History: Patient (pt) came into the ER stating that they severely sprained their ankle a few days ago while exercising. They made the decision to come to the ER since the pain and swelling would not go away. Upon examination, there was evident swelling to the right ankle and the pt was not able to perform eversion/inversion. Some flexion/extension was still possible at the ankle joint, but with pain 9/10. X-rays have been taken and presented with a clear fracture to the lateral malleolus, possible tearing of the deltoid ligament, and a malunited talocrural (ankle) joint. Based on these results, it could be determined that this injury resulted from a severe eversion sprain which caused a malunited ankle fracture. With such injury, the ED staff called for an orthopedic physician to come down, assess the injury, and determine the next action(s) to be taken. From there, it was determined that this pt will have to go through reconstructive surgery to repair the fractured bone and properly realign the ankle joint.
Q: Can this pt fully recover from such injury? Will they have the same function(s) at the ankle as they had before their injury took place?
A: The primary goal for treatment of ankle fractures is to restore full function to the extremity. However, malunited ankle fractures are the most common and most difficult to reconstruct during surgery. Based on a review found about this topic, it was determined that subjective outcomes are good or excellent in more than 75% of pt’s. Along with this, it was found that the sooner a pt goes into surgery, the better their outcomes are for full recovery and function(s). There are many factors that come into play when trying to see if this pt will fully recover and if they will have the same ankle function(s) as they had in the past. Full recovery is possible, but additional factors and follow-ups are needed to ensure this pt is on the right path to recovery. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150649/