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Ankle Fractures

What Is an Ankle Fracture?

An ankle fracture is a condition characterized by a partial or complete break in one or more of the bones that make up the ankle joint. These fractures can range from minor avulsion injuries, where small bone fragments are pulled off, to more severe, shattering-type breaks involving the tibia, fibula, or both.

It’s not uncommon for individuals to mistake an ankle fracture for a simple ankle sprain, but these injuries are distinct and necessitate accurate and prompt diagnosis. Sometimes, they can even occur simultaneously with a sprain.

Symptoms of an Ankle Fracture

Ankle fractures typically manifest with one or more of the following symptoms:

  • Pain: Pain is a common hallmark, often concentrated at the fracture site and sometimes radiating from the foot to the knee.
  • Swelling: Significant swelling may occur, either along the entire length of the leg or in a more localized area.
  • Blisters: In some cases, blisters can form over the fracture site. It’s crucial to address these promptly, and consulting a foot and ankle surgeon is advisable.
  • Bruising: Bruising usually develops soon after the injury.
  • Inability to Walk: In many cases, individuals find it impossible to bear weight on the affected ankle. However, it’s important to note that even with less severe fractures, walking may be possible, so relying solely on this as a diagnostic criterion is not recommended.
  • Altered Appearance: The affected ankle often appears noticeably different from the uninjured one.
  • Bone Protrusion: In extremely severe cases, the bone may protrude through the skin, signaling the need for immediate medical attention due to the risk of infection and prolonged recovery.

Ankle Fractures

Ankle Fractures Bone

Diagnosis of an Ankle Fracture

Following an ankle injury, it’s imperative to have the ankle assessed by a foot and ankle surgeon for a precise diagnosis and appropriate treatment plan. If immediate access to a specialist isn’t feasible, visiting the emergency room is advisable, with subsequent follow-up care by a foot and ankle surgeon for a comprehensive evaluation.

The foot and ankle surgeon will perform a physical examination, assessing specific areas of the injury. Additionally, they may order imaging studies, such as X-rays, to further evaluate the extent of the fracture.

Non-Surgical Treatment of an Ankle Fracture

The treatment approach for ankle fractures hinges on the type and severity of the injury. Initially, the foot and ankle surgeon may recommend adhering to the RICE protocol:

  • Rest: Resting the injured ankle is crucial to prevent further harm, as walking can exacerbate the injury.
  • Ice: Applying ice packs to the injured area, with a thin towel between the ice and skin, can help reduce swelling. It’s typically advised to ice for 20 minutes. then wait at least 40 minutes before icing again.
  • Compression: Employing an elastic wrap can aid in controlling swelling.
  • Elevation: Elevating the ankle slightly above the heart level can reduce swelling.

Additional treatment options may include:

  • Immobilization: Certain fractures are managed by immobilizing the ankle and foot in a cast or splint. This facilitates proper healing of the bone.
  • Prescription Medications: To alleviate pain and inflammation, the surgeon may prescribe pain medications or anti-inflammatory drugs.

When Is Surgery Necessary?

In some instances, ankle fractures necessitate surgical intervention to repair the fracture and address associated soft tissue injuries. The specific surgical procedure will be determined by the foot and ankle surgeon based on the nature and severity of the injury.

Follow-Up Care

Adhering to your surgeon’s post-treatment instructions is vital. Neglecting to do so can lead to complications such as infection, deformity, arthritis, and persistent pain. Your commitment to follow-up care plays a pivotal role in ensuring a successful recovery from an ankle fracture.


Dr. Kris Dinucci