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Forum Name: Bone trauma and fractures

Question: Ankle sprain or fracture?


 holydivinity - Mon Nov 16, 2009 1:37 pm

I badly rolled my ankle last week playing basketball and am still experiencing discomfort. I am (and have been) able to move my toes and even put limited weight on my foot. I can walk now, but have a slight limp. There is swelling on both sides of my foot towards the soul of my foot. It has been exactly 7 days since the injury. I've sprained my ankle in the past, and was typically fully recovered within 4-5 days. I have taken all necessary steps to reduce swelling (elevation + icing), which has subsided the swelling, however, as I've mentioned, I still have a slight limp. I haven't seen much improvement in the last 2-3 days. Just wondering if I should be concerned that it might be something more serious than an ankle sprain. Thanks
 Dr.M.Aroon kamath - Mon Feb 08, 2010 8:47 am

User avatar Hi,
Missed fractures (occult fractures) around the ankle and in the foot do occur at times.
The most commonly missed fractures are that of the talus, the bone that articulates with the lower ends tibia and fibula, forming the ankle joint proper.
Other fractures that are known to be missed at first presentation are...
- fractures of the base of the fifth metatarsal bone,
- calcaneal stress fractures ,and
- tibiofibular syndesmotic injuries.

Fractures of the talar dome (the most commonly missed), are usually the result of inversion injuries of the ankle. They are located medially or laterally on the talar dome with equal frequency and occasionally through both.
Lateral talar dome fractures are almost always associated with trauma, while medial talar dome fractures can be traumatic or atraumatic.

Fractures of the base of the fifth mata-tarsal bone(styloid process) can present with swelling over the outer aspect of the foot.

All these fractures present like ankle sprains and can be missed on routine plain X-ray projections.They tend to show up on plain films weeks after the injury.

As you have not responded satisfactorily to the conservative management for the 'ankle sprain', it will be best to consult an orthopedic surgeon and exclude any underlying fractures such as the ones mentioned above.
Best wishes!

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