Ankle Fractures

An ankle fracture is a broken bone involving the fibula and/or tibia, which comprise the ankle joint.

Table of Contents

What is an ankle fracture?

An ankle fracture is a broken bone involving the fibula and/or tibia, which comprise the ankle joint. A fibular fracture is the most common ankle fracture, which is a break in the smaller bone on the outside of the ankle. The larger tibia on the inside of the ankle may also fracture either in conjunction with the fibula or in an isolated fashion. Ankle fractures most commonly occur with twisting injuries similar to that of ankle sprains. This usually occurs by stepping awkwardly off a stair or curb or a trip or step onto an uneven surface.

What should I do if I think I may have fractured my ankle?

Ankle fractures can often be mistaken for a sprain. If an ankle sprain does not improve in a day or two, you should be evaluated by a foot and ankle specialist. If you are unable to bear weight on the injured ankle, you will require an X-ray as soon as possible. This can be ordered by your primary care doctor or performed in the office of a foot and ankle specialist pending available appointments. If the injury occurs after office hours or appointments are unavailable, you should be evaluated by an emergency room or urgent care physician.

If there is any visual deformity or lacerations in the skin from the fracture, you should proceed to the nearest emergency room for evaluation and treatment. The ankle may have to be put back into proper alignment if it is dislocated in order to decrease the pressure on the surrounding skin, nerves, and blood vessels. Any lacerations in the skin from the fracture increase the risk of infection and needs to be treated promptly.

Do all ankle fractures require surgery?

Many ankle fractures do need an operation; however, not all ankle fractures require surgery. Several factors are taken into consideration when determining whether the best course of action is surgery or conservative care including: displacement of the fracture, stability of the fracture, integrity of the ankle ligaments, as well as many patient specific factors.

What would conservative care treatment consist of?

In general, conservative treatment consists of immobilization of the injured ankle. Many factors determine whether or not you can be weight bearing in a walking cast vs. non-weight bearing with crutches, walker, or a scooter.

How are ankle fractures repaired surgically?

The ankle bones are manipulated back into their anatomic position and stabilized. Most ankle fractures treated surgically are stabilized using internal fixation, which consists of screws, plates, and/or pins which are placed in the bone and remain under the skin.

All ankle fractures regardless of treatment modality require routine follow-up with a foot and ankle specialist to monitor progress and ensure the fracture is healing well in the proper alignment.

Can ankle fractures lead to ankle arthritis?

The ankle joint is generally resistant to age related arthritis, however, when the ankle has been traumatized, then arthritis unfortunately can develop. The time it takes for arthritis to develop depends on the severity of the injury.