Ankle Fracture

A fracture is a partial or complete break in a bone. Fractures in the ankle can range from the less serious avulsion injuries (small pieces of bone that have been pulled off) to severe shattering-type breaks of the tibia, fibula or both.

Ankle fractures are common injuries most often caused by the ankle rolling inward or outward. Many people mistake an ankle fracture for an ankle sprain, but they are quite different and therefore require an accurate and early diagnosis. They sometimes occur simultaneously.

Symptoms

An ankle fracture is accompanied by one or all of these symptoms:

  • Pain at the site of the fracture, which in some cases can extend from the foot to the knee
  • Significant swelling, which may occur along the length of the leg or may be more localized
  • Blisters may occur over the fracture site. These should be promptly treated by a foot and ankle surgeon.
  • Bruising that develops soon after the injury
  • Inability to walk—however, it is possible to walk with less severe breaks, so never rely on walking as a test of whether a bone has been fractured
  • Change in the appearance of the ankle—it will look different from the other ankle
  • Bone protruding through the skin—a sign that immediate care is needed. Fractures that pierce the skin require immediate attention because they can lead to severe infection and prolonged recovery.

Diagram of ankle indicating location of tibia and fibula.

Diagram of the front of the ankle indicating the location of the fibula and tibia

Diagnosis

Following an ankle injury, it is important to have the ankle evaluated by a foot and ankle surgeon for proper diagnosis and treatment. If you are unable to do so right away, go to the emergency room and then follow up with a foot and ankle surgeon as soon as possible for a more thorough assessment.

The affected limb will be examined by the foot and ankle surgeon who will touch specific areas to evaluate the injury. In addition, the surgeon may order x-rays and other imaging studies, as necessary.

When Is Surgery Needed?

For some ankle fractures, surgery is needed to repair the fracture and other soft tissue-related injuries, if present. The foot and ankle surgeon will select the procedure that is appropriate for your injury.

Follow-Up Care

It is important to follow your surgeon’s instructions after treatment. Failure to do so can lead to infection, deformity, arthritis and chronic pain.