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Foot and Ankle Injury

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Ankle Fracture (Open)
Ankle Fracture (Open) :: LMS Inc. :: (click image to see Copyright)

X-Ray - Ankle Fracture
X-Ray - Ankle Fracture :: LMS Inc. :: (click image to see Copyright)

Ankle Sprain
Ankle Sprain :: LMS Inc. :: (click image to see Copyright)

First Aid - Cold Pack for Minor Ankle Injury
First Aid - Cold Pack for Minor Ankle Injury :: LMS Inc. :: (click image to see Copyright)

First Aid - Splint for Ankle Injury
First Aid - Splint for Ankle Injury :: LMS Inc. :: (click image to see Copyright)

First Aid - Bleeding Leg
First Aid - Bleeding Leg :: LMS Inc. :: (click image to see Copyright)

First Aid - R.I.C.E.
First Aid - R.I.C.E. :: LMS Inc. :: (click image to see Copyright)

Definition

  • Injuries to a bone, muscle, joint or ligament of the ankle and foot

Types of Injuries

  • Achilles tendon rupture - There is pain in the Achilles tendon (area above heel and behind ankle). There is weakness or inability to extend the foot (e.g., can't stand on tiptoes).

  • Contusion - A direct blow or crushing injury results in bruising of the skin, muscle and underlying bone.

  • Cuts, abrasions

  • Dislocations (bone out of joint)

  • Fractures (broken bones)

  • Sprains - Stretches and tears of ligaments

  • Strains - Stretches and tears of muscles (e.g., pulled muscle)

If not, see these topics

First Aid:

FIRST AID Advice for Bleeding: Apply direct pressure to the entire wound with a clean cloth.

FIRST AID Advice for Penetrating Object: If penetrating object still in place, don't remove it.

FIRST AID Advice for Shock: Lie down with feet elevated.

FIRST AID Advice for a Sprain or Twisting Injury of Ankle or Foot:

  • Apply a cold pack or an ice bag (wrapped in a moist towel) to the area for 20 minutes.

  • Wrap area with an elastic bandage.

FIRST AID Advice for Suspected Fracture or Dislocation of Ankle or Foot:

  • Do not remove the shoe.

  • Immobilize the ankle and foot by wrapping them with a soft splint (e.g., a pillow, a rolled-up blanket, a towel).

  • Use tape to keep this splint in place.

Transport of an Amputated Body Part:

  • Briefly rinse amputated part with water (to remove any dirt).

  • Place amputated part in plastic bag (to protect and keep clean).

  • Place plastic bag containing part in a container of ice (to keep cool and preserve tissue).

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When to Call Your Doctor

call 911

Call 911 Now (you may need an ambulance) If

  • Major bleeding (actively bleeding or spurting) that can't be stopped

  • Limb has been partially or completely amputated

  • Injury looks like a dislocated joint (crooked or deformed)

  • Bone sticking through skin

  • Note: For bleeding, see First Aid

call now

Call Your Doctor Now (night or day) If

  • You think you have a serious injury

  • Severe pain

  • You can't stand (bear weight) or walk

call within 24 hours

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

  • You think you need to be seen

  • There is a large swelling or bruise (wider than 2 inches) at the site of the injury

  • You are limping

  • You are over age 54, have osteoporosis, or use steroid medications routinely

call within 24 hours

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns

  • Injury interferes with work or school

  • Injury and pain have not improved after 3 days

  • Injury is still painful and swollen after 2 weeks

home care

Self Care at Home If

  • Minor bruise

  • Minor strained (pulled) muscle or sprained (stretched) ligament

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HOME CARE ADVICE FOR MINOR BRUISE, SPRAIN OR STRAIN

  1. Treatment of Minor Bruise (e.g., direct blow to ankle or foot):

    • Apply a cold pack or an ice bag (wrapped in a moist towel) for 20 minutes each hour for 4 consecutive hours. (20 minutes of cooling followed by 40 minutes of rest for 4 hours in a row).

    • 48 hours after the injury, use local heat for 10 minutes 3 times each day to help reabsorb the blood.

    • Rest the injured part as much as possible for 48 hours.

  2. Treatment of Minor Sprains and Strains of Foot and Ankle:

    • FIRST AID - Wrap with a snug elastic bandage. Apply an ice pack (crushed ice in a plastic bag covered with a moist towel) to reduce bleeding, swelling, and pain.

    • Treat with R.I.C.E. (rest, ice, compression, and elevation) for the first 24 to 48 hours.

      • REST the injured leg for 24 hours. You may return to normal activity after 24 hours of rest if the activity does not cause pain.

      • Continue to apply crushed ICE packs for 10-20 minutes every hour for the first 4 hours. Then apply ice for 10-20 minutes 4 times a day for the first two days.

      • Apply COMPRESSION by wrapping the injured part with a snug, elastic bandage for 48 hours. If you experience numbness, tingling, or increased pain in the injured part, the bandage may be too tight. Loosen the bandage wrap.

      • Keep injured ankle or foot ELEVATED and at rest for 24 hours. Keep your foot up on a pillow and stay off your feet as much as possible.

  3. Pain Medicines:

    • For pain relief, take acetaminophen, ibuprofen, or naproxen.

    Acetaminophen (e.g., Tylenol):

    • Take 650 mg by mouth every 4-6 hours. Each Regular Strength Tylenol pill has 325 mg of acetaminophen.

    • Another choice is to take 1,000 mg every 8 hours. Each Extra Strength Tylenol pill has 500 mg of acetaminophen.

    • The most you should take each day is 3,000 mg.

    Ibuprofen (e.g., Motrin, Advil):

    • Take 400 mg by mouth every 6 hours.

    • Another choice is to take 600 mg by mouth every 8 hours.

    • Use the lowest amount that makes your pain feel better.

    Naproxen (e.g., Aleve):

    • Take 250-500 mg by mouth every 12 hours.

    • Use the lowest amount that makes your pain feel better.

    Extra Notes:

    • Acetaminophen is thought to be safer than ibuprofen or naproxen in people over 65 years old. Acetaminophen is in many OTC and prescription medicines. It might be in more than one medicine that you are taking. You need to be careful and not take an overdose. An acetaminophen overdose can hurt the liver.

    • Caution: Do not take acetaminophen if you have liver disease.

    • Caution: Do not take ibuprofen or naproxen if you have stomach problems, kidney disease, are pregnant, or have been told by your doctor to avoid this type of medicine. Do not take ibuprofen or naproxen for more than 7 days without consulting your doctor.

    • Before taking any medicine, read all the instructions on the package

  4. Expected Course: Pain and swelling usually begin to improve 2 or 3 days after an injury. Swelling is usually gone in 7 days. Pain may take 2 weeks to completely resolve.

  5. Call Your Doctor If:

    • Pain becomes severe

    • Pain does not improve after 3 days

    • Pain or swelling lasts more than 2 weeks

    • You become worse

And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.

Online Medical Reviewer: Louise Akin, RN, BSN
Online Medical Reviewer: Daphne Pierce-Smith, RN, MSN, FNP, CCRC
Last Review Date: 2/21/2012
© 2000-2014 The StayWell Company, LLC. 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.