A broken ankle is one of the most common injuries that an orthopedic surgeon or podiatrist will see. Twisting or rolling the ankle, trauma from an accident or landing forcefully on the ankle or even a heavy object falling on the ankle can cause an ankle fracture.  Although ankle fractures can affect people of all ages, they most commonly happen as people age and the bones weaken or become more brittle.

There are three bones that make up the ankle – the Tibia, the Fibula, and the Talus. With an ankle fracture you may have a non-displaced fracture, where the bone is broken, but the alignment is intact. Often these types of fractures do not require surgery. A displaced fracture means there may be one or more fractures within the ankle and the bones are separated and no longer aligned. These types of fractures often need surgery to re-align the bone and hold it in place while healing. The last type of ankle fracture is an open fracture or a compound fracture. With this type of fracture, the bone is protruding through the skin.  It is important that that with this type of fracture, you seek care immediately to reduce the risk of infection.

Signs You May Have An Ankle Fracture

Common symptoms that may indicate that you have a fractured ankle

  • The area is painful to touch
  • Swelling at the site
  • Bruising
  • Inability to put weight on the ankle or walk

Diagnosing An Ankle Fracture

Your doctor will use an x-ray to see your bones and evaluate their health and alignment.  The type of treatment needed will depend on the where the fracture is located and the severity of the break. Sometimes a boot or a cast can be used to stabilize the ankle while the fracture heals. A cast may be used to hold the bone in its proper position for healing.

Treating An Ankle Fracture

Sometimes the sections of broken bone must first be realigned. This is done by a process known as reduction. The type of reduction is based on how far the bone has moved from its normal position. Other times the surgeon may need to realign the bones so that they are in their proper place before casting. This process of aligning the bones is called a “reduction”. Most fractures that are simple and don’t involve soft tissue injuries or an open wound are able to be re-aligned with a closed reduction. The surgeon may use a light anesthetic to relax your muscles. Then they will manually re-adjust the position of the broken bone.

If you have an open fracture – where there is a break in the skin and bone is visible, a badly misaligned bone, or severe tissue injury, surgery may be needed.  In this case a general anesthetic may be used during the procedure to let you sleep and relax your muscles. Your doctor then makes small incisions to realign the bone and repair soft tissues. Sometimes it may be necessary to hold the bone in place while it screws or plates that will hold the bones in place for proper healing.

Once the bone is properly aligned, the ankle is put in a cast to hold the bones in place during healing. Casts are generally worn for 4 – 8 weeks while the bone heals. The cast protects the ankle from injury and movement so that it can heal in place. For less severe fractures, a walking boot, brace, or splint may be all that’s needed to hold the bone during healing.

The Road to Healing

Once your fracture has been treated, your doctor will tell you how to help it heal. Most ankle fractures take at least 6 weeks to heal, but it can take longer for any involved ligaments and tendons to heal. During this time, you may be instructed to limit ankle use, take medications, and elevate the foot. The good news is that most people return to their regular activities within 3 to 4 months.

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