The bimalleolar ankle fracture describes a fracture (fracture) of the ankle joint involving both ankles, the malleoli. Due to its structure and taut ligaments, the ankle joint is a very stable joint that supports the entire body weight in standing and walking. A fracture of the entire structure including both ankles, i.e. the ends of both lower leg bones (tibia and fibula) is therefore relatively rare and requires a considerable external force. Usually the trigger is an extreme twisting accident in sports.
Treatment/Physiotherapy
Bimalleolar ankle fractures are treated either by immobilization in a plaster cast or surgically, depending on the extent and concomitant injury to other structures. In both cases, physiotherapeutic follow-up treatment is performed, which is discussed in this article. The therapeutic measures are based on the respective healing phase.
Every healing in the body proceeds in certain stages.
- The goals of the first phase are decongestant, pain reduction and the avoidance of complications. Since the focus is still on protection, walking on forearm supports and correct everyday behaviour and positioning are also learned together with the treating physiotherapist.
Measures here are regular lymph drainage (removal of fluid), passive movement of the affected and adjacent joints, cooling and gait training. New tissue fibers have formed, which must now be adapted to their future tasks – meaning they need movement and stress, but still in moderation. Depending on the doctor’s instructions, the foot may and should be subjected to more and more load when walking.
Passive movement exercises are now replaced by active ones, slight resistance is set, muscles are trained again. Nerves and depth perception are also trained with electrotherapy, balance exercises and gait exercises such as walking on different surfaces. The extent of pain-free mobility is trained and constantly expanded.
In addition to these active measures, tense surrounding structures are stretched, massaged and loosened as support. The aim is to return to the full old ability to bear weight, freedom of movement and functionality. Strength exercises, gait exercises and everyday movements are trained to their full active extent. As soon as the pain has faded and the doctor gives his OK, the foot is fully loaded again without crutches and the gait pattern is optimized.
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