January 5, 2006

A slip on the ice can be tough on the ankles

By Megan Rauscher

NEW YORK (Reuters Health) - With old man winter bearing
down in Northern climes, the American College of Foot and Ankle
Surgeons (ACFAS) warns that falls on icy surfaces are a major
cause of ankle sprains and fractures.

And it's not just the elderly who run the risk of taking a
spill on the ice. "Yes, it's very common for older people to
slip and fall on the ice in winter, but pretty much everyone is
vulnerable to slipping on ice in the winter time," Dr. Matthew
Dairman, an ankle and foot surgeon, noted in an interview with
Reuters Health.

Dairman, a member of the ACFAS, and an assistant professor
at Eastern Virginia Medical School in Norfolk, Virginia, also
noted that the ankle joint is especially susceptible to
sustaining a serious injury from an ice-related fall because
ice accelerates the fall, often leading to more severe trauma.

Most people don't often realize, warned Dairman, that
sprains and fractures often occur at the same time and a bad
sprain can mask a fracture. "Just because you can walk on your
ankle or foot after a fall doesn't mean you don't have a

Dairman advises "anyone who falls and has a great deal of
swelling, bruising, and difficulty with walking to seek medical
attention," to prevent further damage that can prolong

If that's not possible, it's best to follow the RICE
strategy -- an acronym for Rest, Ice, Compression, and

"Rest it immediately after the injury; apply ice to it, 20
minutes on 20 minutes off; apply compression, usually with an
ACE wrap; and elevate it above heart level or at least above
the hip to reduce swelling," Dairman explained.

"Sometimes a P is added to it to make it PRICE therapy,
which is protection in the form of a cast or splint," he added.

Never soak the injured ankle or foot in warm water, Dairman
stressed. "That's absolutely the wrong thing to do because that
will increase the swelling, increase the pain, and prolong the
injury," he said.

According to the ACFAS Web site -- FootPhysicians.com --
symptoms of ankle sprains and fractures overlap, but, in
contrast to sprains, fractures are associated with pain at the
site of the fracture that can extend from the foot to the knee.
Also fractures often involve significant swelling, blisters
over the fracture site, and bruising soon after the injury.

A fracture is obvious if bone protrudes through the skin,
which is a sign of a compound fracture. This requires immediate