Kolton Miller, left tackle for the Las Vegas Raiders, has been diagnosed with a high ankle sprain and lower leg fracture, which the team is calling a “hairline fracture”. This is bad news for Raiders QB Geno Smith, who has been sacked 12 times this season, putting him in the top 5 most sacked QBs over the first 4 weeks.
High ankle sprains involve the ligaments and membrane that hold the two long bones in the lower leg together. High ankle sprains tend to happen with external rotation on a planted, and usually pronated foot. The hairline fracture the Raiders have mentioned is likely what’s called a Maisonneuve fracture, which is often associated with high ankle sprains. Maisonneuve fractures happen at the higher end of the fibula (the thinner, outer long bone of the lower leg), when the twisting forces from the injury travel up the bone.
Considering the team describes Miller’s fracture as “hairline,” the good news is that healing should be faster than if it were displaced. Unfortunately, the healing time for a high ankle sprain with a Maisonneuve fracture is still significant.
Treatment options
High ankle sprains with Maisonneuve fractures can be treated without surgery, typically involving multiple weeks in a cast or boot, non-weight-bearing, followed by a gradual progression back to full weight and extensive physical therapy to regain strength and range of motion. If a high ankle sprain is severe enough, surgery to stabilize the lower ends of the lower leg bones may be necessary. The good news is that the actual Maisonneuve fracture doesn’t usually need fixation. The ankle stabilization and time non-weight bearing (with or without surgery) is enough for the fracture to heal. Regardless of surgical or non-surgical treatment, Miller will be out for a significant amount of time, possibly the season.
