Pott’s Fracture is a type of fracture of the ankle joint. The ankle joint is basically a hinge joint, an articulation of the lower end of the tibia (shin bone) and its medial malleolus with the lateral malleolus, both joining the body of the talus (foot bone). The ankle joint has a strong medial collateral (deltoid) ligament which is triangular in shape, it is made up of the tibionavicular, tibiocalcaneal and the tibiotalar (anterior and posterior) ligaments. Pott’s fracture, otherwise called as Pott’s syndrome I or Dupuytren fracture, is a term used to describe bimalleolar (both malleolus) ankle fractures. Injuries about the ankle joint cause destruction of not only the bony architecture but also of the ligamentous and soft tissue components.
What are the reasons for Pott’s fracture ?
If there is fracture of either one or both malleoli or only one malleolus, it is Pott’s fracture. The injury is caused by the patient stumbling and falling with the foot anchored to the ground and the body twisting. This action strains the powerful medial (deltoid) ligament of the ankle, often tearing off the medial malleolus due to its strong attachment. If the malleolus is pushed the fracture is oblique; if it is pulled the fracture is transverse. It is mostly due to contact sports or injury. Skiers, footballers and climbers are more prone to it.
What is the treatment of Pott’s fracture ?
The treatment should not be delayed. The bony and ligament injuries should be treated simultaneously. Accurate reduction of fracture has to be done whilst maintaining it in the same place is the basic treatment. The conservative treatments are used for non displaced ankle injuries. Immobilization, elevation and Plaster of Paris casts will have to be used for 6-8 weeks. The procedure can be done under either local, regional or general anesthesia. An open reduction means the surgeon makes a surgical cut in the skin to reach the bones and then moves them back into their original position. Open Reduction can be combined with a process called Internal fixation in a procedure known as Open Reduction and Internal Fixation (ORIF). Internal fixation means fixing the bone in place with metal screws, plates, sutures, or rods whilst it heals. This internal fixation is permanent and will not be removed. A radiograph may be taken after the bones are approximated and the implantable devices are attached. The surgical incision will then be closed with stitches or staples and covered with a bandage. A cast or splint will be put into place to shield the repair as it heals. The joint will have to be immobilized or splinted so the wound heals well.
What are the risks of Pott’s fracture surgery ?
The most common risk is that of malunion or delayed union, which will limit normal joint mobility. Wound infection may also occur. There might also be stiffness of the joint or loss of joint use. If the cause is not corrected or avoided, the fracture may occur again.
What is the recovery and after-care for Pott’s fracture surgery ?
The emergency treatment consists of cold ice packs, tight compression bandages and weight-easing crutches. It is hard to bear weight on the affected joint for a few weeks after surgery, so casting or splinting may be needed to ease tension on the ankle joint. Physical therapy, physiotherapy and proprioceptive training are needed to learn the protective reflexes to safe-guard the joint for customary daily activities. The recovery can take upto twelve weeks.
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Disclaimer: The content provided here is meant for general informational purposes only and hence SHOULD NOT be relied upon as a substitute for sound professional medical advice, care or evaluation by a qualified doctor/physician or other relevantly qualified healthcare provider.
