Ankle Fracture

(Broken Ankle)
  • Definition

    An ankle fracture is a break of a bone in the ankle joint. The joint is made up of three bones:
    • Tibia (shin bone)—The main bone of the lower leg that runs along the inside of the leg
    • Fibula—The smaller bone of the lower leg that runs along the outside of the leg
    • Talus—The bone that provides the connection between the leg and the foot, and is less often fractured than the others
    The ankle joint is supported by three groups of ligaments. An injury that causes a fracture may also damage one or more of these ligaments.
    Ankle Fracture
    ankle fracture
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  • Causes

    An ankle fracture can occur when the joint is forced beyond its normal range of motion. It can also be caused by a direct blow to the bone itself. Any form of ankle trauma may cause injury, including:
    • Falls
    • Twists
    • Blows
    • Collisions
  • Risk Factors

    A risk factor is something that increases your chance of getting a disease, condition, or injury. Risk factors include:
    • Decreased muscle mass
    • Osteoporosis (common in women after menopause and in older, less active people)
    • Any condition that increases the risk of falls, such as poor muscle control or poor balance
    • Participation in certain sports, such as basketball, football, soccer, and skiing
    • Being overweight can increase the risk of fractures and make rehabilitation more difficult
  • Symptoms

    Symptoms include:
    • Immediate pain (can be severe, but sometimes with fibula injuries, is surprisingly minor)
    • Swelling
    • Bruising around the injured area
    • Tenderness when touching the injured bone in the ankle area
    • Inability to put weight on the injured foot without pain, although some people are able to walk with minor fractures
  • Diagnosis

    Your doctor will ask about your symptoms, physical activity, and how the injury occurred. An examination of the injured area will be done.
    Tests may include x-rays to look for the broken bone.
  • Treatment

    Treatment will depend on the severity of the injury. Treatment includes:
    • Putting the pieces of the bone back into position, which may require anesthesia and/or surgery
    • Holding the pieces together while the bone heals itself
    Devices that may be used to hold the bone in place while it heals include:
    • A cast (may be used with or without surgery)
    • A metal plate with screws (requires surgery)
    • Screws alone (requires surgery)
    • A rod down the middle of the bone (requires surgery)
    Your doctor may prescribe pain medication. They will order more x-rays while the bone heals to ensure that the bones have not shifted position.
    Exercises
    When your doctor decides you are ready, start range-of-motion and strengthening exercises. You may be referred to a physical therapist to help you with these exercises. Do not return to sports activity until your doctor says your ankle is fully healed. You will need near-normal motion and muscle strength.
    Healing Time
    It takes at least 6-8 weeks for even a simple ankle fracture to heal. It will be several months before you can return to intense physical activity.
  • Prevention

    To help prevent ankle fractures:
    • Do not put yourself at risk for trauma to the ankle.
    • Eat a diet rich in calcium and vitamin D.
    • Do weight-bearing exercises to build strong bones.
    • Build strong muscles to prevent falls and to stay active and agile.
  • RESOURCES

    American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org

    American Orthopaedic Foot & Ankle Society http://www.aofas.org

    CANADIAN RESOURCES

    British Columbia Podiatric Medical Association http://www.foothealth.ca

    Canadian Orthopaedic Foundation http://www.canorth.org

    References

    Ankle fractures. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00391 . Updated September 2007. Accessed November 5, 2012.

    Broken Ankle. American Orthopaedic Foot & Ankle Society website. Available at: http://www.aofas.org/footcaremd/conditions/ailments-of-the-ankle/Pages/Broken-Ankle.aspx . Accessed November 5, 2012.

    Chaudhry S, Egol KA. Ankle injuries and fractures in the obese patient. Orthop Clin North Am . 2011;42(1):45-53.

    Scott AM. Diagnosis and treatment of ankle fractures. Radiol Technol . 2010;81(5):457-475.

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