What is a Pott’s fracture?
A Pott’s fracture is another term for an ankle fracture that includes one, or both of the malleolus, of the ankle.
A Pott’s fracture is a collective term, which includes various fractures of the ankle and a whole range of severity, thus these injuries are usually just referred to as a broken ankle.
A break of the ankle usually takes quite a lot of force to occur, so often this injury is accompanied by other injuries such as ligament ruptures or tendon strains.
The image above demonstrates some of the different types of Pott’s fractures.
How does a Pott’s fracture occur?
Pott’s fractures often occur when a person severely rolls their ankle, lands on their ankle in an awkward position, or takes a high impact to the ankle.
In short, if a force applied to the ankle is higher than the force the bone is able to withstand, a fracture will form.
Sometimes this fracture will only go through a small portion of the bone, and other times it will fracture all the way through the diameter of the bone.
For example, when a person rolls their ankle, it is common to see part of the very end of the fibular chip off as the ligament that attaches at this site pulls on it with an excessive force.
How is a Pott’s fracture assessed?
Depending on the location, severity and whether bones are displaced or non-displaced, some forms of Pott’s fracture will be very easy to detect on a plain film X-ray and others will not be.
Your doctor or podiatrist will use information such as a description of how you did the injury, the level of pain present, and even palpation of the bones in your leg and visual assessment to determine if X-rays are necessary.
If the X-ray comes back negative but a fracture is still suspected, you may be sent for further imaging such as an MRI to ensure a fracture is not present that did not show up on plain film X-ray.
How is a Pott’s fracture treated?
Depending on the type of Pott’s fracture that has occurred, initial treatment will differ greatly.
However, most fractures will follow a similar treatment pathway.
The first step will involve deciding whether a surgery is required or not. This will depend on whether everything is sitting in the right place still or not. If any bones are displaced or pieces of bone are not sitting where they should be, surgery is often required.
Following this decision, the limb needs to be immobilised to allow the fractured bones to heal. This could involve the use of a moon boot, a cast, crutches or a combination of these methods.
The length of the immobilisation period is also dependent on the severity of the fracture, as very small fractures may heal much faster than larger fractures that require major surgery.
Once the bones have healed and you are able to come out of your immobilisation device, the ankle will begin rehabilitation.
The rehabilitation phase will first involve regaining range of motion in the ankle joint and build up to strengthening of the muscles surrounding the ankle joint. This may involve theraband work, as well as lots of bodyweight and balance exercises.
Once a majority of strength has returned to the ankle, it is important to start building up towards more functional movements. If you are an athlete, working on sport specific movements will help to make your return to sport as seamless as possible.
What is the long term outcome for Pott’s fractures?
In general, the outlook for most Pott’s fractures is relatively good.
Most people are able to return to sport within weeks to months.
However, this completely depends on the type and severity of fracture that has occurred.
If you suspect you have a Pott’s fracture, you should visit the emergency room immediately to be put on the right pathway to proper rehabilitation for your fracture.
