Orthopedics: Ankle and Foot

Ankle injuries are very common, whether it’s rolling your ankle while stepping off a curb or twisting it during a game of soccer. An ankle sprain is when the ligaments (the supporting structures of the ankle joint) are stretched or torn. They can be partially torn or fully torn, ranging in severity from Grade 1 to Grade 3.

An ankle sprain is usually quite painful on the lateral side, accompanied by swelling and bruising. There can also be pain on the inside of the ankle with an inversion ankle sprain or lateral ankle sprain, because the ankle bone as well as the foot bones can be compressed during the injury. In the first 48 to 72 hours following an ankle injury, it's important to follow the RICE protocol (rest, ice, compression and elevation). Depending on the severity of the ankle sprain, it may be necessary to have an x-ray done to rule out an ankle fracture. 

Ambulatory care procedures:

Ambulatory care procedures (also known as minor procedures) are operations that are done under local anaesthesia only, are less than 20 minutes duration, do not require preoperative fasting, and although we recommend that someone drive you home, this is not mandatory. The post operative course for the most common procedures will be presented

Most ankle injuries can be treated non-surgically, but patients with severe injuries, ankle arthritis or Achilles tendon disorders may require it. There are virtually dozens of different surgical procedures performed, so you’ll need to work with your physician and orthopedic surgeon to determine the right one for you. Today, many ankle surgeries are done using an arthroscope, which allows  orthopedic surgeons to see inside the joint and project an image onto a TV screen. The incision is also smaller, so arthroscopic surgery is less invasive and your healing time is shorter.

Physiotherapy for Ankle Injuries :

If you don’t have a fracture, you should seek treatment from a physiotherapist as soon as possible. The physiotherapist can assess the severity of the injury and create a customized treatment plan. Usually, your physiotherapist will start you off with exercises to improve your range of motion and strengthen your ankle. You may also do some trunk exercises, because while you can’t weight bear on your ankle, you need to keep your trunk strong. As you’re able to weight bear a bit more, you’ll move to weight-bearing exercises and proprioceptive exercising. 

Main operating room procedures  

            If you have been scheduled for a procedure in the main operating room, then likely you will have been asked to be fasting from the night before, and to have someone drive you home and be with you for the first 24 hours after surgery. Many procedures are performed after just freezing your arm. If requested, intravenous sedation will be administered so that you may even fall asleep during the procedure. A variety of narcotics are usually prescribed after surgery. Pain management usually starts with maximizing on non narcotics options. This usually starts with 1000mg of Tylenol along with 400mg of Ibuprofen (Advil) every 6 hours. If you are taking another anti-inflammatory (Aspirin, Naprosyn, Voltaren etc), then do not take Ibuprofen. A narcotic analgesic will likely have been prescribed. The most common is Tylenol #3. This medication contains a narcotic (codeine) along with Tylenol. If taking Tylenol #3, then do not take additional Tylenol, but please continue with the Advil. If only taking one tablet of Tylenol #3, then supplement with additional Tylenol up to a maximum of 1000mg every 6 hours. Other narcotics may not contain Tylenol (like oxycodone and hydromorphone), and you should be taking a full dose of Tylenol (1000mg) every 6 hours along with the Advil. Discontinue the narcotics as soon as you can.

 Some procedures require immobilization after completion. If you do not have a splint or cast after your surgery, you will be asked to keep your dressing on for 48 hours, followed by light bathing and washing of the wound. Do not soak your wound until after your suture have been removed. If your hand has not been immobilized, it is very important to move your fingers from fully straight to fully bent as frequently as possible.

Talk to your healthcare provider  or orthopedic surgeon if you'd like more information on ankle injuries.

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