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HSS Surgeon Helps Keep Ankles Fracture-Free This Fall

Dr. David S. Levine of HSS.
Dr. David S. Levine of HSS. Photo Credit: Hospital for Special Surgery

STAMFORD, Conn. -- Hospital for Special Surgery's Dr. David Levine answers your questions on ankle fractures.

I am an active woman in her 20s recently diagnosed with a stress fracture in my ankle from breaking in new high-heel shoes. I thought stress fractures only occurred in people with bone density issues. Are there other causes?

Stress fractures occur when bones are subjected to moderate forces that occur either too frequently or for too long. Think of a young gymnast performing too many practice vaults developing a shin stress fracture or a runner increasing the length of their marathon training runs. Alternatively, there may be an abnormality of bone quantity (osteoporosis) or bone quality (osteomalacia).

I’m a life-long soccer player and will be playing on a college team this fall. Is there anything I can do to prevent ankle fractures on the field?

Soccer is considered ‘high-risk’ with respect to ankle injuries as it involves running, jumping, leaping and landing. Studies have suggested that artificial playing surfaces may predispose players to ankle injury. Appropriate conditioning, sport-specific strengthening and agility training all contribute to injury prevention. Unfortunately, bracing has not been shown to reduce risk of ankle injury in contact sports.

Are there long-term effects from sustaining an ankle fracture?

Ankle fractures are very common. Post-traumatic arthritis -- or loss of cartilage -- of the ankle is the most significant long-term effect of an ankle fracture. This can cause swelling, stiffness and limitation during activities. Proper management of an ankle fracture and a carefully designed course of rehabilitation help maximize recovery.

What’s the best way to stabilize an ankle when fractured? 

Ankle fractures that do not result in instability of the joint can be treated in a removable boot. Patients can begin early motion and weight bearing once discomfort is reduced. 

Ankle joint instability following ankle fracture should be surgically stabilized with metallic implants. Crutches, a walker or a knee walker are used to assist patients during the recovery period.

Dr. David S. Levine is an orthopedic surgeon who specializes in treating fractures, dislocations, and other traumatic injuries of the foot and ankle. He practices at both the HSS Outpatient Center in Stamford and the hospital’s main campus in New York