Joint Pain › Ankle Pain › [Broken Ankle]
Broken Ankles are usually the result of a high impact collision such as landing on your feet from a great height, or a ‘mis-step’ involving an inversion injury…
These are usually diagnosed correctly with imaging…
But, there is one that can get away from the diagnostician even with an advanced model x-ray machine…
A hairline fracture in the Talar bone can get mis-diagnosed fairly easily due to swelling in the area which occludes proper vision on radiograph films (x-ray)…
And it is this situation that causes ongoing difficulty; especially in athletes…
If you suspect that this is a situation that applies to you, it is a good idea to keep your ankle iced and bandaged for support until you have a firm diagnosis and can proceed from there…
Why Swelling Causes Misdiagnosis
The inflammatory process has four features, only one of which is swelling…
When we talk about swelling, we are referring to the part of the inflammatory process that involves a collection of water containing white blood cells that eventually collects as debris under the skin at the site of injury…
Movement of plasma, leukocytes and granulocytes increase dramatically as the inflammatory response broadens and goes through its four stages (heat, pain, redness and swelling) which each act as a component to stop the initial cause of injury buy protecting the area from the initial source of damage, remove the debris field, and finally, initiate the healing process of the wounded area…
It is necessary for the body to go through this process but it does have a habit of blocking the clarity and cleanliness of our x-ray diagnosis…
However, x-ray does not penetrate a covering of water…
A broken ankle consisting of a hairline fracture in a swollen ankle may be dismissed as artifact or not seen at all on film initially…
In the event that you have have been diagnosed with an ankle sprain that is refusing to clear up…
And by that I mean feels fine in the morning but gets progressively sore with weight bearing throughout the day, and will not allow a return to sport or normal movement without painful consequences; you may have a broken ankle …
Next is a list of the possible mis-diagnosed situations…
Sprained Ankle or Broken Ankle?
Scores of people have visited hospital emergency rooms and have left with a diagnosis of ‘sprained ankle’ when the correct diagnosis would state ‘broken ankle’ as the cause of ankle pain…
Ankles are tricky to diagnose, and often the initial set of exams and diagnostics does not reveal anything other than an impression of a sprain; which involves stretched or torn ligaments and this diagnosis has merit…but…a broken ankle will have stretched and torn ligaments an a break in the Talar bone…
Broken ankle fragments off the Talar bone are challenging to see and could be present and simply not visible as of yet…
They are like secret little injuries that keep themselves hidden under the swelling, and when that is gone, they come out with a vengeance…
These are seemingly small injuries that can have big consequences and any ankle injury should be monitored for a break…
Below is a list of of injuries that I have translated from a table published by “American Family Physician”…
As you can see, the Talar bone or Talus can be complicated…
Translation In Pictures
If you look at the pictures I have supplied, you can figure out each of the structures of the ankle in relation to where your pain is located…
If you can figure out –
Where the medial line is (which is straight down the centre of the body) this is your guideline to how everything else is described and located on the body…
- Lateral – outside of the medial line…
- Medial – Inside or on the medial line…
- Anterior – to the front of the body and medial line
- Posterior – to the back of the body and medial line
- Superior – higher in relation to another part of the body…
- Inferior – lower in relation to another part of the body…
If you can gain and understanding of this, I would say you can give yourself a quick, accurate exam…
Sometimes it can take a sprain, depending on how badly the ligaments are damaged, a long time to work itself out and return to normal, but if you are struggling eight months to a year later with pain and tenderness that gets worse through the day, it would be worth it to get another x-ray taken…
Sometimes in rare cases it takes an MRI or a C.T. SCAN (computed tomography) to get a proper visual on what has happened to the bony material, or to see if, for example, osteochondral material that has gotten torn off as can be the case in a Talar Dome injury…
You will need imaging to see if it is in situ or not, and to stage the injury to see if it will need surgical intervention…
If tissue has been torn or broken and is floating around displaced, it will require surgery and you will need to contact an orthopedic surgeon…
What ever the case, it is worth your while to get a definitive diagnosis and correct imaging so that your pain can be resolved and your ankle stays healthy as you age…
A List Of Talar Bone Injuries
If your injury occurred like one of these:
- Inversion with dorsiflexion…
- Eversion with plantar flexion…
For inversion with dorsiflexion:
Find the lateral Malleolus (look at the picture below) – If you find tenderness by pressing with two fingers in front and the Talar bone there may be a lateral dome break…
It is important to get this checked out because you may need surgery to correct it and keep the area from degenerating…
This may be a Lateral Talar process break…
Find the Lateral Talar process…
There will be point tenderness in front of and under the outside ankle bone…
Again, depending on the stage surgical intervention will be necessary to correct this and protect the health of the ankle…
For Inversion with plantar flexion
Find the medial mallelous (inside the ankle bone) – If you find that it is tender when you press on it, it may be a Medial Talar Dome injury…
Like the one above it may require surgery depending on the stage of deterioration…
If you experienced the force of a Hyper plantar flexion or forced inversion…
This could be a posterior Talar process break…
There will be tenderness upon deep palpation in front of the Achilles tendon on the outside of the ankle. Pushing off with the foot may reproduce the pain…
Get it checked and staged for treatment…
If you experienced a dorsiflexion with pronation injury…
this may be a posterior Talar Process break (inside the ankle)…
Pain and tenderness is produces with deep palpation between the inside ankle bone and achilles tendon…
Treatment is similar to lateral tubercle fractures…
If your injury was an inversion with plantar flexion can lead to an avulsion fracture….
This one will usually have a twisting downward motion…
With Forced dorsiflexion compression fracture…
If your foot was forced upward by a heavy force, this is the type of broken ankle you are looking at…
For both of these – if the bone is in situ, it will be treated with a compression bandage and nonweight bearing for four to six weeks…
If the bone is displaced surgical intervention will be needed…
As you can see, a broken ankle/Talar break can get complicated but it is worth it to get to the bottom of this condition as it can lead to ongoing or even permanent joint pain if left untreated…
Natural Pain Relief
Over the counter as well as prescribed pain relief medications are fast acting and potent, but what happens if you need to take them to manage your pain over a period of years, or for the rest of your life…?
You may wish to do some research and look into some natural pain relief remedies that will not have the toxic effects on your internal organs that most pain medications do after a lengthy period of time…
I have provided some basic information regarding supplementation that provides natural pain relief to help get you started – just click on the link below…
Joint Pain › Ankle Pain › [Broken Ankle]
Disclaimer – This is information on joint pain. I teach, but I do not diagnose, prescibe or treat people who contact me. You are responsible for your condition using your own best judgement combined with what you have learned. Just a heads up – bodies carry unusual differences from time to time, in saying that, you could be one of those rare and unusual beings; if you are in doubt, please contact a physician in your area, so you can rule it out.
Move Freely and Knowledgeably and Be Well!
Dr. Jo
P.S… “Greater certainty of your condition alone can be a powerful form of pain relief.”