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Broken Ankle - Injury Overview

by Jaydee Vykoukal, PT, DPT September 06, 2017 0 Comments

Ankle Pain

Half of reported broken or dislocated ankles are due to athletic activities. Other ankle fractures happen during daily life with activities like walking, traveling or shopping. A broken ankle may range from a simple, small break in the bone to a complete crack that stabs through the skin. If you think you’ve suffered an ankle injury, read on to learn the signs of a broken ankle and the types of breaks. Then jump into our guide to see how to treat a broken ankle.

Ankle Anatomy

The “true” ankle is formed from 3 bones- the largest tibia bone on the inside, the fibula on the outside, and the talus (part of the heel) on the bottom. However, there are eleven additional smaller bones within the foot that also provide secondary support to the ankle. Fracturing any of these bones can affect ankle function.

What is a Broken Ankle?

When an ankle breaks, one or more of the bones in the ankle joint are fractured or out of place.  Additionally, the ligaments may be seriously damaged. The severity of a broken ankle ranges from a simple injury that minimally hinders your daily activities to severe fractures requiring surgery and rehabilitation. This depends on whether the fracture is a hairline fracture or more complex and traumatic.

Types of Ankle Injuries

Doctors categorize broken ankles according to the area of bone that is fractured. A broken ankle can happen in two general places: the ankle joint itself (any of the three main bones) or the syndesmosis joint (the area that connects the tibia and fibula together). The primary ankle fractures are:

  • Medial Malleolus Fracture

    The lower portion of the tibia, or shinbone, creates the bony knob on your  inner ankle called the medial malleolus. Medial malleolus fractures are often a result of a direct trauma and typically mean a long recovery time and a long period of immobility. Whether the break is from a fall on the stairs, a stress fracture, or a sports injury, a broken tibia can be a complex injury that includes the foot and knee, as well.

  • Lateral Malleolus Fracture

    The fibula is the thinner outer lower leg bone. The portion creates the outside knob of the ankle known as the lateral malleolus. A broken lateral malleolus occurs after an impact to the ankle or leg. Stress fractures may also happen due to repetitive impact. In severe fibula fractures, displaced bones can cause a visible deformity. Plus, a severe ankle sprain can cause an avulsion fracture (pulling a section of the bone away) of the fibula too.

  • Bimalleolar Fracture

    When impact to the ankle is severe, it can result in a fracture of both sides of the ankle at once. This often results in severe ligament and cartilage damage. It is most common with traumatic car accidents and high impact sports injuries.

Causes of a Broken Ankle Bone

There are several different reasons an ankle fracture might occur. The major causes of an ankle injury include:

  • Simple Missteps

    Sometimes, twisting or rotating your ankle when putting weight through your foot can result in a broken bone. Even putting your foot down wrong (on an edge or off a step) may cause a fractured ankle.

  • Car Crash

    The impact of a car accident may cause more complex fractures or even dislocations, which may require surgical repair.

  • Heavy Lifting

    Lifting heavy objects every day or dropping one on your foot can easily cause a broken ankle.

  • Sports

    High-impact sports can cause inflammation and strain in the bone over time. Dangerous twisting injuries, direct blows, and stresses usually occur in sports like football, soccer, tennis, and basketball.

  • Trips or Falls

    Falling can cause broken bones in the ankle or foot.

Broken Ankle Symptoms

After you hear that pop or experience ankle pain, you may wonder, is my ankle broken? Knowing whether your ankle is broken or sprained helps you determine how to efficiently treat the injury. Every fracture must be properly evaluated by a physician to avoid serious problems later such as poor fracture healing, chronic pain, and non-union. If you have any doubts or your ankle feels unstable, see your doctor immediately.

What does a broken ankle look like? Common signs of a broken ankle include:

  • Moderate to severe ankle swelling
  • A sudden, throbbing pain, which may extend from your foot to your knee
  • Bruising, redness, and tenderness
  • Deformity
  • Protruding bones—open ankle fracture
  • Difficulty to walk or bear weight

Broken Ankle Diagnosis

A fractured ankle can be complicated to diagnose, especially to self-diagnose unless severe. If you are suffering from any of the symptoms listed above, visit a medical professional as soon as possible. The doctor will conduct a careful examination of your foot, ankle, and lower leg to determine the best course of action.

Diagnosing an Ankle Injury with Imaging

Your doctor may also utilize these imaging tests to effectively examine your injury.

  • Broken Ankle X-Ray

    X-rays are intended to visualize ankle and foot fractures. The doctor may suggest one or more ankle images from different angles. Unfortunately, stress fractures often do not appear in X-rays until they begin to heal.

  • Magnetic Resonance Imaging (MRI)

    For detailed images of the ligaments of your foot and ankle, MRIs use strong magnetic fields and radio waves. This imaging test shows damaged bones, cartilage, and ligaments and can reveal fractures that are not visible on X-rays.

  • Computerized Tomography (CT) Scan

    CT scans involve combining several X-rays to create a cross-section image of the fractured ankle. A CT scan can unveil more information about the damage to your bone and soft tissues.

Broken Ankle Treatment

If a broken bone is diagnosed, rest will be a necessary part of the treatment process. A fracture will often require wearing a stabilizing ankle boot or cast and not bearing weight through the foot with use of crutches or a scooter for at least 6 weeks. More severe injuries may result in surgery and more extensive healing time.

Learn More About Proper Treatment for a Broken Ankle

Broken Ankle Recovery Time

Broken ankle recovery time, regardless of surgery or not, takes a minimum of 6 weeks for healing. Although pain can lessen after two to three weeks. Medications are available to help ease the pain after fracture or surgery.

Walking After a Broken Ankle

Suffering from a broken ankle injury puts your ankles at risk for re-injury. Once you've fully recovered, it's important to take preventative measures once you start walking around again to ensure your ankles are supported. To start walking again safely consider these tips:

  • Ask your doctor when you can walk on your healing ankle.
  • Wearing an ankle brace when participating in recreational activities or spending a long time on your feet. 
  • Rehab to properly restore ankle coordination
  • Don’t rush it

Remember, follow your recovery plan to get back on your feet quickly. Talk to your doctor and physical therapist about your goals for strengthening your ankle and improving mobility when the time is right.


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Jaydee Vykoukal, PT, DPT
Jaydee Vykoukal, PT, DPT

JayDee Vykoukal is a Doctor of Physical Therapy, owner of the healthy habit platform Health Means Wealth, and freelance medical writer. She loves traveling and spending time with her family in nature. Her passion is helping others continue to participate in the activities they love through education and proper exercise.

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