Understanding Ankle Fractures: A Comprehensive Guide

By Tracy Wilcox, PTA

Understanding Ankle Fractures and Broken Ankles

Ankle fractures or broken ankles, which refer to breaks in the bones that make up the ankle joint, are common injuries that can arise from various incidents such as a sudden twist, a fall, or a direct impact on the ankle. Grasping the concept of ankle fractures or broken ankles is crucial to ensure accurate diagnosis and appropriate treatment.

Ankle Fractures

Ankle Fractures can cause significant dysfunction in your life. The Jacksonville Orthopaedic Institute has foot and ankle specialists who can help diagnose and treat your ankle fracture. There are several different types of ankle and foot fractures, and each treatment may be different.  To read about cardiovascular exercises which you could do with a fracture, please read 4 cardio workouts you can do with an injured leg

Defining Ankle Fractures and Broken Ankles

An ankle fracture or a broken ankle is a medical term for a break or crack in any of the three main bones constituting the ankle joint, namely the tibia, fibula, and talus (collectively referred to as the malleolus). Ankle fractures can range from minor avulsion fractures of the ankle to severe trimalleolar fractures, depending on the impact on these bones.

There are several types of ankle fractures, each defined by its unique characteristics and treatment methods. The most frequent types include:

• Stable Fractures: In this scenario, the bones remain aligned, and the ankle joint is relatively intact.
• Unstable Fractures: These fractures result in significant displacement of the bones, destabilizing the ankle joint.
• Open Fractures: Also known as compound fractures, these occur when the broken ankle bone protrudes through the skin, enhancing the risk of infection.

Ankle fractures or broken ankles can originate from various causes, including:

• Twisting or Rolling the Ankle: Abrupt movements that place excessive strain on the ankle joint can fracture the bones.
• Direct Impact: A direct hit to the ankle, such as during a fall or collision, can result in an ankle bone fracture or a broken ankle.
• Overuse or Repetitive Stress: Activities involving repetitive movements or extreme stress on the ankle can weaken the bones over time, enhancing the risk of fractures.

Immediate medical attention is vital if you suspect an ankle fracture. A foot and ankle orthopedic specialist can evaluate the severity of the ankle bone break and advise appropriate treatment options, such as immobilization, medication, physical therapy, or ankle fracture surgery.

Types of Ankle Fractures

Lateral Malleolus Fracture

This is the most common type of ankle fracture. It is a break of the bump on the outside of the ankle (in the lower portion of the fibula).

Bimalleolar Ankle Fracture

This second-most common type involves breaks of both the lateral malleolus and of the medial malleolus, the bump on the inside of the ankle (in the lower portion of the tibia).

Trimalleolar Ankle Fracture

This type involves breaks in three sides of the ankle: the medial malleolus of the tibia, as well as the lateral malleolus and posterior malleolus (in the lower portion of the fibula).

Pilon Fracture (also called a plafond fracture):

This is a fracture through the weight-bearing “roof” of the ankle (the central portion of the lower tibia). This is usually a higher energy traumatic injury resulting from a fall from a height.

Within each of the above types, the fracture will be either:

• Nondisplaced – Bones are broken but still in the correct position and alignment.
• Displaced – Fractured portions of bone are separated or misaligned.

 

 

Identifying Symptoms of an Ankle Fracture or Broken Ankle

An ankle fracture or broken ankle presents several noticeable symptoms that can help ascertain if you have sustained a fracture or broken ankle. Recognizing these symptoms is essential for seeking timely medical attention and receiving appropriate treatment. The common symptoms associated with an ankle fracture or broken ankle include:

Pain, Bruising and swelling in the ankle: Intense pain and swelling in the affected area are primary indicators of an ankle bone fracture. The pain can be severe, impeding weight-bearing or movement of the ankle.

Difficulty walking or bearing weight: An ankle fracture or broken ankle may make it challenging to walk or bear weight on the affected ankle due to the pain and instability caused by the ankle bone break.

Visible deformity or abnormal ankle position: An ankle fracture or broken ankle may lead to a visible deformity or abnormal positioning of the ankle. There may be noticeable misalignment or a change in the shape of the ankle.

If you experience any of these symptoms, it is crucial to consult a healthcare professional immediately or visit the nearest emergency room. Accurate diagnosis and appropriate treatment are essential for successful recovery and preventing further ankle bone breaks.

Determining an Ankle Fracture or Broken Ankle

If an ankle fracture or broken ankle is suspected, seeking medical attention for a precise diagnosis is crucial. A qualified doctor will conduct a thorough physical examination to assess the extent and location of the injury.

During the examination, the doctor will inspect the ankle for signs of swelling, bruising, or deformity. They may gently manipulate the ankle to check for tenderness and assess the range of motion. By applying pressure in specific areas, the doctor can pinpoint the exact location of the ankle bone fracture or broken ankle.

Imaging tests like X-rays are often necessary to confirm the presence of an ankle fracture or broken ankle. X-rays provide detailed images of the bone structure, helping the doctor determine the type and severity of the fracture. In certain cases, the doctor may order an MRI (magnetic resonance imaging) to get more detailed information about the soft tissues surrounding the ankle.

After confirming the fracture or broken ankle, the doctor will evaluate the stability of the ankle by assessing the ligaments and other supporting structures. An unstable ankle fracture, such as a lateral malleolus fracture, may require additional treatment, such as surgical intervention, to ensure proper healing and prevent long-term complications.

 

Treatment of Ankle Fractures

The type of fracture and the stability of your joint will determine the type of splint or cast that and how long it will need to be in place. Depending on the type of fracture, you may have a walking cast, which can bear some weight. You may still need a non-weight-bearing cast that will require the use of crutches to help you walk.

A common nonsurgical treatment method is immobilization with casts or boots. This method helps protect the fractured ankle bones and promote proper healing by stabilizing the ankle and preventing excessive movement. The type of immobilization device used depends on the severity and location of the ankle bone fracture and the patient’s specific needs.

Pain management is a crucial aspect of treating ankle fractures or broken ankles. Anti-inflammatory medications like nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and swelling by decreasing inflammation around the fracture site.

When is Ankle Fracture Surgery Necessary?

Ankle fracture surgery may be necessary in certain cases of ankle fractures or broken ankles. Here are typical scenarios where ankle fracture surgery is recommended:

Severe or displaced fractures requiring realignment: In some cases, ankle fractures can be severe or displaced, meaning that the bones are not in their correct position. Ankle fracture surgery may be necessary to realign the bones and ensure proper healing.

Fractures with ligament damage or joint instability: If ankle fractures involve ligament damage or joint instability, surgical intervention may be required. Ankle fracture surgery can help restore stability and reduce the risk of long-term complications.

If your bones do not align properly, the doctor may realign them before placing the splint or cast. If the bones still do not align properly, you may require an operation.
An operation will may be necessary if any bone has broken through the skin. If the bone breaks through the skin, the fracture is a compound fracture. This is more serious than a simple fracture.

Ankle Fracture Recovery Time

It takes about six weeks for bones to heal. It may take longer for ligaments or other soft tissues to heal as well. Depending on the fracture you may or may not be able to put weight on your ankle.

If your fracture requires surgery; patients are typically non-weightbearing for 4 to 6 weeks until the bone heals. For the first couple of weeks, patients are in a splint and are elevating the limb most of the day. After 10 to 14 days, removal of sutures and the patient receives a removable boot. This allows patients to start moving the ankle and to shower. At the six-week visit, X-rays are taken to determine if the bone is healing.  Assuming the bone is well healing, patients can start weight-bearing/walking and physical therapy. Patients will generally have six to eight weeks of physical therapy.  Full recovery can take 6 months to a year depending on the patient.

Rehab for Ankle Fracture

Your physician may refer you to physical therapy to improve your strength, range of motion, balance, and help return you to your previous level of function. JOI has physical therapists, physical therapist assistants, and athletic trainers that can develop a treatment plan of various exercises and manual interventions to return you quickly and safely to your favorite activities.

Ankle Fractures can cause significant dysfunction in your life. The Jacksonville Orthopaedic Institute has foot and ankle specialists who can help diagnose and treat your ankle fracture. There are several different types of ankle and foot fractures, and the treatment may be different.   JOI also has DME (Durable Medical Equipment) for foot and ankle fractures. Cast shoes and walking boots can be given if you have a fracture.

Post-Treatment Care After Ankle Fracture or Broken Ankle

Proper post-treatment care is crucial for a successful recovery after an ankle fracture or a broken ankle. This involves monitoring the healing progress and undergoing regular X-ray evaluations to ensure the ankle bone fracture is healing correctly.

During the healing process, it’s important to gradually return to weight-bearing activities under professional guidance. Initially, you may need to use crutches or a walking boot to protect the injured ankle and gradually increase the amount of weight you put on it.

Preventing future ankle injuries and fractures is also essential. Strengthening the muscles around the ankle joint through exercises recommended by your healthcare provider and wearing appropriate footwear that provides stability and support can help reduce the risk of future ankle bone fractures.

If you want to learn more about ankle fractures, go to ankle fracture.

Ankle Pain

Many different conditions can cause ankle pain.

1. Arthritis of the ankle.
2. RA (Rheumatoid Arthritis) or Osteoarthritis of the ankle.
3. Fractures of the ankle.
4. Ankle Sprain or Strain.
5. Cartilage Injuries.
6. Stress Fractures of the ankle.

The Jacksonville Orthopaedic Institute has Board Certified Orthopedic Foot and Ankle Surgeons, who will diagnose the pain in your ankle and provide an individualized treatment program.  JOI has 13 Physical Therapy Centers in the North Florida Region to provide the highest physical therapy level for the best outcome.  If you want to learn more about Ankle Pain, go to ankle pain.

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JOI Can Help with Ankle Fractures

JOI is Northeast Florida’s most respected orthopedic practice.  Our Physicians continue to offer online new patient appointments. This is another option to make it more convenient to make new patient appointments with less phone hold times. Follow the link below to select your JOI MD and schedule online.

You can still call 904-JOI-2000 to make new patient JOI Physician Appointments if that is your preference.  A new option, you can now schedule and cancel follow-up appointments with your physician at the JOI Patient Portal. 

To make appointments with JOI Rehab, please call 904-858-7045.