Ankle fractures, also known as broken ankles, are bone injuries in the ankle joint.
Because this joint is highly complex, many types of breaks can occur. Typically, this term refers specifically to a full or partial break in the lower end of the tibia or fibula — the bones of the lower leg.
Treatment and rehabilitation protocols for a broken ankle depend on the type and severity of the break.
Common Causes of Broken Ankles
Both the tibia and the fibula wrap around the talus bone to form the ankle joint. A fracture can occur in one or both bones, typically as a result of an accident or impact.
Car or sports accidents and falls are the most common causes of ankle fracture. You can also break your ankle by twisting, rolling or rotating your foot the wrong way. Breaks can occur when undue pressure is placed on the joint, such as that which would result from jumping from high up and landing on the foot.
Any of these scenarios may result in the lesser injury of ankle sprain, which patients may mistake for a fracture based on similar symptoms. A sprain, however, does not involve injury to the bone. Instead, sprains result from damage to the ligaments and tendons of the joint.
Symptoms and Diagnosis of Ankle Fracture
Ankle fractures are primarily characterized by intense pain at the site of the break, which may extend down the foot or up the leg. Broken ankles are also notorious for excessive swelling and bruising. The area may be painful to the touch or appear deformed.
Patients who suffer from a broken ankle may not be able to walk or put weight on the injured leg. If the break is less severe, you may be able to put weight on it, but you shouldn’t.
In the case of an open fracture, broken bones can protrude through the skin.
Initial diagnosis and treatment are often conducted in an emergency room or urgent care facility. An examination and X-rays are the most common tools used to diagnose a broken ankle. The ER physician will typically stabilize the joint, immobilizing it with a splint until the swelling diminishes. Most patients are also advised to avoid all weight-bearing activities until further notice.
If you suffer an ankle fracture, it is important to see an orthopedic surgeon or sports medicine specialist as soon as possible after the break. Prompt diagnosis and treatment greatly improve the prognosis for this injury.
Ankle Fracture Treatment and Prevention
The orthopedic surgeon may order additional imaging tests, including MRI, CT scans or a specialized X-ray known as a stress test.
Ankle fractures are designated as either stable or unstable, depending on whether the movement of the talus bone is compromised (an unstable fracture) or unchanged (a stable break). The appropriate course of treatment depends on whether the break is stable or unstable and which bone or bones are broken.
Nonsurgical treatments may include a splint, removable brace or cast. You may require crutches if you are unable to bear weight on the broken ankle. The doctor will likely recommend the RICE protocol of rest, ice, compression and elevation, along with pain medication.
Some ankle fractures, including unstable and extensive breaks, require surgical repair that includes metal screws and plates for reconstructing the bone. Surgically repaired ankles place the patient at greater risk for developing arthritis as well as some degree of long-term or permanent swelling.
The duration for healing can be as long as eight weeks. Rehabilitation can last from a few weeks to several months.
Regardless of whether your injury requires surgery, the rehabilitation process will be essentially the same. It will likely include physical therapy and strengthening exercises, and a slow return to bearing weight.
Follow up periodically with your orthopedic surgeon to ensure that future complications do not develop as a result of your ankle fracture.