Medial Malleolus Fracture: Types, Symptoms, Diagnosis and Treatment

Introduction

A range of bones and ligaments makes up the ankle. The three bone segments of the ankle include the medial, lateral, and posterior malleolus. The medial malleolus is a protruding bump present on the inner aspect of the ankle. It is a continuation of the long bone of the leg called the tibia. Ankle fractures are common in adults with a greater degree of involvement of the medial malleolus. In addition, women are more likely to encounter these fractures than men. Falls and accidents are considered the predominant causes of these ankle fractures.

What Is a Medial Malleolus Fracture?

Ankle fractures are common with injury to the connected bones or ligament, including the medial malleolus bone. Medial fractures typically result from wide eversion or external rotation of the foot. Medial malleolus fractures can be isolated or be part of complex means of ankle fracture. The complex pattern involving three bones is the common incidence of the medial malleolus fracture.

What Are the Types of Medial Malleolus Fractures?

The medial malleolus is connected to the ligaments or tendons of the ankle. The fractures of this bony bump of the ankle are classified into five major types based on the nature of the break.

• Chip Fractures: Chip fractures do not concern an injury; rather, it is attributable to tendons and ligaments separating from the bone.

• Comminuted Fractures: Here, the bone seems to be broken into multiple fragments.

• Oblique Fractures: This kind of fracture occurs at the corner aspect of the ankle joint. The oblique fracture can be an indication of an unstable ankle.

• Vertical Fracture: This fracture results from the orientation of the force of injury on the leg bone.

• Transverse Fracture: A transverse fracture is seen in a similar direction as of the ankle joint.

What Are the Signs and Symptoms of Medial Malleolus Fracture?

Medial malleolus fracture induces painful symptoms according to the extent of the fracture. The common symptoms of medial malleolus fracture involve the following.

• Acute severe pain.

• Swelling around the ankle.

• Tenderness to pressure.

• Bruising.

• Decreased ability to hold weight as of in the injured site.

• The apparent displacement of the ankle bones.

• Difficulty in walking.

• Pain and discomfort in the inner aspect of the ankle.

What Are the Complications of Medial Malleolus Fracture?

Subsequently, the medial malleolus fracture can lead to the worsening of symptoms, resulting in certain complications. The possible complications include.

• Bruising or hematoma.

• Cell necrosis is common among the borders of the wound.

• The severe fracture with the involvement of bone displacement can result in necrosis and permanent tissue damage due to internal pressure.

• On a long-term course, there is a ten percent risk of the development of arthritis of the ankle. This compilation can result even after appropriate healing and treatment. The symptoms of ankle arthritis include joint pain with motion, stiffness, and difficulty carrying or putting weight on the ankle.

How Is a Medial Malleolus Fracture Diagnosed?

Medical healthcare professionals elicit an extensive physical examination of the ankle and the affiliated leg. The individual is investigated about the pain intensity with a slight manipulation of the affected aspect. In addition, the individual is asked to move the ankle or walk a few steps. Additionally, X-ray imaging for the ankle is recommended. An X-ray for the determination of the foot is advised in case of requisition.

What Are the Treatment Options for Medial Malleolus Fracture?

Not every fracture requires surgical intervention. The treatment can be conservation or surgical as per the impact of the ankle joint.

Medical Management: The wounds are addressed first with dressings and antibiotics. Then, the following options are prescribed:

• The specialized doctors will advise for early restoration of the fractured bones in cases of damage to nerves and blood vessels. In this case, closed reduction, known as the manual realignment of the bones, is advised.

• A splint is placed after closed reduction. The splint is responsible for maintaining the position of the bone during the process of healing.

• A brace or cast is applied in cases of severe fractures.

Immobilization: Immobilization of the fracture is preferred so as to decrease or eliminate the motion and encourage healing. Immobilization is generally indicated in cases of the fragment being small and influencing joint stability.

Surgery: The surgery is generally recommended for medial fractures since the alignment and stability are affected. The doctors will commence with the surgery only after the swelling subsides or even before the signs of swelling. The surgical intervention is of two kinds, namely.

• Internal Fixation: Internal fixation is known for surgery by means of rods, plates, screws, and wiring techniques to hold the bone in position and promote healing.

• Open Reduction: Open reduction is the realignment of the bone by surgical procedure.

How Is the Recovery From the Medial Malleolus Fracture?

The recovery takes longer with conservative medical treatment and much longer with surgical treatment. It takes about six weeks for the bones to heal after conservative treatment. The doctors will eventually monitor the bones for healing. So, one must not lift or put weight on the affiliated area since it would delay the healing or induce reinjury. In contrast, it takes several months to draw back the daily activities following surgery. The physical therapists will guide and address the following concerns.

• Pain and discomfort concerning the joint over time.

• Improvement in range of motion.

• Enhancement of the function in the specified joint area.

• Joint stiffness.

• Improvement of joint mobility and, thus, functionality.

• Muscle spasms and muscle tension.

• Optimal motion.

• Therefore, the quality of life overall.

Conclusion

A medial malleolus fracture is a fracture involving the articular surface of the ankle bone joint, where certain bones meet. The fracture break may occur on its own or with accompanying injuries occurring outside of the ankle or lower extremity. Aside from the fracture and pain, an infection can soon develop along with the fracture, slowing recovery and exacerbating the disease. So, one must take into consideration the appropriate intervention and care for the fracture. The outlook and prognosis seem favorable with effective intervention, though the median malleolus fracture sounds like an intense injury.