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Ankle Fracture – Cause, Symptoms, Diagnosis & Treatment

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What Is An Ankle Fracture?

Ankle fracture is a common orthopedic injury that can be caused by an accident. It is a break in one, or more, of the bones that form the ankle joint. It is the severity of pain and instability of the joint that will usually lead a patient to seek immediate medical care. Patients with a suspected ankle fracture are usually referred to an orthopedist for evaluation and treatment.

To make the diagnosis, an orthopedist will usually first order an x-ray to determine whether there is a fracture in the ankle, as opposed to a dislocation, tendon injury or sprain.

Understanding The Anatomy of the Ankle

A fracture is a broken bone. If there is a fracture in your ankle, this means you have broken a bone in the ankle joint. The ankle joint is comprised of three bones, including the tibia, fibula and talus. The talus is the primary bone that connects the leg to the foot.

The bones of the ankle joint have ligaments that connect them to each other, providing stability to the joint. Your ankle can be injured when the ligaments that connect these bones stretch or tear. This is called an ankle sprain. Sometimes, a torn ligament can also rip off a piece of bone. This is called an avulsion fracture.

Common Causes Of Ankle Fractures

A fracture of the ankle can be caused in many different ways. Inward and outward twisting of the ankle, or blunt trauma to the ankle are both major causes of trauma-related ankle fracture. These types of forces commonly occur in car crashes, falls, and other types of accidents

What Are the Symptoms of a Fractured Ankle?

You might experience some, or all, of the following symptoms with a broken ankle:

  • Throbbing pain in the joint or fractured area. This can be lateral ankle pain, foot pain, or medial ankle pain;
  • Swelling of the ankle;
  • Bruising and blistering;
  • Difficulty bearing weight on the ankle.

What Are Some Common Ankle Fractures?

  • Fracture of the Malleoulus: This type of ankle fracture is the most common. The condition refers to a break in the lateral malleolus or the knobby bump on the outside of the ankle.
  • Bi-malleolar Fracture: This is the second most common ankle fracture type. It involves a break of both the medial and lateral malleolus. The medial malleolus is the bump on the inside of the ankle.
  • Tri-malleolar Fracture: This type of ankle fracture involves breaks in three parts of the ankle. This type of fracture includes the lateral, medial, and posterior portions of the malleolus.
  • Pilon Fracture: Also known as a Plafond fracture, this fracture goes all through the ankle’s weight-bearing covering. This type of fracture is most commonly caused by a high-impact incident, like a fall from a height.

Ankle Fracture Treatment

A fracture can be either displaced or non-displaced. The classification of fracture is important because these two different types of fractures usually require different forms of treatment. While the goal of restoring stability to the ankle is the same, the manner of achieving this goal is different depending on whether the fracture is displaced, or non-displaced.

Your doctor will use an x-ray, or sometimes a CT Scan to determine, whether and where your ankle is fractured. The use of this type of diagnostic testing is important in managing the fracture and determining your best treatment options.

A non-displaced fracture refers to a condition when the broken bone remains essentially aligned and in position. When a patient has a non-displaced fracture, the most common form of treatment is closed reduction.

With the closed reduction, your doctor will manipulate the broken bone back into the proper position and then apply a cast. The goal of a closed reduction is to stabilize the broken bone, and allow the body to heal naturally with callous formation at the fracture site. Callous formation is analogous to scar tissue that forms on your skin to close a cut.

A displaced fracture requires more to manage. When a fracture is displaced, broken bones are misaligned and oftentimes fragmented. When bone fragments are displaced, your surgeon may recommend surgery to reconstruct the broken bones. This surgery is called an open reduction and internal fixation procedure.

During an open reduction procedure, your doctor will put the pieces of bone back into correct alignment. The broken bones will be held together with a combination of hardware which may include plates, screws, wire, pins, and rods allowing the bones to heal in a proper position. After the procedure, your doctor will use a cast to immobilize the area.

Ankle Fracture Treatment Casts and Splints

Casts and splints are supportive devices used to help patients keep injured bones in place as they heal. These are commonly used to treat injured joints and broken bones. Depending on the type and area of the fracture, there are different types of casts. These include:

  • Waterproof casts;
  • Bivalve casts;
  • Casts designed for upper extremities; and
  • Casts designed for lower extremities.

After a cast is removed, you ankle will feel weak. Your doctor may order a course of physical therapy to improve ankle function and strength. Your doctor may suggest some specific exercises such as making a circle with your foot, turning the ankle inward and outward, and gently pulling your toes.

Ankle Fracture Recovery Time?

Your healing over time depends on a number of factors. These include how severely your ankle was fractured, and whether it required surgery. Many patients experience stiffness in the ankle joint over time, as well as weather-related increases in pain. Some patients develop osteoarthritis in the ankle, which can result in pain, stiffness, and limited range of motion of the ankle joint.

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