Healing time of an external ankle fracture

introduction

The outer malleolus fracture (distal fibular fracture = fracture of the lower fibula) is one of the ankle fractures that occur relatively often in people, especially in the context of sports injuries. In over 80% of cases, an external malleolus fracture occurs as a result of a traumatic injury in the form of a dislocation (Subluxation or dislocation) of the ankle bone from the ankle fork, with which it forms the ankle joint. This is usually caused by a misstep or fall, i.e. an ankle injury. Depending on the position of the foot during the injury and the forces acting, different injury patterns can occur.

The most common is the Danis-Weber classification, which divides the fractures according to their location in relation to the syndesmosis. The syndesmosis is a fake joint, the tibia (Tibia) and fibula (Fibula) holds together.

An external malleolus fracture can be described more precisely with the help of the common AO classification (Working group osteosynthesis), into which all fracture forms can be divided exactly. Regardless of the type of fracture, the prognosis of a lateral malleolus fracture is consistently good. The prerequisite, however, is that the bone parts must be precisely returned to their anatomical, physiological position (Reduction).

Conservative therapy

In principle, both a conservative (non-operational), as well as surgical treatment. However, conservative treatment can only be offered insofar the break did not move (dislocated) is and the syndesmosis unharmed stayed. This is for example with simple External ankle fractures below the syndesmosis or non-displaced outer ankle fractures at the level of the syndesmosis without injuring the same. Therapy then usually consists of the six weeks of wearing a plaster cast. The time it takes to completely heal varies from patient to patient. How badly affected leg After the plaster cast has been removed, it depends to a large extent on the individual healing process that the doctor goes through X-rays controlled. As a rule, however, after approx. 3 to 6 months intensely stressful sports such as tennis or running can also be carried out again.

Even with conservative therapy there are complications, albeit very rarely, that can significantly delay healing. In a few cases it can be Slipping of the fracture (secondary dislocation) come, which then usually must be resolved operationally. Furthermore, wearing the plaster cast Pressure damage cause that additionally limit the functionality of the ankle. In addition, between the fracture parts a Pseudoarthrosisto form a wrong joint. If, depending on the affected person, one speaks of a pseudoarthrosis bone, Months after a fracture no firm bony connection between the bone fragments originated. The consequences are prolonged pain, Functional restrictions as well as a abnormal mobility of the respective part of the skeleton.

Another complication that resulted from Soft tissue and nerve injuries as part of the fracture is the Sudeck's disease. A largely unknown mechanism leads to an irregular healing process with symptoms such as Pain at rest, muscle weakness, a tremor, excessive sweating or edema. However, the above-mentioned complications occur extremely rarely in the conservative treatment of an external malleolus fracture. Complaints like a Numbness or Swelling can persist for a few months, but then usually go away. Chronic complaints such as permanent pain or functional impairment are not to be expected in the vast majority of cases.

Appointment with ?

I would be happy to advise you!

Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)

Athletes (joggers, soccer players, etc.) are particularly often affected by diseases of the foot. In some cases, the cause of the foot discomfort cannot be identified at first.
Therefore, the treatment of the foot (e.g. Achilles tendonitis, heel spurs, etc.) requires a lot of experience.
I focus on a wide variety of foot diseases.
The aim of every treatment is treatment without surgery with a complete recovery of performance.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

You can find me in:

• Lumedis - your orthopedic surgeon
  Kaiserstrasse 14
  60311 Frankfurt am Main

Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
Further information about myself can be found at Dr. Nicolas Gumpert

Operative therapy

In most cases, however, ankle fractures such as the lateral ankle fracture require surgical treatment. That includes everyone displaced external ankle fractures or fractures where the Syndesmosis injured has been. It is crucial for the success of the therapy that the Ankle axis, length and rotation precisely restored can be. This should be the operation in the first six hours after the injury.

exceptions are open fractures, the one Emergency indication for surgical treatment and massive swelling, as a result of which the operation has to be postponed for a few days. Depending on the injury pattern, surgical treatment is carried out with the help of Screw or plate techniques, or a combination of both. Here, a millimeter-accurate restoration of the anatomical ankle joint relationships is of great importance, as otherwise the wrong load will result premature joint wear can come (post-traumatic ankle arthrosis). After removing the wound tubes (Drainages) On the 2nd day postoperatively, the first x-ray control image is usually taken. The Sutures are pulled after about 10 to 14 days.

If the operation was successful, the patient should have a early functional follow-up treatment of the lateral malleolus fracture Tobe offered. Functionality and mobility of the ankle are under Relief of the affected leg operated on. For this the patient should Forearm crutches for mobilization for at least 6 weeks use. Bed rest with a plaster cast is only necessary in the rarest of cases. After about 6 weeks, the build-up of stress can begin after an X-ray check. Here the support is from physiotherapy exercises highly recommended. A smooth gait should be achieved after approx. 8 weeks. After 3 to six months at the latest, intensely stressful sports such as tennis or running are possible again. Plates and screws are usually removed after approx. 1 year. In addition to the complications that result from conservative therapy, surgery can still result in additional delays in healing. So can during the operation Vessels, tendons, or nerves get hurt.

Furthermore, every surgical procedure has a certain aspect Risk of infection, which can sometimes drastically limit the healing of wounds and fractures. In rare cases it can lead to Loosening of implants that must subsequently be correctly positioned again in a further operation. Especially with ankle and ankle fractures there is a risk of thrombosis or one of the following Pulmonary embolism is relatively high, it should be sufficient for both surgical and conservative treatment Thrombosis prophylaxis (e.g. with Heparin syringes) respectively. However, all of these complications are rare, so that complete healing can be expected even after surgical treatment of a fracture of the outer ankle.

Summary

Regardless of the fracture type Outer ankle fractures a very good prognosis. After approx. 2 months normal, moderate loading of the affected leg is possible again, after 6 months at the latest, sports such as running or soccer can be performed again. Complications rarely arise with either conservative or surgical therapy. There are also long-term effects like chronic pain or functional impairment not to be expected.