Ankle Fracture

An Ankle Fracture is a break in one or more of the three bones that make up the ankle joint. The three anklebones are:

Tibia (shin bone) – the main bone of the lower leg that runs along the inside of the leg

Fibula – the smaller bone of the lower leg that runs along the outside of the leg

Talus (ankle bone) – the bone that provides the connection between the leg and the foot

The ankle joint is supported by three groups of ligaments, which provide stability to the joint. A fracture can injure these ligaments as well.

Causes

An Ankle Fracture can occur when the joint is forced beyond its normal range of motion or there is a direct blow to the bone itself. This is caused by trauma to the joint. Trauma includes:
  • Falls
  • Twists
  • Blows
  • Collisions

Symptoms

Symptoms include:
  • Immediate and severe pain
  • Swelling
  • Bruising around the injured area
  • Tenderness when touching the ankle area
  • Inability to put weight on the injured foot without pain

Diagnosis

The doctor will ask about your symptoms, physical activity, and how the injury occurred, and examine the injured area.

Tests may include:

X-rays – a test that uses radiation to take a picture of structures inside the body, especially bones. It is used to look for a break in the bone.

Bone Scan – a test that involves injecting a bone-seeking nuclide into a vein and then performing a scan of the area. The test locates places in the bone where unusual amounts of bone repair activity are occurring. This is usually not needed for ankle fractures.   

Treatment

Treatment will depend on the severity of the injury. Treatment involves:
  • Putting the pieces of the bone back in position, which may require anesthesia and/or surgery
  • Keeping the pieces together while the bone heals itself
Devices that may be used to hold the bone in place while it heals include:
  • A cast (may be used with or without surgery)
  • A metal plate with screws (requires surgery)
  • Screws alone (requires surgery)
  • A rod down the middle of the bone (requires surgery)
The doctor may prescribe pain medication depending on the level of pain. Your doctor will order more x-rays while the bone heals to ensure that the bones have not shifted position. Exercises

When your doctor decides you are ready, start range-of-motion and strengthening exercises. You may be referred to a physical therapist to assist you with these exercises. Do not return to sports activity until your ankle is fully healed.

Healing Time

It takes at least 6-8 weeks for even a simple ankle fracture to heal. It will be several months before you can return to intense physical activity.

Risk Factors

A risk factor is something that increases your chance of getting a disease, condition, or injury.
  • Advancing age
  • Postmenopause
  • Decreased muscle mass
  • Osteoporosis
  • Participation in certain sports, such as basketball, football, soccer and skiing

Prevention

To help prevent Ankle Fractures:
  • Do not put yourself at risk for a trauma to the ankle.
  • Eat a diet rich in calcium and vitamin D.
  • Do weight-bearing exercises to build strong bones.
  • Build strong muscles to prevent falls and to stay active and agile.