Frequently Asked Questions

I don't get it. I'm 67-years-young, active and in good health. Even so, I broke my ankle badly enough to need surgery and will be "off-line" so-to-speak for weeks while I'm on crutches. No driving, no biking, no putting weight on that foot. I exercise every day. I eat well. How could this happen to me?

Don't take it so hard. All your good efforts to be healthy and stay healthy may actually be why you didn't have a worse injury. Someone else without all those things to their credit may have broken even more bones. And, it's entirely possible that the same injury in someone half your age would have resulted in the exact same injury. In the past, osteoporosis (decreased bone density or "brittle bones") was blamed for most ankle fractures in adults 65 years old and older. Osteoporosis is linked with hip, wrist, and shoulder fractures. But new data suggests there are other possible more important risk factors. One of those risks is taking multiple medications called polypharmacy. Being overweight appears to be the most common risk factor. The heavier body mass increases the force on the soft tissue and bony structures when a fall happens. But diabetes, cigarette smoking, and inactivity may be the real underlying culprits. If none of these risk factors describes you, it could be just a case of bad luck. If you landed just right (or wrong as it were), the twisting motion may have just been enough to tear one or more of the many supportive ankle ligaments (e.g., anterior and posterior talofibular ligaments, calcaneofibular ligament, deltoid ligament, tibiocalcaneal ligament, tibiotalar ligament). Without this important soft tissue structure, the force continues through the bone causing a spiral or oblique (at an angle) break in one or both of the bones along side the ankle. Identifying risk factors for fractures is good in that it can help you address these problems and reduce your risk for future falls and/or fractures. But if none of this describes you, set your course for recovery and put your mental, emotional, and physical efforts toward healing.

Eric J. Strauss, MD, and Kenneth A. Egol, MD. Identifying and Managing Ankle Fractures in Older Patients. In The Journal of Musculoskeletal Medicine. April 2011. Vol. 28. No. 4. Pp. 137-147.

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