Depending on the extent of the ankle joint bone, the classification and accordingly the treatment is determined. Decisive for a classification according to A-D fractures is the height of the fracture. In the case of an A and B fracture, the foot is protected in a Lightcast splint or Vacoped shoe for 6 weeks. These patients are allowed to put on 15-20kg in the first 6 weeks, which is practiced immediately after the treatment with a physiotherapist. From the 7th week on, depending on the pain, the weight may be increased to full weight bearing.
Exercises
The exercises for an ankle fracture depend on the phase of wound healing. In the early phase, care should be taken in both treatment options to ensure that no movement takes place in the upper ankle joint. In order to avoid swelling, the foot can be elevated and supported by the manual lymph drainage of a therapist.
For further information please refer to the articles:
- Stress after an ankle fracture
- PNF (Proprioceptive Neuromuscular Facillation)
- Physiotherapy for ankle fracture
- Spiral Dynamics
- In order to train the support phase while running, you can directly start with support strength training. This can be done by using supports on the edge of the bed or a chair back with your hands. In order to avoid stress on the foot, a therapist can help to achieve muscular tension across the diagonal of the body (PNF pattern).
The patient stretches with the arm “upwards outwards” against the set resistance (e.g. through a wall or the therapist’s hand) and thus ensures that the tension runs into the affected opposite leg.
- PNF is a therapeutic treatment technique and includes 3-dimensional movements that are typical in everyday life. With this treatment technique, in addition to mobilization, strength can also be improved. It addresses the extremities in each case hand, elbow and shoulder, as well as hip, knee and foot, so that complete tension is created.
The technique proceeds in a specific direction of movement and setting. If the foot is not under load, it cannot be included in the movement, but the PNF Leg Pattern can be performed for the hip and knee muscles. The therapist guides the leg into a final flexion, outer rotation and abduction or flexion, inner rotation and adduction (combinations must be adhered to according to the PNF), whereby the knee is also flexed and the foot is left in a neutral position.
Then he returns the leg to the stretched position and repeats the procedure until the patient is able to carry the movement along without error. To achieve muscular tension, the therapist lets the patient perform the direction of movement independently and also gives resistance in the specific directions of movement. The patient can also perform the exercise without guided resistance to avoid a large loss of strength in the leg.
- In addition to PNF techniques, exercises such as riding a bicycle lying down without involving the feet are suitable for maintaining muscle strength.
As long as a load is not allowed, no exercises with pressure over the foot, such as knee bends or bridging, may be performed.
>If the load is released and the set screw removed, all exercises from the strength training can be performed carefully. It is also important to ensure a good gait pattern, as movement restrictions may have occurred. This can be restored with gait training.
The rolling motion should be practiced consciously and in front of a mirror. To improve proprioception and mobility, exercises on uneven surfaces are recommended. Such exercises can be found in the article Coordination and Balance Training.
Likewise, stability can be improved by using the other leg when tentacle movements are performed. The exercises should not cause any further pain and the course of wound healing should be discussed with the doctor. Further exercises can be found in the articles:
- Exercises for an ankle fracture
- Stress after an ankle fracture
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