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Ankle pain, injury and surgery

There are three bones in the ankle which are bound together by ligaments. Two of the bones, the tibia and fibula, run down the front of the leg alongside each other. The third bone, the talus, is a foot bone which slots between the two leg bones. They create a joint which is far more than a simple hinge.

Causes of ankle pain

Arthritis is a common cause of ankle pain. The main types are ankle arthritis, rheumatoid arthritis, psoriatic arthritis, gout and septic arthritis.

Sprains and breaks are the two most common injuries.

Types of injuries

An injury to the ligaments – This occurs when the foot twists, which normally results in a straight forward sprain. It is possible to damage the cartilage and small pieces of bone can tear off.

How to treat a sprained ankle – It is often recommended that ice and a bandage be applied to a sprained ankle. The ankle should also be rested however in some cases a visit to the hospital and further treatment is necessary.

Stability can be affected and physiotherapy/orthotics can be an effective treatment for this. In severe cases a ligament reconstruction may be necessary.

A break – It is often difficult to tell a break from a sprain when the injury first happens. There are some important characteristics of a break and if any of the below are present seek medical advice:

  • A cracking noise when the injury happens
  • The ankle appears deformed
  • The swellings gets worse three or four days later
  • The skin over the ankle joint is broken
  • The pain is acute in the bones around the injury

Typical treatment – Treatments for ankle problems normally include ankle arthroscopy, ankle replacement and ankle fusion.

A plaster cast is used in most cases and is normally left on for between six and eight weeks. A removable cast or special boot is sometimes used after the initial four weeks, which allows the patient to put some weight through the joint.

More severe breaks will require surgery. The procedure is known as an open reduction and internal fixation and involves using metal work to realign and fix the bone. The metalwork is normally left in place and is rarely removed.

Rehabilitation – This process can vary depending on the severity of the injury. In most cases it takes around 12 weeks to recover from a fractured ankle however this can increase dramatically depending on the individual injury. It is important to follow the advice of your surgeon on when to rest and exercise.

This page is intended for information purposes only and should not replace advice that your relevant health professional would give you.

Ankle pain, injury and surgery Consultants