Broken Ankle (Fractured Ankle)

A broken ankle happens when you break one or more bones in your ankle joint. Its medical name is an ankle fracture. It’s one of the most common causes of ankle pain.

Your ankle joint contains three bones:

• Tibia: Your shinbone. It’s the big bone in your lower leg.
• Fibula: Your calf bone. It’s the smaller, thinner lower leg bone.
• Talus: The main link between your lower leg and your foot.

The lower ends of your fibula and tibia come together and butt up against your talus to form your ankle.

You can break one or more ankle bones at the same time. Serious fractures require ankle surgery. It can take several weeks to a year to fully recover from a broken ankle.

Types of ankle fractures

There are several types of fractures, including:

• Lateral malleolus fracture: This is when you break the bony knob on the outside of your ankle (lateral malleolus). It’s the most common type of ankle fracture.
• Medial malleolus fracture: This happens when the bony knob on the inside of your ankle (medial malleolus) breaks.
• Bimalleolar fracture: This fracture means you broke both bony knobs on your ankle. It’s the second most common type.
• Bimalleolar equivalent fracture: This is when you break one of your ankle bones and damage ligaments inside your ankle.
• Posterior malleolus fracture: Your posterior malleolus, a bony section on the back of your tibia, breaks.
• Trimalleolar fracture: All three of your ankle bones break.
• Pilon fracture: Your tibia ends in a section called the roof of your ankle. When you break this section, it’s called a pilon fracture.
• Maisonneuve fracture: This happens when you sprain your ankle and break the upper part of your fibula, near your knee.
• Syndesmotic injury: A syndesmotic injury happens when you break your tibia or fibula and sprain ligaments in the joint between them (syndesmotic joint).

Symptoms of a broken ankle

Broken ankle symptoms may include:

• Sudden, severe ankle pain
• Not being able to put weight on it
• Pain when you touch it
• Bruising
• Swelling

It’s not always easy to know if your ankle is broken just by how it feels. Ankle pain is a common symptom that many issues can cause. And if your ankle is broken, you probably won’t know if you’ve broken more than one bone until a healthcare provider can take a look at it.

Ankle fracture causes

Getting hit directly in your ankle is the most common cause of fractures. You might fall hard or get hit by something hard enough to break one of your bones. Broken ankle causes include:

• Car accidents
• Sports injuries (especially playing contact sports or ones where you make sudden, twisting moves with your ankles)
• Falling from a significant height
• Tripping and falling
• Rolling your ankle

How doctors diagnose fractured ankles

A healthcare provider will use several tests to diagnose an ankle fracture, including:

• Physical examination
• X-ray
• CT scan
• MRI
• Bone scan

How are ankle fractures treated?

The treatments you’ll need depend on the type and severity of your fracture. Not all broken ankles require surgery. But all ankle fractures need a diagnosis and treatment to make sure they heal properly.

You probably won’t need surgery if you have a stress fracture or if the fracture is non-displaced. That means the bones didn’t move out of place (they’re still lined up correctly). You might need a brace, cast or walking boot to support your ankle while it heals.

More serious fractured ankles need closed reduction or surgery. A closed reduction is when healthcare providers push on the outside of your body to reposition your broken bones. This will correctly align your ankle. Your providers will give you local anesthesia to numb your ankle.

You’ll probably need surgery if the fracture is displaced. Displaced means the bones moved during the injury and are out of place (not in line). A surgeon will insert pins, wires, screws and sometimes plates to repair your ankle and hold the bones in place. They’ll probably perform an open reduction and internal fixation.

When should I contact my healthcare provider?

Contact your healthcare provider or go to the emergency room if you have:

• Unmanageable pain
• Numbness
• Tingling
• Increased swelling
• An inability to put weight on your ankle
• Signs of infection — like fever, chills and redness — or your surgery site is draining

How long does a broken ankle take to heal?

Healing times from a broken ankle vary. If you didn’t need surgery, your ankle might heal in 12 to 16 weeks. If you had surgery to repair more than one ankle bone, it could be up to two years before your ankle is back to normal.

An ankle fracture will temporarily affect your quality of life, whether or not you need surgery. You may be in a cast or walking boot, taking medication or keeping weight off your ankle for weeks or months. Your broken ankle recovery time can vary based on all these factors. Ask your healthcare provider or surgeon what to expect based on your unique situation.

Can you walk on a broken ankle?

If you have a minor fractured ankle, you should still be able to walk on it. You might not even know you’ve broken it. But more severe fractures will require you to keep off your foot for several months. After treatment, as your ankle begins to heal, you can gradually return to walking. Don’t resume walking or any other physical activities before your healthcare provider says it’s safe.