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Distortion or ankle fracture? How to recognize it and what to do

January 1, 2018


Thousands of people suffer from ankle trauma every day, more frequently during sports activities such as basketball, tennis, football, volleyball and motorcycling, but not uncommon while performing daily activities such as walking down the stairs or walking. Although they concern the same joint, fracture and ankle distortion are traumas of different severity, often difficult to distinguish by the non-experienced, and sometimes with similar symptoms but very different treatments – explains Dr. Lara Castagnetti, osteopath and specialist in Physical and Rehabilitation Medicine at Humanitas. The common symptoms in both traumas, which create more confusion among non-experienced people, are:


– Swelling and pain: in case of distortion, only the outer part of the ankle is affected; in case of fracture, the entire ankle is affected.

– Difficulty walking: if there is a fracture, the difficulty also concerns placing the weight of the body on the fractured ankle;

In case of distortion with tendon lesion, there is more of a feeling of instability.


Characteristic signs of fracture are also the deformation of the joint and the feeling of “breaking” that can also appear along with a sound of “explosion” of the bone; in case of distortion, however, these signs are not present, but a bruise may appear. If not treated properly, the ankle may not heal and returning to walking without pain can be difficult. Above all, underestimating distortions and not treating them properly can lead to chronic ankle instability, repeated distortions, or damage to tendons and cartilage resulting in increased risk of ankle arthrosis.


What to do in case of ankle trauma?

Called R. I. C. E. in English, these are first aid actions to be implemented while waiting for a doctor, in case you suspect a fracture or distortion of the ankle:


R (Rest): after the trauma, avoid loading the weight of the body on the traumatized ankle, i.e. not to walk.


I (Ice): for the whole day of the trauma, place ice on the ankle in cycles of 20 minutes.


C (Compression): Cover the skin with a bandage or cloth to avoid placing the ice directly on the skin. Rely instead on expert hands, or wait to go to First Aid, for the bandage to be postioned around the ankle to reduce swelling.


E (Elevate): Hold foot and ankle up, possibly above the heart level: in a seated or lying position, place a cushion under the foot.

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