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Ankle fractures

An ankle fracture refers to a broken bone in the ankle joint. Ankle fractures are among the most common joint and bone injuries. In many cases, tests such as an x-ray are needed in order to distinguish an ankle fracture from a dislocation or a sprain. If the fracture is particularly bad, a CT scan may also be needed.

Ankle fractures can occur in one or both of two bones which comprise the ankle joint. These are the tibia (the lower leg's main bone), and the fibula (a smaller bone which runs parallel to the tibia). Usually the fibula is the first bone to break, followed by the medial malleolus which is part of the tibial bone and less commonly the posterior malleolus can also fracture.

Causes

Ankle fractures are caused by an overwhelming level of force which is exerted onto the ankle joint, resulting in the bone giving way and breaking. This can occur with the rolling of the ankle; the twisting of the ankle; the application of severe pressure to the joint, either from an object falling or by jumping; or the abnormal extension or flexing of the joint.

Falls, car accidents and sports injuries are some of the typical incidents which can lead to ankle fractures.

Symptoms

Among the most obvious symptoms of an ankle fracture are pain, either from the site of the fracture or other areas of the foot and leg; other associated fractures in the foot or leg; swelling around the ankle; the inability to walk and bear weight and bruising.

Symptoms of severe fractures can include swelling, bruising, stretched skin; injured blood vessels or nerves; the inability to move, or feel, the toes and feet; a cold or blue foot; and exposed bone.

Treatment

Some ankle fractures can heal well over time, aided by immobilisation and the temporary ceasing of activities which put weight on the ankle joint.

The type of treatment which is recommended will depend on the specific type of fracture, and the resulting stability level of the ankle joint. Typically, a cast or splint will be used, and the bones may be realigned before they are put in place. No weight should be put on the ankle until the doctor gives the go-ahead, and a re-examination can be conducted once swelling decreases, before another cast may be put in place. These can vary between non-walking casts which are used with crutches, and walking casts which are able to bear some weight. 

Medication can be prescribed for pain, and the type will depend on the degree of pain which is being felt by the individual. On average, an ankle bone takes four to eight weeks to heal following a fracture. 

Unstable fractures require surgical procedures to be carried out, and in these cases the ankle joint can take longer to heal. Surgery can also be the course of action in cases where the bone has broken through the skin - this is known as an open fracture. Usually metal plates and screws are used to hold the bones in their correct positions once they are re-aligned. If the syndesmosis is damaged this will also need repairing which can be done with screws or a tightrope

As with all foot surgery it is normal for swelling to persist for some months after surgery and is completely normal. This swelling will eventually completely subside with time and can take up to 12 months but often goes well before this.

Hear what our patients have to say

Patient stories

Mr Ajis is a great surgeon, he listens to any concern you may have and explains what is going to happen also gives great care... He suggested a fairly new procedure that wasn't available on the NHS but he pushed me through and he and his team have worked wonders, I am now healing very well and pain-free in my ankle after 6 years!

Written by a patient at BMI Goring Hall Hospital

Mr Ajis was very informative and reassuring about my surgery. He was professional at all times and allowed time for me to have all my questions answered without feeling rushed.

Written by a patient at BMI Goring Hall Hospital