Two Shoulders, an Ankle and a Nose (Part 2)

Supreme Court nominee, Sonya Sotomayor, fractured her right ankle Monday after a stumble at New York’s LaGuardia airport. Justice Sotomayor was on her way to Washington to meet with senators considering her confirmation. Xrays performed at George Washington University Hospital revealed what was called a “small fracture in her right ankle.”
The ankle joint is made up of 3 bones, ligaments and a joint capsule:

  • The tibia,sometimes called the shin bone, is the main bone of the lower leg, and makes up the inside of the ankle joint.
  • The fibula is a smaller bone that lays next to the tibia on the outside of the lower leg and makes up the outer side of the ankle joint.
  • The talus is a odd hump shaped bone of the foot that the tibia and fibula arch over to form the ankle. Those bumps that stick out from the sides of your ankles are called malleoli (singular is malleolus). They are the end parts of the tibia and fibula that surround the talus.
  • A fibrous membrane called the joint capsule, lined with a smooth layer called the synovium, encases the bony joint structure. The joint capsule contains synovial fluid produced by the synovium which allows for smooth movement of the joint surfaces.
  • The ankle joint is stabilized by 3 groups of ligaments, which are fibers that hold these bones in place.

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Although there are many ways to fracture an ankle bone, the most common injuries involve a sharp twist of the ankle or a direct impact that breaks at least one (or more) of the ankle bones.

Symptoms of a fracture include:

  • Pain, swelling, tenderness and bruising at your ankle joint
  • Inability to move your ankle through its normal range of motion
  • Inability to bear weight on your injured ankle (although being able to bear weight doesn’t rule out a fracture
  • In more severe cases, there may a deformity of the lower part of the leg

These symptoms are nearly identical to those of a ankle sprain, and the only way to know for sure whether an injury is a fracture or a sprain is by taking an xray of the ankle. Treatment for a fractured ankle usually involves casting to prevent movement while the bones heal. More severe fractures, especially involving both bones, may require surgical stabilization as well.

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Mark Boguski, M.D., Ph.D. is on the faculty of Harvard Medical School and is a member of the Society for Participatory Medicine, "a movement in which networked patients shift from being mere passengers to responsible drivers of their health" and in which professional health care providers encourage "empowered patients" and value them as full partners in managing their health and wellness.

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