From the Guidelines
The treatment for an undisplaced fracture of the lateral malleolus should prioritize functional treatment over immobilization, with a focus on early mobilization and rehabilitation using alphabet movements, as supported by the most recent evidence from 2018 1. The goal of treatment is to minimize pain and swelling, restore range of motion, proprioception, and strength, and promote functional recovery.
- Initially, the RICE protocol (Rest, Ice, Compression, Elevation) should be applied to reduce pain and swelling.
- Once the acute phase has passed, rehabilitation can begin with alphabet exercises, where the patient "writes" the letters of the alphabet with their foot and ankle, 2-3 times daily, with 1-2 complete alphabets per session.
- As healing progresses, weight-bearing should increase gradually from partial to full, typically over 6-8 weeks.
- Pain management may include acetaminophen or NSAIDs like ibuprofen (400-600mg every 6-8 hours) as needed, with consideration of the potential side effects and complications reported in the literature 1.
- Physical therapy is often recommended to supplement home exercises, focusing on progressive strengthening, balance training, and functional activities, with the aim of achieving full recovery within 8-12 weeks, as individual healing times vary based on fracture severity, patient age, and compliance with treatment protocols. The use of functional support devices, such as braces or tape, may also be beneficial in promoting recovery and preventing recurrent ankle sprains, as suggested by the evidence from 2018 1.
From the Research
Treatment of Undisplaced Fracture of Lateral Malleolus
- The treatment of undisplaced fracture of lateral malleolus depends on the stability of the fracture and the presence of any other injuries 2, 3.
- For stable fractures, non-operative treatment is often recommended, which includes immobilization and physical therapy 2, 4.
- The stability of the fracture can be assessed using weight-bearing radiographs and gravity stress tests 2, 3.
- If the fracture is unstable, surgical treatment may be necessary to stabilize the fracture and prevent further complications 2, 5.
- The type of surgical treatment used can vary, including locking plates and non-locking plates, but the choice of treatment does not seem to affect the outcome significantly 6.
Alphabet Movements in Treatment
- There is no specific information available on "alphabet movements" in the treatment of undisplaced fracture of lateral malleolus.
- However, physical therapy and rehabilitation are important aspects of treatment, and may involve various exercises and movements to improve range of motion and strength 2, 4.
- The goal of rehabilitation is to restore normal function and mobility to the ankle, and to prevent long-term complications such as arthritis or chronic pain 2, 4.
Key Considerations
- The treatment of undisplaced fracture of lateral malleolus should be individualized based on the specific characteristics of the fracture and the patient's overall health and condition 2, 4.
- A structured treatment algorithm can help to standardize treatment and reduce the number of unnecessary surgical procedures 4.
- Long-term follow-up is important to monitor for potential complications and to ensure that the treatment is effective in restoring normal function and mobility to the ankle 4.