The ankle joint consists of three bones: the tibia, fibula, and talus. The tibia and fibula are the two long bones of the lower leg. The tibia is located on the inner side of the leg and ankle, and the fibula is located on the outer side. The lower ends of these bones form an arch that rests on the talus, a bone in the foot.
A fibrous membrane, called the joint capsule, surrounds the bones. The capsule contains synovial fluid, which permits the joint to function smoothly. Several ligaments hold the bones in place, thereby stabilizing the joint.
When the talus or the lower end of the tibia or fibula breaks, this is called an ankle fracture.
The most common causes of ankle injuries are the twisting of the ankle joint, trauma that crushes the ankle, a direct blow to the ankle, tripping, falling, and missteps. There are multiple types of ankle injuries, however, not all of which involve broken bones. The symptoms can be confusingly similar across different forms of ankle trauma, but there are some differences.
If the ankle ligaments are damaged or torn, the ankle has been sprained. Symptoms may include moderate swelling, joint tenderness, and bruising. Often, the joint feels unstable, and it may be difficult to stand or walk.
When one or more bones in the ankle are broken, symptoms include severe swelling, pain, bruising, deformity, and/or difficulty bearing weight on the ankle. In some cases, a distinct snap or crack of a bone may have been heard when the injury occurred. Typically, the swelling that accompanies an ankle fracture does not respond to icing and does not decrease in the days following the initial injury.
Generally, individuals who participate in high impact sports, use faulty sports equipment, fail to properly train or prepare for physical activity, or initiate a sudden increase in activity level have the greatest risk of an ankle injury. Any of these activities can result in a stress fracture or a break in the ankle bone. Decreased bone density associated with age, cigarette smoking, and certain medical conditions also increase the risk of ankle fracture.
It is often difficult to determine whether an ankle is sprained or fractured. That’s why it is important to consult with a physician whenever a significant joint injury occurs. Leaving an ankle injury untreated may result in more serious and lasting damage not only to the ankle, but to the leg and hip.
It is often difficult to determine whether an ankle is sprained or fractured. That’s why it is important to consult with a physician whenever a significant joint injury occurs. Leaving an ankle injury untreated may result in more serious and lasting damage not only to the ankle, but to the leg and hip.
If the ankle is sprained, it may be wrapped or otherwise immobilized. Treatment most often involves rest, ice, and keeping the ankle elevated.
Treatment for an ankle fracture depends on the type and severity of the injury. When segments of the broken bone lie close together, the ankle may be immobilized with a brace or cast to enable the bone to reknit. Usually, the patient will utilize crutches or another assistive device to keep weight off of the ankle while the bone heals. In most cases, the ankle will remain immobilized for six to eight weeks. A physician will actively monitor the healing process through the use of an imaging device. Once the bone has healed, physical therapy may be necessary to ensure the patient has full range of motion in the ankle joint.
More extensive damage will require surgery. For example, when an ankle bone has been shattered, it must be repaired with special screws or wires. Holding the pieces of bone together this way allows them to reknit properly. Surgical repair is also required when parts of a bone are displaced and require realignment, and when the bone breaks the skin.
More extensive damage will require surgery. For example, when an ankle bone has been shattered, it must be repaired with special screws or wires. Holding the pieces of bone together this way allows them to reknit properly. Surgical repair is also required when parts of a bone are displaced and require realignment, and when the bone breaks the skin.
To prevent future injuries, high-top shoes, taping of the ankle, or an ankle brace may be recommended.
Fractured ankles are the most common of all bone injuries, perhaps because the ankle plays such an important role in overall mobility. When an ankle fracture is treated promptly and correctly, the ankle should heal without further complications. However, any injury to or near a joint may eventually develop arthritis, and all surgical procedures carry minor risks associated with anesthesia. Other complications may include bone infection or damage to a nerve or blood vessel. All in all, when a physician recommends surgery for a fractured ankle, the risks of the procedure are far smaller than the risks of leaving the injury untreated.
“Ankle Fracture,” Harvard Health Publishing, https://www.health.harvard.edu/a_to_z/ankle-fracture-a-to-z
“Ankle Fractures,” WebMD, https://www.webmd.com/fitness-exercise/ankle-fracture#1
“Ankle Fractures (Broken Ankle),” OrthoInfo, https://orthoinfo.aaos.org/en/diseases--conditions/ankle-fractures-broken-ankle/
“Broken Ankle,” Mayo Clinic Patient Care and Health Information, https://www.mayoclinic.org/diseases-conditions/broken-ankle/symptoms-causes/syc-20450025
