Ankle Fracture
A break in one or more of the ankle bones
Quick Facts
- Type: Bone fracture
- Common causes: Twisting injury, falls, impacts
- Main symptoms: Pain, swelling, trouble walking
- Healing time: Often 6-12 weeks
Overview
The ankle joint is formed by the ends of the two lower leg bones (the tibia and fibula) and the top of the foot bone (the talus). An ankle fracture is a break in one or more of these bones. It can range from a small crack in a single bone to several breaks that leave the joint unstable.
Ankle fractures are common and are often confused with severe sprains because the symptoms overlap. Proper diagnosis matters, since stable breaks may heal in a cast while unstable ones may need surgery to line up the bones correctly.
Symptoms
- Immediate, often severe pain at the ankle
- Swelling and bruising around the joint
- Tenderness directly over the ankle bones
- Difficulty or inability to bear weight or walk
- A deformed or out-of-place appearance in serious fractures
- Numbness or a cold, pale foot if blood vessels or nerves are affected, which is an emergency
Causes
Ankle fractures usually result from sudden force on the joint:
- Twisting or rolling the ankle, such as stepping awkwardly or landing badly.
- Falls, especially from a height or onto an outstretched foot.
- Direct impact, such as a heavy object falling on the foot or a vehicle collision.
- Sports injuries involving sudden stops, pivots, or contact.
Risk Factors
- High-impact and pivoting sports
- Weak bones from osteoporosis
- Older age and a higher risk of falls
- Previous ankle injuries
- Uneven walking surfaces and inadequate footwear
Diagnosis
A doctor examines the ankle for tenderness, swelling, deformity, and the ability to bear weight, and checks circulation and sensation in the foot. X-rays confirm the fracture and show which bones are broken and whether the joint is aligned. A CT scan is sometimes used for complex breaks, and an MRI may assess soft tissue or ligament injury.
Treatment
Treatment depends on which bones are broken and whether the joint is stable:
- Immobilization: A cast, boot, or splint protects stable fractures while they heal, often with crutches to limit weight on the ankle.
- Reduction: If bones are out of place, the doctor realigns them.
- Surgery: Plates, screws, or rods may be needed for unstable, displaced, or open fractures to hold the bones in proper position.
- Rehabilitation: Physical therapy restores strength, motion, and balance after healing.
Most ankle fractures heal over about 6 to 12 weeks, with full recovery of strength taking longer.
Prevention
- Wear supportive, well-fitting footwear appropriate to your activity
- Strengthen the muscles around the ankle and work on balance
- Warm up before exercise and avoid uneven or slippery surfaces
- Keep bones strong with adequate calcium, vitamin D, and exercise
- Reduce fall hazards at home, especially for older adults
When to See a Doctor
See a doctor for ankle pain and swelling after an injury, especially if you cannot bear weight or walk a few steps. Seek emergency care if the ankle looks deformed or out of place, the bone breaks the skin, the foot is numb, pale, or cold, or there is severe pain or uncontrolled bleeding, as these need urgent treatment.
Frequently Asked Questions
How can I tell if my ankle is broken or just sprained?
It can be hard to tell, since both cause pain and swelling. Being unable to bear weight, tenderness directly over the ankle bones, or a deformed appearance suggest a fracture. An X-ray is the reliable way to know, so an injured ankle should be evaluated.
Do all ankle fractures need surgery?
No. Stable fractures where the bones stay aligned often heal in a cast or boot. Surgery with plates and screws is usually reserved for unstable, displaced, or open fractures where the bones need to be held in proper position.
How long does a broken ankle take to heal?
Most ankle fractures heal over about 6 to 12 weeks, though regaining full strength, motion, and balance can take several months, often with physical therapy. Healing time depends on the severity of the break and whether surgery was needed.
When is an ankle fracture an emergency?
Seek emergency care if the ankle is deformed, the bone pierces the skin, the foot becomes numb, pale, or cold, or there is severe pain or heavy bleeding. These signs may mean nerves or blood vessels are affected and need urgent treatment.
References
- American Academy of Orthopaedic Surgeons (OrthoInfo). Ankle Fractures.
- MedlinePlus, U.S. National Library of Medicine. Broken ankle.
- Mayo Clinic. Broken ankle.