Foot and Ankle Fractures

There are a number of common foot and ankle fractures that we will discuss here.







Malleolar fractures

The malleoli are the ankle bones. There is a medial malleolus (inside ankle bone) and a lateral malleolus (outside ankle bone). They may be fractured by a direct blow or fall where the force causes a sprained ankle, tearing the ligaments before the bone gives way under the stress. The additional ligament damage is often overlooked and can result in problems during the rehabilitation process.

It is not uncommon to fracture both malleoli. This is called a bimalleolar fracture The other type of malleolar fracture is called a trimalleolar fracture A trimalleolar fracture is an injury where there is a fracture of both the medial and lateral malleoli together with a fracture of the posterior lip of the tibia.

Malleolar fractures will be treated appropriately with immobilisation or internal fixation (plates and screws), followed by intense rehabilitation. Following foot and ankle fractures the joints of the foot can be very stiff post surgery and/or immobilisation in a cast and many weeks of work may be involved in the rehabilitation process.

Potts Fracture

This is an injury where there is a fracture of the lower end of the fibula, lower end of the tibia and displacement, usually laterally of the foot.

Calcaneal Fractures

The calcaneum is the heel bone. Calcaneal fractures are another nasty injury. They commonly occur as a result of a fall or jump from a height.

It is not uncommmon to see presentation of bilateral cases (fractures of both right and left heel bones). I have seen this injury on more than one occasion in young men convicted of a crime attempting to get away from police by jumping off or over a wall with a drop of unknown height on the other side. The landing resulting in the painful and debilitating fracture of both heel bones.

If the bone is not shattered it can be fixed surgically with pins and a cast. Internal fixation may not be possible if the damage to the bone is too great. In such cases the foot has to be immobilised in the best position possible. The joints of the foot are often severely affected by this type of fracture and there can be enormous variation in recovery levels following such injuries.