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Conditions & Treatments

Ankle Fractures (Broken Ankle)

Ankle fractures are common in children and adults. An ankle fracture is one or more broken bones in the ankle. In the elderly ankle fractures are the 3rd most common fracture. To achieve good long-term functional outcome, it is crucial to receive early evaluation to determine the type of fracture, and whether there is also a ligament rupture.

Ankle anatomy

The ankle is a complex joint made of three bones – the tibia or shinbone, the lower leg bone or fibula, and the talus the small bone between the heel and the tibia and fibula.

What are the symptoms of an ankle fracture?

  • swelling and bruising
  • severe pain
  • tenderness
  • difficulty walking
  • inability to put weight on the injured foot
  • dislocation or deformity of the joint
  • other symptoms depend on the type of fracture and the cause of the break

What causes a broken ankle?

  • twisting or rotating the ankle
  • rolling on the ankle
  • jumping or falling at any height
  • tripping and falling from poor balance, uneven surfaces, poor lighting
  • auto accident
  • high impact sports that stress the ankle such as football, hockey or soccer

How is an ankle fracture diagnosed?

Your OANC orthopedic surgeon will review the circumstances surrounding the injury, your medical history and your symptoms. They will conduct an examination of the foot and lower leg testing for swelling and tenderness over the bones, and range of motion.

X-rays will reveal the type, location and severity of the fracture and whether the bones are in alignment or displaced. Stress x-rays may be ordered to determine whether ligaments are injured, and whether surgery is needed. A CT scan will evaluate the joint. An MRI will evaluate the ankle bones, and ligaments for damage.

Common types of ankle fractures

A bone can break, crack or develop a hairline fracture also called a stress fracture.

  • A lateral malleolus fracture is a fracture of the end of the fibula. The malleolus is the bony knob on the outside of the ankle.  It can fracture in 3 different locations. The location and level of the fracture will determine treatment. This is the most common type of ankle fracture.
  • A medial malleolus fracture is a break in the bony knob on the inside of the ankle. It is the end of the tibia.  The fracture can occur at different levels. This type of fracture often involves a fracture of the fibula, and the tibia or with ligament injury. This type of fracture is more common in women and about half of them are the result of falls and 20% are due to an auto accident. It usually requires surgery
  • A bimalleolar ankle fracture involves the fracture of the ankle knobs on the inside and outside of the ankle and is the second most common type of ankle fracture.
  • Posterior Malleolus fracture involves a fracture to the back of the tibia at the ankle and is usually accompanied by a lateral malleolus break in the fibula and the medial malleolus fracture.

The concern here is ankle instability, and the risk of post traumatic osteoarthritis. The posterior of the tibia is covered with cartilage and if the break injuries the cartilage the surface will not be smooth when healed and can lead to arthritis due to uneven pressure on the joint surface.

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