Ankle Fracture

Symptoms of ankle fractures

Common symptoms for a broken ankle include:

  • Immediate and severe pain
  • Swelling
  • Bruising
  • Tender to touch
  • Cannot put any weight on the injured foot
  • Deformity (“out of place”), particularly if the ankle joint is dislocated as well

What is an ankle fracture?  

A broken ankle is also known as an ankle “fracture.” This means that one or more of the bones that make up the ankle joint are broken.

A fractured ankle can range from a simple break in one bone, which may not stop you from walking, to several fractures, which forces your ankle out of place and may require that you not put weight on it for a few months.

Common causes include:

  • twisting or rotating your ankle
  • Rolling your ankle
  • Tripping or falling
  • Impact during a car accident

One example of an ankle fracture is this

Before you see a physician

It is very important to consider how the injury occurred as ankle injuries routinely fall into predictable patterns based on how they happen. Understanding the mechanism of injury helps doctors to treat the fractures, making the decision to proceed to surgery or attempt non-surgical treatment easier.

Reasons to see a physician and treatment options

Any time you have experienced an event that has caused you to suspect you might have fractured your ankle you should immediately consult a foot and ankle orthopedic surgeon

Due to the wide range of possible fractures in the foot and ankle specific surgies or treatments should be discussed with you physician. However, there are some general treatments for ankle fractures.

Non-surgical Treatments

In general, non-surgical treatments will likely be recommended if the ankle is stable. X ray imaging will need to be done to determine that.

Treatment may be with a short leg cast, a removable brace or walking boot. Patients are typically advised not to put any weight on the ankle for 6 weeks.

Surgical Treatments

If after X ray imaging the fracture is out of place or the ankle is deemed unstable surgery is likely recommended.

Many different surgical options are available. However, many will involve the placement of a plate and screws in order to stabilize the ankle.


The ankle is made up of three bones:

  • the tibia (shin bone), which forms the inside, front, and back of the ankle
  • the fibula, which forms the outside of the ankle
  • the talus, a small bone that sits between the tibia and fibula and the heel bone

The tibia and fibula have three specific parts that make up the ankle

  • Medial malleolus – inside part of the tibia
  • Posterior malleolus – back part of the tibia
  • Lateral malleolus – end of the fibula

The ends of these bones are called malleoli. The tibia has a medial (inside) malleoli and a posterior malleolus. The fibula forms the lateral (outside) malleoli.

A fracture is a partial or complete break in a bone. In the ankle, fractures involve the far (distal) ends of the tibia and/or the fibula. Some distal tibia fractures can involve the rear (posterior) part of the bone, which also are known as posterior malleolar fractures. Ankle fractures can range from less serious avulsion injuries (small pieces of bone that have been pulled off) to severe, shattering-type breaks. Some fractures also may involve injuries to important ankle ligaments that keep the ankle in its normal position.

Recovery and return to activity

Although most people return to normal daily activities, except for sports, within 3 to 4 months, studies have shown that people can still be recovering up to 2 years after their ankle fractures. It may take several months for you to stop limping while you walk, and before you can return to sports at your previous competitive level. Most people return to driving within 9 to 12 weeks from the time they were injured.

Because there is such a wide range of injuries, there is also a wide range of how people heal after their injury. It takes at least 6 weeks for the broken bones to heal. It may take longer for the involved ligaments and tendons to heal.

Your doctor will most likely monitor the bone healing with repeated x-rays. This is typically done more often during the first 6 weeks if surgery is not chosen.

Pain management

Pain after an injury or surgery is a natural part of the healing process. Your doctor and nurses will work to reduce your pain, which can help you recover faster.

Medications are often prescribed for short-term pain relief after surgery or an injury. Many types of medicines are available to help manage pain, including opioids, non-steroidal anti-inflammatory drugs (NSAIDs), and local anesthetics. Your doctor may use a combination of these medications to improve pain relief, as well as minimize the need for opioids.

How a broken ankle happens

A broken ankle, also known as an ankle fracture, is a common but serious injury sustained when some kind of external force is applied to the foot compromising one or more of the bones. Broken ankles affect a large part of the population, and men and women of all ages may be susceptible to a broken ankle, regardless of activity level.

Three bones make up the ankle: the tibia, or shin bone; the fibula; and the talus, a small bone resting between the heel bone and the tibia/fibula. The location of the break in your ankle, as well as the severity and mechanism of the injury, will impact your recovery plan and timeline. A sudden or violent twisting or rolling of your ankle, such as might be common in high-impact sports, may cause a broken ankle. Falling from height, stepping on an object while walking or running, or trauma in a bike or car accident are other common causes of ankle fractures.

How to know if you have a broken ankle 

As with any other type of fracture, pain near the broken bone, bruising, swelling or redness, tenderness, visible deformity, and inability to move or bear weight on the ankle are all common signs of a broken ankle. Not all fractures exhibit each symptom.

How to diagnose a broken ankle 

Your physician will conduct a physical/visual examination and discuss the history of your injury. An X-ray, MRI or CT scan may also be ordered to confirm the location and severity of the break.

How is a broken ankle treated?

If you sustain a broken ankle or foot, your physician will review your imaging to determine if the fracture is stable or unstable. In a stable fracture, the bones remain properly aligned despite the break. In this case, the physician may not recommend surgery in favor of stabilizing and protecting the ankle as it heals. This may be accomplished by wearing a cast or protective boot for several weeks after the injury. Additional measures, such as a padded orthotic sole may be prescribed to lower the weight burden on the ankle and provide some level of additional comfort. A follow-up appointment will be scheduled after several weeks to review the progression of healing in the ankle. Over-the-counter medication may be used to treat pain and inflammation, as necessary.

If the fracture is unstable and bones are out of place, surgery will be required to set the fracture. The bones will be reduced and fixed into their normal position so that they maintain properly alignment during healing. This is typically accomplished through the use of implanted hardware such as pins, plates or screws. Some or all of this hardware may be removed once healing is complete, but some may remain to protect future displacement.

The prognosis is good for patients, regardless of treatment method, and they can usually return to full function within eight to ten weeks or less.

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