Abstract

Introduction: The ankle joint complex is a highly intricate, weight-bearing structure formed at the meeting point of the lower ends of the tibia and fibula, along with the small tarsal bones. It supports body weight and allows foot movement. Ankle injuries including sprain, tendon tears & fractures ranging from isolated lateral malleolar breaks to complex trimalleolar disruptions involving syndesmotic & ligamentous injuries are one of the frequent lower-limb injuries. A twisted ankle might seem like a minor “sprain,” but could be a serious fracture in disguise. Inability to bear weight, as evidenced by struggling to take four steps on the foot usually means a severe grade 3 sprain or a possible fracture requiring an X-ray. Swelling & bruising signals rapid inflammation or a torn ligament or high ankle injury, which takes longer to heal than a stretch. The key mechanisms of injury to ankle include i) twisting of the foot inward (inversion) harming the outer ligaments, & ii) a rotational fall can cause a high ankle sprain. General epidemiological research in India regarding foot and ankle injuries shows a higher overall prevalence and presentation in males, largely driven by occupational exposure, road traffic accidents, and male-dominated sports participation. However, distinct gender vulnerabilities of higher chronic ankle instability and lateral laxity in females are observed. Diagnosis is based on clinical examination for local tenderness; inability to walk a few steps to be confirmed by a plain Xray.
Materials and Methods: This article is based on two cases of fractures (One in an elderly male with minimal mobility and another in a young lady with avulsion fracture), managed recently to highlight the role of general practitioners in ankle injuries and modern approaches to fix the fractures and Sprains
Outcome: Both case management strategies were based on stability, fragment size and soft-tissue condition. Unstable fractures needed open reduction and internal fixation (ORIF) using plates, screws but managed with a plaster boot as the general condition was risky for the operative procedure. For Ligament Tears & Sprains of soft-tissue, inversion, and high-ankle sprains involving the Anterior Talofibular Ligament (ATFL) or Calcaneofibular Ligament (CFL), was managed by POLICE framework which mean Protection by braces, crutches, optimal loading, cryotherapy, compression bandage and elevation of the foot above heart level. Rehabilitation protocols include early mobilization and weight-bearing, to accelerate return to function without compromising healing.

Keywords:Ankle joint; Ankle fracture; Avulsion fracture; ATFL (Anterior Talofibular Ligament); CFL (Calcaneofibular Ligament)