Anatomy
Each foot has two ankles: the outer ankle is part of the fibula, while the inner ankle is the end of the tibia. In a healthy person, the inner ankle is physiologically slightly higher than the outer ankle. Together, the two ankles – known as the malleolar fork – form the socket for the upper ankle joint.
- Outer ankle (lateral malleolus)
- Inner ankle (malleolus medialis)
By moving the ankle roll in this socket, the foot can be raised by 20° and lowered by 30°, making it a hinge joint. This joint is reinforced by additional ligaments on both sides: outer ligament consisting of 3 parts: Ligamentum talofibulare anterius and posterius and Ligamentum calcaneofibulare
- Outer band consisting of 3 parts:
- Inner band (medial ligament, deltoid band)
Ankle fracture
The ankle fracture (malleolar fracture) is one of the most common injuries in the lower extremity. These fractures are often caused by bending over. Either only ligament injuries occur or parts of the ankle are broken off in the process.
If one bends away outwards, both ankles can break. If you bend inwards, only the outer ankle is affected (outer ankle fracture). The inner ankle breaks slightly more frequently than the outer ankle, but both ankles can also be affected (bimalleolar fracture).
The fracture causes severe pain and swelling in the area of the ankle, and the movement of the foot may be restricted. The X-ray image then shows the fracture lines. Depending on the extent of the fracture and the malposition, the treatment is carried out with a plaster cast or by surgery.
Rupture of the outer ligament
Rupture of the outer ligament (ankle joint distortion) is often caused by outward twisting during sports (especially soccer, volleyball, basketball) and is the most common ligament injury in humans. A distinction is made between overstretching/tensioning and ligament rupture. Such injuries always result in the formation of a hematoma with swelling of the surrounding tissue and a resulting restriction of movement.
In addition, it hurts especially when pressure is applied to the outer ankle and when overstretched (sole of the foot inwards). It is important to provide absolute relief and cooling of the injured ankle. An x-ray should always be taken in order not to miss any bone fractures.
If the outer ligament is only stretched and the joint is stable, an elastic support bandage should be applied. If there is little instability, immobilization with special splints must be used for about 30 days. If the joint is unstable or the ligament has torn at the bone, surgery is performed with suture of the ligament or suture to the bone.
In addition, the joint should always be exercised physiotherapeutically to prevent stiffening. When the joint can be fully loaded again depends on the healing process, but this can take up to 3 months.