Compound Ankle Fracture: Types, Symptoms, and Treatment

By Tim Wall, ATC, LAT

Understanding Compound Ankle Fractures

A compound ankle fracture is a serious injury that requires immediate medical attention. It is crucial to comprehend the nature of this compound bone fracture, its causes, symptoms, diagnostic procedures, compound ankle fracture treatment options, and prevention strategies. This article aims to provide detailed information on compound ankle fractures, thereby helping you make informed decisions regarding your health.

What is a Compound Ankle Fracture?

The quick answer, a compound ankle fracture can be debilitating and needs medical attention. Ankle injuries are among the most common types of injuries, ranging from sprains to fractures. However, compound (or open) ankle fractures are less common than the typical ankle sprain and can become far more problematic. In compound ankle fractures, a fragment of the involved bone breaks through the skin and causes an open wound.  This condition is different from other fractures due to the risk of infection from the external environment. Ankle fractures occur in various forms, but compound fractures are among the most serious and require immediate medical attention. Common causes of compound ankle fractures include high-impact accidents, falls, and sports injuries. If you ever find yourself in this situation, JOI has the most experienced team of orthopedic surgeons in North Florida to get you back on the road to a full recovery.

 

Anatomy of the Ankle

• The ankle joint has three bones:
  • Tibia (Shinbone): Makes up the inside or medial side of the ankle joint.
  • Fibula: Parallels the tibia and makes up the outside or lateral side of the joint.
    • The far ends of the tibia and fibula come together to form an arch and sit atop the talus. The singular form is the malleolus.
    • The tibia makes up the posterior and medial malleoli, while the fibula makes up the lateral malleolus.
  • The talus transfers the forces from the tibia to the heel bone (calcaneus).
  • The bones of the ankle joint are held together by a joint capsule. Several ligaments provide stability to the ankle. If any of the ligaments or soft tissues have an injury, it may lead to chronic ankle pain and instability.

Identifying a Compound Ankle Fracture

Recognizing the symptoms of a compound ankle fracture can expedite the compound ankle fracture treatment process. Symptoms typically include severe pain, visible deformation, and sometimes, an exposed bone. Certain risk factors such as engaging in high-risk sports, osteoporosis, and previous ankle injuries can increase the likelihood of sustaining a compound bone fracture.

How Do You Get a Compound Ankle Fracture?

A variety of different mechanisms causes compound ankle fractures. However, the most commonly occur from a high energy event such as a fall from a height, motor vehicle accident, or a sports injury. Often, these injuries will be present with other significant injuries.

If you would like to learn more about Tibia and Fibula Fractures, this ARTICLE may help.

Diagnosing Compound Ankle Fractures

Medical professionals employ various examinations and imaging tests, including X-rays and CT scans, to diagnose compound ankle fractures accurately. These procedures help determine the type and severity of the fracture, which is crucial for deciding the most effective treatment plan. It’s also important to differentiate compound ankle fractures from other conditions that may present similar symptoms, such as sprains or simple fractures.

What are Compound Ankle Fracture Treatments?

Compound ankle fractures require prompt and effective treatment. Initial care generally involves emergency measures to control bleeding and minimize pain. Compound ankle fractures require a different treatment than closed (no break in the skin from a bone fragment) fractures. Due to the break in the skin, bacteria and other contaminants from the outside environment may cause an infection. For this reason, it is of the utmost importance to seek emergent medical treatment. The compound ankle fracture treatment often includes surgical intervention to realign the bone fragments and repair the wound. Non-surgical treatments may be considered depending on the type and severity of the compound fracture. After treatment, a comprehensive rehabilitation program is essential for restoring ankle function and promoting recovery. The broken ankle rehab time and fracture recovery time ankle can vary based on the severity of the injury.

 

Surgical Intervention

• Since compound fractures pose an immediate threat of infection, cleansing of the wound and administering antibiotics are necessary steps to prevent further contamination of the tissues.
  • Following the tissues’ debridement, the patient will be placed in a splint until the surgical team determines that it is safe to proceed with the surgery.
• If the wound is more complex than a puncture, and the tissue and bones are not yet ready for a permanent implant, an external fixator can be placed on the involved limb to heal wounds.
  • An external fixator is a frame that is on the outside of the limb to stabilize the bones. Once the wounds are healing and the physician deems the patient is ready for a permanent implant, the MD removes the external fixator.
• The primary surgical intervention often involves fixation with plates and screws to stabilize the fractures and allow the bones to heal in an anatomically correct position.
• Following the surgery, the patient will be placed in a cast or boot and remain non-weight bearing until the physician determines the bones and incisions have healed and the patient is ready to progress to therapy.

 

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  Walking Boot

Post-Operative Recovery after Ankle Surgery

The time it takes for the patient to fully return to daily living activities can vary greatly depending on the severity of the injury. It is common for patients to experience pain, stiffness, and weakness for several weeks to months after the surgery. Your physician and physical therapist will develop an individualized program specific to the injured body part. This will include a range of motion and strengthening exercises to help restore function. The recovery time will also depend on the patient’s cooperation. Exercises are for the patient’s best interest in mind to help them return to activity as quickly and safely as possible.

Prognosis 

The prognosis for compound ankle fractures depends on several factors, including the severity of the fracture, the patient’s overall health, and the effectiveness of the compound ankle fracture treatment. Most people can expect a significant recovery with proper treatment and rehabilitation. However, potential complications such as infection, nerve damage, and arthritis may occur. Understanding these long-term implications is essential for managing expectations and planning for the ankle break recovery time and fractures ankle recovery time.

Preventing Compound Ankle Fractures

Preventing compound ankle fractures involves maintaining strong, healthy ankles and taking protective measures during high-risk activities. Wearing appropriate footwear, warming up before exercise, and maintaining a balanced diet for bone health are all strategies that can help prevent these severe compound fractures. Being aware of the risks and taking precautions can significantly reduce the likelihood of a compound bone fracture.

Related Articles: Lower ankle sprain and Ankle Fracture. 

Where Do I Go If I Think I Fractured My Ankle?

The Jacksonville Orthopaedic Institute has the area’s top Foot & Ankle Specialists to help you. JOI is Northeast Florida’s most respected orthopedic practice.  With several convenient locations, we are ready to get you on the Road to Recovery.  To schedule for physical therapy, please call 904-858-7045.

Schedule with a JOI Orthopedic Foot and Ankle Doctor, call 904-JOI-2000, schedule online, or click the link below.

By: Tim Wall, MS, ATC