Fractured Ankle

Fractures of the tibia, fibula, or malleoli are common injuries, especially after trauma resulting from accidents, falls, and rolling or twisting of the ankle. Fractures, such as stress fractures, can also be caused by repetitive forces and overuse associated with running, jumping, and directional changes.

The following symptoms can accompany a fractured ankle:

• Pain and swelling at the fracture site, which may extend to the foot or knee
• Bruising which develops shortly after injury
• Difficulty or inability to bear weight or walk
• Deformities of bones around the ankle, with severe fractures

Diagnosing Ankle Fractures

Because symptoms of a fractured ankle mirror those associated with sprains, an early and accurate diagnosis is essential to identifying whether any fractures have occurred, as well as treatment approaches that may be used to reduce pain, stabilize the bones and joint, promote healing, and restore function.

Whether at an emergency room or with an ankle specialist, a doctor will perform a physical examination to evaluate the injury. Imaging tests, including X-rays and MRIs, may also be ordered to determine the severity of a fracture, whether there is displacement between broken bones, and whether there are any injuries to important ligaments.

Treating a Fractured Ankle

Treatment of ankle fractures is directed by the location and severity at which bones of the ankle are fractured. Some fractures, including less severe injuries, may be treated non-surgically using:

• Nonsteroidal anti-inflammatory and pain medications
• Casts, splints, or bracing to immobilize and protect the fracture while it heals
• Reduction in weight-bearing activity
• Physical therapy to restore range of motion

In some cases, ankle fractures may require surgery, especially if they are severe, displaced, or bones of the ankle need to be realigned and stabilized. The surgical approach used to repair the fracture and any other soft tissue injuries will be personalized to every patient, but the main goal is to restore the ankle joint to its normal shape, and reduce chances of ankle arthritis in the future.

Many ankle fracture surgeries involve open reduction and internal fixation (ORIF), where fractured bones are set through incisions made on the outer ankle if the fibula is fractured (lateral incision) or the inner ankle if the tibia is broken (medial incision). Repositioned bones are then held in place using medical grade metal screws and / or plates. Restricted activity and a cast or boot will be used to protect the ankle until the fracture fully heals, which typically takes 2 to 3 months. Physical therapy can also help improve recovery and allow patients to regain ankle function and improve range of motion.