Is it a Sprain? Or a Fracture?

Dr. Rami Calis
When you injure your ankle, it may be hard to tell whether you’ve sprained it (stretched or torn a tendon or ligament) or fractured it (broken a bone). Generally speaking, here are some things to keep in mind:

  • If you have pain around the soft tissue areas but not over the bone, you probably have a sprain, not a break.
  • If you have pain over the ankle bone, you most likely have a break.
  • If you’re not able to walk on it, there’s a good chance you have a break.

If you’ve hurt your ankle but you’re not sure it’s serious, a general rule of thumb is to watch it for two to four days and use the RICE method—REST your ankle, put an ICE pack on it, use COMPRESSION, such as an Ace bandage or air cast (available at your local drugstore) to stabilize it, and ELEVATE it. If, after two to four days, you still have significant pain or difficulty putting weight on your foot, or you see black and blue marks or blisters, it’s time to see a doctor.

At the Emory Orthopaedics & Spine Center, our orthopedic specialists are experts at diagnosing and treating foot and ankle injuries. We use our clinical knowledge, an MRI when needed (we have the only 3-tesla MRI in the state—think of it as an MRI in HD), and X-rays to help determine whether you’ve fractured a bone or torn a ligament and whether the injury requires surgery. Most ankle injuries, whether fractures or sprains, can be treated conservatively, without surgery. However, if a fracture calls for surgery, we may use a plate and screws on the side of the bone or a screw or rod inside the bone to realign the bone fragments and stabilize them as they heal. Sometimes a soft tissue injury will require surgical intervention, as well, as it may create ankle instability and need to be repaired. However, most cases will do well with conservative care and physical therapy to follow.

When you see your doctor after an ankle injury, it’s important to describe in detail how the injury occurred. Did your foot turn under, out, in, or rotate? The more you can tell us, the more effectively we’ll be able to diagnose and treat your injury. Any information you can tell us is useful. At Emory Orthopaedics & Spine Center, we focus on listening to the patient and tailoring a treatment plan that fits the patient, without compromising care or adequate healing time.

If you’ve sprained your ankle in the past and now find that it twists easily or feels weak, you may have damaged the ligaments, causing chronic ankle instability. Although you may not feel any pain originally, over time you may develop arthritis in your ankle. At Emory, we can try to implement physical therapy for ankle strengthening, but if that fails, it may be necessary to repair the ligaments so that your ankle is stabilized.

Remember—if your ankle hurts, don’t push it. There’s a reason your body is talking to you, so get it looked at by a doctor. Our goal is to keep you active for the long term not just the short term. The worst thing you can do is to try to push through the pain and ignore your body’s communication, as that may lead to long-term ankle joint disability and arthritis. It’s not uncommon for an ankle sprain to be painful for many months after an injury, and swelling may last for four months to a year, but if it still hurts to put weight on it two to three weeks after you’ve injured it, make an appointment at the Emory Orthopaedics & Spine Center to see a foot and ankle specialist.

Have you sprained or broken your ankle? Have you had an ankle injury that required surgery? We’d like to hear about your experience. Please take a moment to give us feedback in the comments section below.

About Rami Calis, DPM:

Rami Calis, DPM, is assistant professor in the Department of Orthopedics. He is board certified and a Diplomate, American Board of Podiatric Orthopedics and Primary Podiatric Medicine, with an interest in sports medicine of the lower extremity and foot and ankle biomechanics. Dr. Calis holds clinic and does surgery at Emory Orthopaedics & Spine Center at Executive Park and also holds clinic in Duluth, at our satellite office. Dr. Calis’ professional goal is to improve patient care and quality of life for patients with foot and ankle problems. Dr. Calis began practicing at Emory in 2003.

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