An ankle fracture is a break in one or more of the three bones that make up the ankle joint. The three ankle bones 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 – the bone that provides the connection between the leg and the foot and is less often fractured than the others
The ankle joint is supported by three groups of ligaments, which provide stability to the joint. An injury that causes a fracture may also damage one or more of these ligaments.
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. Any form of ankle trauma may cause injury, including:
A risk factor is something that increases your chance of getting a disease, condition, or injury.
- Decreased muscle mass
- Osteoporosis (common in women after menopause and in older less active people)
- Any condition that increases the risk of falls
- Participation in certain sports, such as basketball, football, soccer and skiing
- Immediate pain (can be severe, but sometimes with fibula injuries, is surprisingly minor)
- Bruising around the injured area
- Tenderness when touching the injured bone in the ankle area
- Inability to put weight on the injured foot without pain
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. For ankle fractures it is unusual to need other tests.
Treatment will depend upon the severity of the injury, whether multiple bones are involved, the status of the ligaments, and the position of the fractured bones. Treatment involves:
- Putting the pieces of the bone back into anatomical position, which may require anesthesia and/or surgery
- Holding 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.
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 the doctor says your ankle is fully healed and you have near normal motion and muscle strength.
It takes at least six to eight weeks for even a simple ankle fracture to heal. It will be several months before you can return to intense physical activity.
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, which helps to prevent falls.