Watch Your Step With A Twisted Ankle




photo: AAOS


Many people delay seeking medical attention for a twisted ankle. For mild cases, that’s okay. Rest, NSAIDs and ice can usually take care of the problem within a week or two. But if it takes longer than that to get better, or if you have strained your ankle to the degree that it becomes tender, bruised and swollen, you should see a doctor, according to Mark Yakavonis, MD, orthopedic foot and ankle surgeon at ONS.

“Without proper treatment and rehabilitation, severe sprains can weaken the ankle and increase the likelihood of re-injury. Repeated ankle sprains can lead to long-term problems, including chronic ankle pain, arthritis, and instability,” he said. Moreover, severe pain and swelling that extends from the foot to the knee or higher is usually a symptom of a fractured ankle. That condition should be treated as soon as possible.

Children, in particular, should see a doctor right away if an ankle fracture is suspected, said Dr. Yakavonis. “A child’s ankle fractures typically involve growth plates.  If it’s not treated properly, the natural growth and development of the child’s leg may be compromised,” he warned.


An ankle sprain occurs when the strong ligaments that support the ankle stretch beyond their limits and tear. This is a common injury that occurs among people of all ages as a result of the foot rolling or twisting to one side. Sprains range from mild to severe, depending upon how much damage there is to the tissues.

You can treat most ankle sprains without surgery. Even a complete ligament tear can heal without surgical repair if it is immobilized properly.  Depending on the severity of the sprain, your physician may wrap the ankle in a bandage or recommend a device for protection and support, such as a boot or an air brace. Mild sprains usually resolve within two weeks. Severe ankle sprains can take as long as 12 weeks to recover.


Similar to ankle sprains, ankle fractures are most commonly caused when a person trips and twists or rolls the ankle in the process, or if there is impact from an accident.

Ankle fractures involve two joints: the ankle joint where the tibia, fibula and talus meet, and the syndesmosis joint, which is the joint between the tibia and fibula. A fracture can range from a simple break in one bone to multiple fractures. Some fractures may coincide with injuries to the ankle ligaments that keep the ankle bones and joint in its normal position.

Absent of a physical deformity such as a bone protruding from the ankle, an X-ray may be required to determine which bones, if any, are broken and the extent of bone separation or displacement.

Children’s ankle fractures, on the other hand, typically involve the tibia, fibula and growth plates. Growth plate ankle fractures require immediate attention because the long-term consequences of an improperly healed fracture can cause the leg to grow crooked or of unequal length to the other. For this reason, a child who has broken an ankle should have regular follow-up check-ups for as long as two years after the injury to make sure that growth proceeds properly.


Of course, the complexity of the treatment depends on the severity of the fracture, the bones involved and whether there is displacement or dislocation. Most fractures require elevation to reduce the swelling and decrease the risk of damage to the surrounding tissue. Splints are usually positioned to support the ankle until the swelling has gone down, at which point a cast or fracture boot will be put in place.  Your physician will determine the length of time you’ll need to use crutches, a walker or wheelchair to avoid weight bearing.  This can range from a several days to several months.  Severe breaks will require surgery to re-position bone fragments to their normal alignment and the insertion of special screws, metal plates and rods to keep everything in alignment.

Michael Clain, MD, is a fellowship-trained orthopedic surgeons who are experts in the surgical and non-surgical treatment of all foot and ankle conditions.

Call 203-869-1145 for to make an appointment or request an appointment online.