What part of the ankle joint can be injured when I break my foot? A broken foot is a medical term for a “sprained ankle”. It refers to an injury in which the muscles, ligaments and even the joint capsule around the joint are stretched and torn by an external force that causes the foot and ankle to exceed its maximum range of motion, resulting in pain, swelling and limping. For example, an injury caused by stepping on another person’s foot while playing basketball and grabbing a rebound, or an injury caused by landing on the toe and the outside of the forefoot on a staircase. After a broken foot, the injured structures are not limited to the ankle, but the joints and ligaments between the bones of the front, mid and hind feet are usually damaged to varying degrees. The types of tissues injured include soft tissue injuries and bone injuries. Soft tissue injuries include injuries to the ligaments between the metatarsals, the articular ligaments between the tarsal bones in the forefoot and midfoot, the ligaments between the heel bone and talus in the hindfoot, the ligaments of the medial and lateral ankle joints, and the ankle capsule. Injuries to the osteochondral bone include: fractures of the outer ankle, fractures of the inner ankle, fractures of the posterior ankle, fractures of the talus, fractures of the fibula; injuries to the cartilage of the articular surface of the tibia or talus. Talus dislocation, ankle dislocation, etc. Why does pain persist after a broken foot? Reasons for pain after a broken foot: 1. Not receiving timely and correct treatment. After the trauma, our regular and accurate treatment is according to the RICE principle; that is, rest (Rest), ice (Ice), bandage (Compression), elevate the affected limb (Elevation); and in some folk traditions or concepts, we feel that immediately posting topical ointment or herbal medicine, rubbing bruise oil sprain will be better faster, and some injured people, after the injury Immediately after the injury with warm water or hot water “to disperse blood stasis and swelling”, I do not know, this way of handling more often cause secondary damage to the tissue and aggravate the tissue oozing blood, aggravate the pain. 2.Serious sprains that are not clearly diagnosed and do not receive enough attention and leave sequelae around the ankle joint, such as joint instability, ankle impingement or abnormal joint force lines after the sprain. When the ankle ligament is injured in the third degree, the ligament is completely torn or ruptured, often accompanied by articular cartilage injury, when the injured ligament is free in the joint can cause soft tissue compression and impact, leaving joint instability. 3.Ankle sprain due to the presence of primary disease, although the sprain is dealt with, the primary disease is not dealt with resulting in the lesion does not heal; for example, some patients often due to their own primary disease hidden, resulting in joint or muscle tendon relaxation, even if the slight violence appeared around the ankle injury; when the ankle sprain healed, its symptoms still do not subside or even more serious. For example, patients with ankle pigmented villous nodular synovitis usually have a long history of painful ankle swelling after a wiener foot; ankylosing spondylitis patients also have painful swelling of the ankle joint that migrates after an ankle sprain. 4. Tarsal sinus syndrome: Part of the ankle sprain will cause damage to the ligaments and surrounding structures between the heel and talus, especially the tarsal sinus, resulting in the formation of local scar hyperplasia, leading to disruption of the anatomical structure between them, and long-term pain on the lateral side of the ankle. What are the effects of ignoring a sprained ankle? Which part of the ankle joint suffers the most? Ignoring a sprained ankle is not conducive to the repair of damaged ligaments and osteochondral tissues, and in severe cases, the condition may be prolonged, affecting the quality of life and work. And the most suffering part is not what we think of as bones, people often say, ‘I’m relieved as long as I don’t hurt the bones’! In fact, in most ankle sprains, fractures are a rare occurrence, and more often than not, ligament damage occurs! And even if the fracture is often treated correctly and timely, in contrast, even if it is a ligament injury, many doctors believe that late treatment results in a good outcome; in fact, when the ligament is seriously injured, it cannot be treated accurately and timely, and the damage caused is quite serious, which will leave joint instability or chronic traumatic arthritis, resulting in a shorter joint life, and in serious cases, affecting the knee and hip joints and spine, leading to abnormal force lines. How should I be examined and diagnosed after an ankle injury? After an ankle injury, the first step of examination is to rely on the patient himself to observe whether there is swelling, bruising and the degree of pain at that time. The degree of injury is usually positively correlated with the severity of symptoms. When symptoms affect walking, it is necessary to go to a foot and ankle specialist or orthopedic clinic for examination. The examination includes a physical examination of the ankle joint and the injury site, ultrasound and X-ray of the ankle joint, and if necessary, further CT or MRI examinations. Is there any way to guide the patient to determine which part of the ankle joint is damaged? The patient can make a preliminary judgment based on the position of the injury and the area of swelling and bruising; for example, when the ankle joint is turned inward, it is often easy to damage the lateral ankle ligament; if you have relevant professional knowledge, you can use your thumb to lightly press the injured area, and the area with obvious pressure pain is usually the place of serious injury. However, for other more specialized physical examinations we recommend that patients come to a specialist clinic to avoid aggravating the injury. What is the early management of an ankle injury? Early management is the RICE principle. This means rest and braking (Rest), ice, compression and elevation. If the injury is mild (no swelling or pain), you can try to move the ankle in all directions and walk under protection; of course, if possible, rehabilitation after consulting a professional will be more beneficial for functional recovery. Why is the duration of conservative treatment stuck at 12 weeks? For more serious injuries, it takes about 3 months to repair tendon ligament or bone cartilage damage, as the old saying goes, ‘it takes 100 days to break a bone’. When can I consider surgical treatment? Early stage of injury: 1, there is a clear important ligament completely ruptured, if not early treatment will definitely lead to joint instability; if the lateral ligament is judged to be completely ruptured, stuck between the joints and difficult to reset or accompanied by avulsion fracture block, it can be repaired early; 2, there is a clear unstable fracture. Severe sprain can lead to outer ankle, inner ankle or even posterior ankle fracture or fibula fracture; 3. Those with high demand or athletes with third degree ligament injury should be handled more aggressively; 4. Patients with tarsal sinus syndrome whose conservative treatment is ineffective for 3 months; 5. Those with definite tendon rupture or free large osteochondral injury should be operated early. Late stage of injury: 1, ligament injury leading to joint instability and painful symptoms, surgical repair or reconstruction of ligaments can be performed to resolve joint instability; 2, intra-articular soft tissue entrapment or bone proliferation leading to joint impingement syndrome. Arthroscopy may be performed to clean up the hyperplastic tissue or free body; 3. Clearly identified lesions causing pain, such as tarsal sinus syndrome and pigmented villous nodular synovitis. Arthroscopy may be performed for cleanup. Why is there a 3-month gap between conservative treatment and surgical treatment? For some people who are difficult to judge the extent or even if the injury is severe, but the patient does not require a high level of joint function, conservative treatment is possible in the early stages. For example, in elderly housewives, even if the ankle ligament is third degree injured and the ligament is completely ruptured, we can still observe it after brace fixation in the early stage and gradually start functional exercise according to the condition. Moreover, the duration of conservative treatment is generally set at 3 months, because the healing time of the ligament or tendon often takes 12 weeks. After 12 weeks of regular rehabilitation, if the patient’s symptoms continue to show no improvement, the imaging results will be clearer and the surgery will be more targeted at this time. Will it heal after surgery? Most ankle sprains with definite ligament and tendon ruptures and fractures can be healed after surgery. Cartilage injuries, which the body cannot repair, heal mostly without symptoms in the early stages of treatment, but become less effective in the later stages. For ankle instability after repairing the ligaments, joint stability is often restored and symptoms disappear. Most tarsal sinus syndrome can be cured by arthroscopic surgery, while pigmented villous nodular synovitis will have its symptoms completely or partially disappear after surgery, but its recurrence may exist; traumatic osteoarthritis of the ankle joint can also be clearly relieved by surgical treatment if there is a clear cause or lesion; and for primary disease with ankle sprain, primary diseases such as gout and ankylosing spondylitis should be actively treated. How to evaluate the effectiveness of hot compress, small acupuncture and orthopedic massage? Hot compress 48 hours after sprain is beneficial for ankle joint recovery, which can promote local blood circulation and repair; small acupuncture and orthopedic massage may be effective for some patients, but the diagnosis and indications should be clarified before application. In the early stage of ankle injury, orthopedic massage and hot compress may aggravate the ligament injury, leading to increased swelling and pain, and the condition will not heal. Therefore, hot compress, small acupuncture and orthopedic massage are all treatments with their own indications and contraindications, and their blind use is not recommended if the diagnosis is unclear.