Fracture of the ankle.

Among all injuries, a large proportion is occupied by injuries of the limbs. Quite often there is a fracture of the ankle.

The ankle is an appendage that forms the ankle joint. This joint consists of two ankles: lateral (located on the outer surface of the shin) and medial (located on the inner side). According to statistics, twenty percent of all injuries to the musculoskeletal system is the fracture of the ankle.

The external (lateral) ankle is most at risk of trauma and fracture (about eighty percent of cases), and only fifteen to twenty percent falls on the medial trauma.

There are several types of fractures , depending on the features of mechanics: supination-leading, prone to retraction and rotational. In addition, in separate groups a fracture of the external and internal ankles is distinguished, as well as open and closed fractures, fracture with displacement.

Symptoms of ankle fracture are pain, swelling, joint articulation, and impaired function. To confirm the fracture, as well as to establish its mechanics and choose the method of treatment, an ankle is taken.

Treatment of an ankle fracture is extremely difficult. First of all, this is due to the fact that the structure of the ankle joint is very complicated, the bones are superficial, the bloodstream in this area is very easily injured. This causes a high percentage of disability of the population as a result of an ankle fracture (up to ten percent).

Fracture of the ankle, the treatment of which was not performed, leads to a violation of the articulation of articular surfaces (congruence of the joint). This causes permanent pain and threatens the formation of deforming arthrosis. This disease leads to violations of statics and joint dynamics, which often ends in disability.

Treatment of an ankle fracture is reduced to two basic methods: conservative and operative treatment. Conservative treatment includes:

- closed manual repositioning, gypsum immobilization;

- closed repositioning with the aid of reponating devices, plaster bandages;

- reposition by stretching with correction in the future. The most common was a manual closed reposition with the imposition of a plaster bandage. In this case, a plaster bandage is applied to the upper third of the shoe type "sapozhok."

Disadvantages of conservative methods of treatment:

• complete anatomical reposition is not possible.

• In a plaster bandage, there is a high risk of developing secondary dislocations after reducing edema.

• it is possible to form recurrences of intercostal diastasis and subluxation of the foot.

With an increase in edema of the joint, there is a possibility of forming epidermal blisters under the plaster bandage. In addition, the risk of formation of postimmobilization contractures of joints is high , rehabilitation in which it can take up to eight to twelve months.

The objectives of surgical treatment are: accurate comparison of fragments, restoration of the ligamentous apparatus, removal of fragments of cartilaginous tissue, and also the conduct of stable osteosynthesis.

Surgically, an ankle fracture is treated with internal (submerged) or external osteosynthesis. The greatest success is achieved with osteosynthesis with screws, as, unlike spokes, this variant of osteosynthesis creates the possibility of accurate comparison of all bone fragments. However, the use of osteosynthesis by means of screws does not allow to resist the forces acting on the bone, therefore, an additional application of the plaster bandage is necessary.

Fracture of the ankle, in which prolonged immobilization was performed, can lead to serious complications.