Ankle Fracture
En Español (Spanish Version)

Definition
An ankle fracture is a break of a bone in the ankle joint. The joint is made up of three bones:

  • 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. An injury that causes a fracture may also damage one or more of these ligaments.

Ankle Fracture

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Causes
An ankle fracture can occur when the joint is forced beyond its normal range of motion. It can also be caused by a direct blow to the bone itself. Any form of ankle trauma may cause injury, including:

  • Falls
  • Twists
  • Blows
  • Collisions
Risk Factors
Factors that increase your chances of getting an ankle fracture include:

  • Decreased muscle mass
  • Osteoporosis —common in women after menopause and in older, less active people
  • Any condition that increases the risk of falls, such as poor muscle control or poor balance
  • Participation in certain sports, such as basketball, football, soccer, and skiing
  • Being overweight
Symptoms
Symptoms include:

  • Immediate pain—can be severe, but sometimes with fibula injuries, is surprisingly minor
  • Swelling
  • 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, although some people are able to walk with minor fractures
Diagnosis
You will be asked about your symptoms, physical activity, and how the injury occurred. An examination of the injured area will be done.

Images may be taken of your ankle. This can be done with x-rays. If additional details are needed, other images may be done, such as a CT scan or an MRI scan.

Treatment
Treatment will depend on the severity of the injury. Treatment includes:

  • Putting the pieces of the bone back into 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
Your doctor may prescribe pain medication. More x-rays will be ordered while the bone heals to ensure that the bones have not shifted position.

Exercises
When your doctor decides you are ready, start range-of-motion and strengthening exercises. You may be referred to a physical therapist to help you with these exercises. Do not return to sports activity until your doctor says your ankle is fully healed. You will need near-normal motion and muscle strength.

Healing Time
It takes at least 6-8 weeks for even a simple ankle fracture to heal. It will be several months before you can return to intense physical activity.

Prevention
To help prevent ankle fractures:

  • Do not put yourself at risk for trauma to the ankle.
  • Do weight-bearing exercises to build strong bones.
  • Build strong muscles to prevent falls and to stay active and agile.



RESOURCES:
American Academy of Orthopaedic Surgeons

American Orthopaedic Foot & Ankle Society

CANADIAN RESOURCES
British Columbia Podiatric Medical Association

Canadian Orthopaedic Foundation

References:
Ankle fracture. American Orthopaedic Foot & Ankle Society website. Available at: http://www.aofas.org/footcaremd/conditions/ailments-of-the-ankle/Pages/Ankle-Fracture.aspx . Accessed August 20, 2014.

Ankle fractures (broken ankle). American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00391. Updated March 2013. Accessed August 20, 2014.

Chaudhry S, Egol KA. Ankle injuries and fractures in the obese patient. Orthop Clin North Am. 2011;42(1):45-53.

Scott AM. Diagnosis and treatment of ankle fractures. Radiol Technol. 2010;81(5):457-475.

9/10/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Mosher TJ, Kransdorf MJ, et al. ACR Appropriateness Criteria acute trauma to the ankle online publication]. Reston (VA): American College of Radiology (ACR);2014. 10 p. Available at: http://www.guideline.gov/content.aspx?id=48284#Section420. Accessed September 10, 2014.

Last Reviewed August 2014



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