1. This shows the ankle joint, with many of the bones and connecting ligaments. This is a complex joint that can be injured in many ways, including OCD lesions, ligament injuries (ankle sprains), and fractures.
2. This shows a trimalleolar ankle fracture before and after surgery.
The Ankle Joint
The ankle is a complex structure of muscles, tendons, ligaments and other soft tissues hold the ankle together. The talocrural joint, commonly referred to as the ankle joint, is capable of a variety of movements and carries the weight of the entire body. The ankle can be injured by acute trauma, sports, or wear and tear. Athletes and individuals 65 and older more frequently experience conditions affecting the ankle, which include fractures, sprains, tendonitis, arthritis, bursitis, and flatfoot.
OCD Lesions (Osteochondritis Dissecans Lesions)
Osteochondritis dissecans (OCD) lesions are lesions of cartilage and bone. Acute trauma like a severe ankle sprain or chronic malalignment or instability causes a loss of blood supply to the bones of the ankle, causing pieces of bone to break off. Symptoms vary on the severity of injury, but can include pain that worsens with activities, clicking and popping sounds, and swelling. It can be treated conservatively with activity modification, and immobilization. More severe injuries may need corticosteroid injection or surgery (if part of a bone has completely detached). Recovery from surgery normally lasts around eight weeks, with a cast.
Ligament Injuries (Ankle Sprains)
Ankle ligaments are a type of slightly stretchy tissue that connects bones within the ankle. An ankle sprain occurs when one of the ligaments of the ankle is torn. This is often caused by falling, someone stepping on your foot, or walking or running on uneven surfaces. Sports like soccer, tennis, and basketball that involve cuts or rolling the foot can also increase the risk of these injuries. Given the variety of ligaments in the ankle that can be torn, grades of severity, and an individual’s own pain and risk for future injuries, treatment for these injuries varies.
Ankle fractures occur when one or more of the bones in the ankle is broken, which are the tibia, fibula, and talus. Ligaments are commonly injured alongside fractures, creating the potential for instability and complications in the joint.
Fractures of the bones of the ankle can be caused by twisting, tripping, falling, or high energy trauma like car accidents. They can also be caused by stress, particularly in an active person who decides to dramatically increase their activity. The elderly are also at risk for these injuries. Treatment for these injuries depends on instability and alignment, as even a slight degree of malalignment can lead to arthritis, especially if there are multiple bones broken.
Attribution for Images
1.OpenStax College. "919 Ankle Feet Joints". Wikimedia Commons, 19 May 2013, https://commons.wikimedia.org/wiki/File:919_Ankle_Feet_Joints.jpg.
2. Chaim Mintz. “Trimalleolar Ankle Fracture”. Wikimedia Commons, February 1, 2017, https://commons.wikimedia.org/wiki/File:Trimalleolar_Ankle_Fracture.jpg.
3.Talento Tec. “03042012Ccm gamosuma juvenilA232”. Wikimedia Commons, March 4, 2012, https://commons.wikimedia.org/wiki/File:03042012Ccm_gamosuma_juvenilA232.JPG.
4. Lorie Shaull. “Carli Lloyd”. Wikimedia Commons, 4 September 2019. https://commons.wikimedia.org/wiki/File:Carli_Lloyd_(48677254417).jpg.