Foot and Ankle

Our feet and ankles are being used everyday for various daily activities. Hence, injuries to the foot and ankle are very common.

The ankle is made up of 3 bones that meet at the ankle joint: the tibia (shinbone), fibula (smaller bone of the lower leg) and talus (small bone in between the tibia and fibula and the calcaneus). The ankle joint where these 3 bones meet are encased by a joint capsule, which contains synovial fluid. This synovial fluid is important as it allows for smooth movement of the joints. The ankle is surrounded by ligaments, which help to stabilise it.

The foot is a complex structure of the body, consisting of 26 bones, 33 joints, 107 ligaments, and 19 muscles. The bones can be categorised into 3 sections:

Forefoot

The forefoot consists of your toes (phalanges) and metatarsals

Midfoot

The midfoot consists of bones that make up the arch of your foot

Hindfoot

The hindfoot consists of the heel and ankle, where the talus and the calcaneus (heel bone) are found.

Muscles, ligaments and tendons in the foot help stabilise your foot and allow for complex movement and motions. As there are many bones in the foot, fractures can occur at many locations in the foot, such as toe fractures, metatarsal fractures or calcaneus fractures. Another type of fracture that can occur in your foot is a stress fracture, which develop due to stress overtime.

Ankle Sprain

WHAT IS AN ANKLE SPRAIN?

An ankle sprain refers to an injury to the ligaments that support the ankle, where they get stretched and torn due to a force that is beyond the normal range of motion. A ligament is a tough band of fibrous connective tissue that connects bone to bone, usually holding structures together to keep them stable.

Sprained ankles mostly involve damage and injury to the lateral ligaments that are located on the outer side of the ankle.

WHAT ARE THE SYMPTOMS OF AN ANKLE SPRAIN?

Symptoms of an ankle sprain include:

  • Swelling and bruising at the ankle
  • Tender to the touch
  • Pain
  • Inability to put weight on the affected ankle
  • Decreased range of motion of the ankle
  • A “pop” sound may be heard when the injury occurs

WHAT ARE THE CAUSES AND RISK FACTORS OF AN ANKLE SPRAIN?

Common causes of an ankle sprain include:

  • Awkward landing after a jump
  • Twisting motion of your ankle
  • Walking on an uneven surface
  • When your foot gets stepped on during a sporting activity

WHAT IS THE DIAGNOSIS OF AN ANKLE SPRAIN?

A history of the injury and a physical examination of the ankle will be conducted by the Doctor. He may gently press on your ankle and move your ankle as well to check on your range of motion.

Imaging tests will be taken, such as x-ray to rule out other causes of pain such as a fracture, and a MRI scan to confirm the type of ligament tear.

Based on the damage done to the ligaments, ankle sprains can be classified into 3 categories:

  • Grade 1

Mild ankle sprain with no significant tearing to the ligament

  • Grade 2

Moderate ankle sprain with a partial tear to the ligament

  • Grade 3

Severe ankle sprain with a complete tear to the ligament

 

WHAT ARE THE TREATMENT OPTIONS FOR AN ANKLE SPRAIN?

The treatment method for an ankle sprain depends on the type of sprain sustained. Patients who sustain a grade 1 and grade 2 sprain can recover with nonsurgical treatment methods, such as:

  • RICE therapy (rest, ice, compression, elevation)
  • Medication such as over-the-counter pain relievers (acetaminophen) and nonsteroidal anti-inflammatory drugs (ibuprofen) to relief pain and swelling
  • Walking supports such as a brace or crutches to support your weight and let your ankle heal
  • Strengthening exercises to regain strength in your ankle and restore your range of movement. This is done when the initial pain and swelling has subsided and you are able to move your ankle

 

For patients who have sustained a grade 3 sprain or nonsurgical treatments have not helped after a period of time, surgery may be recommended.

 

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