Those who watched the Elite Eight game of Louisville against Duke won’t easily forget the injury that guard Kevin Ware suffered during the game. After attempting to guard a shot taken by Duke, Ware landed awkwardly and fractured his tibia (shin bone). Those watching saw the bone protrude through the skin – this type of fracture is known as an “open fracture.” While fractures are a common sports injury, open fractures occur most often in contact sports like football. These fractures can occur in any bone, including the bones of the feet. Recently, UFC fighter Jon Jones suffered an open fracture of his big toe during a match against Tito Ortiz. Unlike Ware’s injury which stopped the game, Jones’ injury was not noticed until after the match was over.

These types of fractures are not only more gruesome than other fractures, but also more difficult to treat for two reasons. First the fact that bone is exposed increases the risk of infection. Before the fracture can be fixed, the bone must be cleaned to reduce the risk of infection. Second, whereas many fractures that don’t break the skin can be treated with a cast, the bone pieces in open fractures are often further apart and need to be held in place with special surgical hardware.

Open fractures can take between 6 months and a year to heal, which is more than the time required for fractures that don’t break the skin. While their injuries may have been gruesome, both Ware and Jones got prompt treatment to fix the fracture and should go on to heal just fine.

While open fractures may be more obvious than other fractures, all injuries with possible fractures need to be examined. Please make an appointment to see one of our four physicians at Advanced Foot and Ankle Care if you injure your lower leg or foot and suspect that one of the bones might be broken. If fractures are not properly identified and treated correctly, the bones may not heal, or they may heal in an inappropriate alignment, which can both be prevented with prompt care.

Dr. Jeffrey Carlson

“I Sprained My Ankle”

Sprains of the ankle do not discriminate, as they affect the layperson as well as celebrities (former Olympic gymnast Kerri Strug, ‘American Idol’ winner Kelly Clarkson, ‘Dancing with the Stars’ winner J.R. Martinez, and the NBA’s Dwyane Wade to name just a few).  Here, at Advanced Foot and Ankle Care, ankle sprains are a far too common condition that many of our patients have been diagnosed with and/or have suffered through.  For the sake of brevity, there are 3 common types:

                1. Lateral ankle sprain (most common; outside the ankle)

                2. Medial ankle sprain (inner side of ankle)

                3. High ankle sprain (i.e. above the ankle…rare. Quarterback Ben Roethlisberger of

                    the Pittsburgh Steelers suffered this injury during the 2011 NFL season)

A “sprain” occurs when there is either an abnormal stretching or actual tearing of a ligament, a fibrous tissue that connects’ bone to bone’.  Blood vessels around a sprain can subsequently burst, leaking blood and fluid into the surrounding tissues causing bruising and swelling.  The nerves around the area will feel this abnormal pressure and become more sensitive, resulting in pain.

Treatment is geared first at “RICE” (Rest, Ice, Compression, and Elevation) therapy and immobilizing or splinting the injury.  Depending on the extent of the injury, what usually follows (during the subsequent weeks) is bracing or physical therapy to get you back on your feet as quickly (and safely) as possible.  In those unfortunate cases where perhaps chronic pain or instability (ligaments have torn too much and leave the ankle loose and unstable) persists, surgical intervention may be warranted where ligaments can be repaired and/or a minimally invasive “clean out” of a painful ankle joint (i.e. arthroscopy) may be performed.  (New England Patriots tight end Rob Gronkowski had arthroscopic surgery on his injured ankle after Super Bowl XLVI)

Oftentimes, sprains that occurred years ago are still painful due to either an inaccurate diagnosis or an incomplete rehabilitation in the first place.  Some sprains are severe enough to “strain” or tear the tendons around the ankle.  Along with a physical exam, diagnostic modalities such as musculoskeletal ultrasound (available at Advanced Foot and Ankle Care) or even an MRI may be warranted to fully understand the extent of your “sprain” and help guide your rehab.  Sometimes, a “sprain” turns out to be more involved, including an actual fracture (i.e. broken bone). 

The bottom line is this…pain in and around your foot or ankle is not normal. But, first and foremost, it is imperative that you see an appropriate physician for an accurate diagnosis.  Our team at Advanced Foot and Ankle Care are trained and fully equipped to accurately assess and treat these types of injuries.  If you’ve had the misfortune of suffering a recent ankle sprain or are still experiencing symptoms from an older injury, contact any of our Advanced Foot and Ankle Care Center locations including our Troy office for an evaluation.

Dr. Michael Jones