associate Professor, Deputy Chief Physician Specialty: Artificial Joint Replacement Joint Diseases: Necrosis of the femoral head, Osteoarthritis of the knee, Rheumatoid rheumatoid arthritis, Ankylosing spondylitis, Joint infections, Bone and joint deformities; Outpatient Clinic Hours: All day every week, 1, 3, 6; Contact: Tel: 13908622515 Welcome to pay attention to me! Welcome to pay attention to my WeChat public number Bone outside the handsome Tian Dad or Sina microblogging @ Bone outside the handsome Tian Dad