Ankle Fracture in Sports Medicine Follow-up

  • Author: John D Kelly IV, MD; Chief Editor: Sherwin SW Ho, MD   more...
 
Updated: Dec 13, 2011
 

Return to Play

Return to play depends on both the ankle fracture and the athlete. Motivated athletes can generally return to sports with documentation of fracture healing and return of normal strength and motion. The goal of rehabilitation should be symmetric range of motion and 85% of contralateral strength before returning to the sport.

The first phase of rehabilitation is restoration of motion and pain-free ambulation after cast immobilization. During the first several days after cast removal, crutch-assisted ambulation can assist the patient in gaining motion and in preventing ankle reinjury secondary to weakness. After the return of passive motion, active motion and active-assisted motion should begin, along with a strengthening program. Particular attention is devoted to the recovery of peroneal and gastrocnemius complex strength. Proprioception and balance training are also an important part of the overall rehabilitation program and have been shown to be effective in reducing the risk for recurrent ankle injury.

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Complications

Nonunion or delayed union is the most common complication of ankle fractures requiring referral to an orthopedist.

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Contributor Information and Disclosures
Author

John D Kelly IV, MD  Associate Professor, Department of Orthopedic Surgery, University of Pennsylvania, Consulting Surgeon Shriner's Hospital for Surgery

John D Kelly IV, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Orthopaedic Surgeons, American Orthopaedic Association, American Orthopaedic Society for Sports Medicine, Arthroscopy Association of North America, Eastern Orthopaedic Association, Pennsylvania Orthopaedic Society, and Philadelphia County Medical Society

Disclosure: Nothing to disclose.

Coauthor(s)

Phillip M Steele, MD  Consulting Staff, Primary Care Sports Medicine, Gem City Bone and Joint; Team Physician, University of Wyoming

Phillip M Steele, MD is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, and American Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

David T Bernhardt, MD  Director of Adolescent and Sports Medicine Fellowship, Associate Professor, Department of Pediatrics/Ortho and Rehab, Division of Sports Medicine, University of Wisconsin School of Medicine and Public Health

David T Bernhardt, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Sports Medicine, and American Medical Society for Sports Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Russell D White, MD  Professor of Medicine, Professor of Orthopedic Surgery, Director of Sports Medicine Fellowship Program, Medical Director, Sports Medicine Center, Head Team Physician, University of Missouri-Kansas City Intercollegiate Athletic Program, Department of Community and Family Medicine, University of Missouri-Kansas City School of Medicine, Truman Medical Center-Lakewood

Russell D White, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Family Physicians, American Association of Clinical Endocrinologists, American College of Sports Medicine, American Diabetes Association, and American Medical Society for Sports Medicine

Disclosure: Nothing to disclose.

Jon B Whitehurst, MD  Clinical Instructor of Surgery, University of Illinois College of Medicine; Partner, Rockford Orthopedic Associates; Orthopedic Chairman, Rockford Memorial Hospital

Jon B Whitehurst, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America

Disclosure: Nothing to disclose.

Chief Editor

Sherwin SW Ho, MD  Associate Professor, Department of Surgery, Section of Orthopedic Surgery and Rehabilitation Medicine, University of Chicago Division of the Biological Sciences, The Pritzker School of Medicine

Sherwin SW Ho, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, Arthroscopy Association of North America, and Herodicus Society

Disclosure: Breg, Inc. Consulting fee Consulting; Biomet, Inc. Consulting fee Consulting; GMV, Inc. Arthroscopy Simulator Evaluation and teaching; Smith and Nephew Grant/research funds Fellowship funding; DJ Ortho Grant/research funds Course funding; Athletico Physical Therapy Grant/research funds Course, research funding

References

  1. Kaplan LD, Jost PW, Honkamp N, Norwig J, West R, Bradley JP. Incidence and variance of foot and ankle injuries in elite college football players. Am J Orthop (Belle Mead NJ). Jan 2011;40(1):40-4. [Medline].

  2. Newman JS, Newberg AH. Basketball injuries. Radiol Clin North Am. Nov 2010;48(6):1095-111. [Medline].

  3. Michelson JD. Fractures about the ankle. J Bone Joint Surg Am. Jan 1995;77(1):142-52. [Medline]. [Full Text].

  4. Thordarson DB. Detecting and treating common foot and ankle fractures. Part 1: the ankle and hindfoot. Phys Sportsmed. Sept 1996;24(9):29-38. [Full Text].

  5. Clanton TO, Porter DA. Primary care of foot and ankle injuries in the athlete. Clin Sports Med. Jul 1997;16(3):435-66. [Medline].

  6. Tandeter HB, Shvartzman P. Acute ankle injuries: clinical decision rules for radiographs. Am Fam Physician. Jun 1997;55(8):2721-8. [Medline].

  7. Schwartz DT, Reisdorff E, Williamson B, eds. Emergency Radiology. New York, NY: McGraw-Hill; 1999.

  8. Wedmore IS, Charette J. Emergency department evaluation and treatment of ankle and foot injuries. Emerg Med Clin North Am. Feb 2000;18(1):85-113, vi. [Medline].

  9. Yu JS, Cody ME. A template approach for detecting fractures in adults sustaining low-energy ankle trauma. Emerg Radiol. Feb 18 2009;epub ahead of print. [Medline].

  10. Leontaritis N, Hinojosa L, Panchbhavi VK. Arthroscopically detected intra-articular lesions associated with acute ankle fractures. J Bone Joint Surg Am. Feb 2009;91(2):333-9. [Medline].

  11. Zalavras CG, Christensen T, Rigopoulos N, Holtom P, Patzakis MJ. Infection following operative treatment of ankle fractures. Clin Orthop Relat Res. Feb 19 2009;epub ahead of print. [Medline].

 
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Diagram showing the typical locations for ankle fractures occurring from the 4 major injury mechanisms (SA= supination adduction, SE= supination external rotation, PA= pronation abduction, PE= pronation external rotation). Note that the SE fracture is shown as a dashed line, since it is best seen in the lateral projection.
 
 
 
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