Ankle Fracture

What is a Fracture of the Ankle Bone?

The ankle is the joint where the lower leg connects to the foot.  It is made up of several bones which move together to allow multiple planes of movement.  This allows the ankle to respond to various walking surfaces and allows us to remain upright.  The bones that come together at the ankle are connected by a complex series of ligaments.  These ligaments, as well as the tendons and muscles in the ankle contain nerve receptors which detect movement and help the ankle adjust to stabilize the body over the foot. 

Illustration of a talus fracture this means a broken ankle or ankle broken. JOI RehabIllustration of a Talus Fracture 

What is the Most Common Injury to the Ankle?

The most common type of injury at the ankle is a sprain.  A sprain occurs when a ligament is forcefully stretched beyond its normal length.  This causes tearing in some of the fibers of the ligament.

Image of an injured ankle
This can occur when the ankle does not have time to respond to the movement detected, such as a quick direction change or stepping into a pot hole.  

A broken ankle or fractured ankle can occur with more forceful injuries.  This may occur with a hard fall onto the foot or ankle or a crush injury of the ankle.  It may also occur with a severe sprain which compromises the bone and the soft tissue.  

Ankle Anatomy

Diagram showing ankle anatomy labeling the individual ankle bones of the leg. JOI RehabAnkle Anatomy

There are several types of ankle fractures.  These include:

  • Fibula Fractures - A fracture in the outer bone of the lower leg
  • Tibial Fractures - A fracture in the inner bone of the lower leg
  • Malleolar Fractures - Fracture of the end of one of the leg bones
  • Bimalleolar fractures - Fracture of both of the ends of the leg bones
  • Trimalleolar fractures - fracture of both of the ends and the back of the lower tibia

What is the Difference between a Fracture and a Break in the Ankle?

A fracture is the technical term to describe a compromise in bone tissue.  The severity can vary for a hairline fracture to a compound or comminuted fracture.  A break is a lay term to describe a fracture.  

Can you Still Walk on a Broken Ankle?

Most of the time, if you can walk around, the ankle is not fractured.  Sprains are more common in the ankle than fractures.  Fractures are typically very painful with weight bearing activity.  Immediate swelling is common with both a fracture and a sprain.  

If pain limits taking steps on the injured ankle, an X-ray is typically performed to determine if there is a fracture. 

How Long Does it Take to Heal a Fractured Ankle?

Uncomplicated fractures in the ankle typically heal within 6 to 8 weeks.  The ankle is typically immobilized in a cast or a medical ankle boot.  This is to prevent extra forces on the injured bone and allow it to heal properly. Patients with a fracture are usually not allowed to place pressure or weight on the injured ankle.  Most patients use crutches but some use a scooter which allows weight through the knee instead. 

In complicated fractures, surgery may be needed to repair the ankle.  This may take much longer to heal.  Most patients can not place weight on the ankle for 8 to 12 weeks after ankle surgery.  There is typically a need for physical therapy after this time, to restore movement, strength, and walking.

Do You Need a Cast for a Fractured Ankle?

Some sort of casting is typically needed to protect the ankle while it heals from a fracture.  A walking boot or a hard cast are both typical.  Some patients opt for the new ActivArmor cast.  

ActivArmor is a cutting edge technology which makes custom waterproof casts.  A 3D scan is made of the ankle and foot and a custom removable hard plastic cast is fabricated using 3D Printing Technology. 

If you want to learn more about the ankle, please watch this video.  If you would like to learn more about what you can do when you have an ankle fracture, read this article 4-cardio-workouts-you-can-do-with-an-injured-leg.  Later in the recovery period, you may need an ankle brace to help protect the ankle while its healing. 

 By: Ehren Allen, PT, COMT

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