Broken & Fractured Ankles

What is a Broken and Fractured Ankle?

A broken and fractured ankle occurs when one or more of the bones connecting your foot to your lower leg become damaged. Sometimes referred to as the tibiotalar joint or the talocrural joint, the ankle is a vital part of your skeletal system and includes the tibia, fibula, and talus.

How an ankle fracture is classified is dependent upon the area of bone that is broken. The ankle joint, where the tibia, fibula, and talus meet, is one of the joints involved in an ankle fracture. The other joint involved is the syndesmosis joint, the ligament-bound gap between the tibia and fibula.

Depending on how many bones and fractures are involved, this injury varies in degree of severity. A break in one bone may not be debilitating, whereas a deep fracture in several areas may require a surgical solution.

Common Causes

Physical trauma - such as twisting, falling, or tripping - is often the most prevalent cause of a broken ankle. For example, falling from a two-story roof or kicking a soccer ball at the wrong angle will lead to varying degrees of trauma. One of the most common causes of a fractured ankle is car accidents. It is more common for this injury to occur as a result of a twisting injury as opposed to a direct blow to the ankle.

Signs and Symptoms

Those experiencing throbbing pain, inflammation, redness, or difficulty bearing weight on the ankle should seek medical attention for a possible ankle fracture. Pain during physical activity that subsides during rest may be another possible sign of a broken ankle. Under some circumstances, even a numbness/tingling sensation may occur throughout the foot.

The assumption that waking on a fractured ankle would be impossible is not entirely accurate. In some cases, a less severe fracture only results in slight swelling and the patient is able to walk despite the injury. For this reason, it is recommended that any sign of the above symptoms should be further investigated by a visit with your doctor or even x-ray images of the ankle.

Risk Factors

There are numerous factors that can increase the risk of ankle fracture. Examples include decreased bone density (osteoporosis), participation in physically challenging or contact sports, abrupt increase in physical activity, and use of improper footwear and equipment. Those who have a prior injury that has not been treated properly or has not yet fully healed are at a greater risk of fracture. Special care should be taken to wear supportive footwear and to avoid uneven surfaces while walking or running.

Prevention Methods

Those seeking to reduce their chances of a broken ankle should focus on maintaining a healthy bone density. Having a calcium-rich diet (with foods such as milk, yogurt, and cheese) and getting enough vitamin D (found in fish, red meat, liver, and eggs) will promote strong, healthy bones, thereby decreasing your chances of a fracture.

Another useful prevention method is to always warm up prior to any sports activity. Warming up allows for more oxygen to reach the muscles and activates the connections between nerves and muscles, resulting in optimal movement.

Reducing tripping hazards and wearing proper footwear will also contribute to a reduced risk of an ankle fracture. In fact, many athletic brands offer shoes that are specifically designed for foot type.

Surgical Treatment Options

An ankle injury where the broken bone is separated, also known as a displaced fracture, often requires surgical intervention. In some cases, patients can even experience an open or compound fracture which means that the broken bone penetrates the skin. This particular injury will also require surgery and should be immediately evaluated by a medical professional to avoid the risk of developing a serious infection.

Open reduction and internal fixation (ORIF) is a common ankle surgery that can last up to two hours. During this procedure, an orthopedic doctor will use screws and a plate to restabilize the displaced bone. Patients are usually cleared to go home as little as one hour following the operation but must undergo several weeks of recovery including rest and rehabilitation. 

Nonsurgical Treatment Options

When the bones are not moved from their usual position, also known as a non-displaced fracture, surgical intervention may not be required. Ample rest, applying ice, and wrapping the affected area of the ankle are all ways to heal the fracture without undergoing surgery. It is also a good idea to keep the ankle elevated as often as possible, especially during sleep.

After the injury is healed, rehabilitation is an important part of any orthopedic recovery. Rehabilitation typically begins after fractures have begun to heal and casts are removed. While complications can persist even after the healing and rehabilitation processes, most patients with ankle fractures can resume normal activity within four months. In some cases, complete recovery from an ankle fracture can take up to two years.

Whether one must undergo surgery or not, all ankle fractures are serious injuries and should be treated as such. Typically, a broken ankle takes at least six weeks to heal, and even longer if other ligaments and tendons are involved. The process should be monitored with frequent x-rays and evaluations performed by a skilled surgeon or trusted medical professional.

To learn more about treatment options for broken and fractured ankles in the Fort Myers area, contact the Institute for Orthopaedic Surgery and Sports Medicine.