What are the bones in the ankle?
The ankle is made up of three bones: the tibia (shinbone), the fibula (lower leg bone), and the talus (small bone between heel bone and the tibia and fibula).
There are also many ligaments that assist in stabilising the ankle joint. These can be injured along with the bones in an ankle fracture.
What constitutes an ankle fracture?
An ankle fracture is a break in one or more of the bones that makes up the ankle. These fractures are classified according to the area of the bone that is broken.
- A fracture at the end of the fibula is called a lateral malleolus fracture.
- A fracture at the end of the tibia is called a medial malleolus fracture
- If the both the tibia and the fibula are fractured, it is termed a bimalleolar fracture.
Ankle fractures can involve the ankle joint (where the tibia, fibula, and the talus meet), and the syndesmosis (where the bottom ends of the tibia and fibula meet).
What can cause an ankle fracture?
Ankle fractures usually result from a twisting injury, often coming from falling or tripping. A direct blow to the ankle can also cause a fracture, as can be the case in car accidents.
Symptoms of a broken ankle
The symptoms of a broken ankle can often be similar to those of a severely sprained ankle, so it is important to see a doctor as soon as possible for an assessment.
Often the following symptoms will be present:
- Swelling
- Bruising
- Pain
- Tenderness
- Deformity
Diagnosing an ankle fracture
Your GP will conduct a thorough examination of your ankle, discuss your medical history, and most likely request an x-ray.
If your x-ray shows a fracture, your doctor might request further tests to determine if surgery is needed. Not all fractures require surgery.
These tests may include:
An MRI
An MRI shows the soft tissue surrounding the ankle, the ligaments, and the ankle bones. This gives the doctor a better indication of the ligaments’ condition after the fracture.
A CT scan
If the fracture extends into the ankle joint, a CT scan can help the GP better see its extent.
Treating a fractured ankle
Self-care
Until you’ve seen your doctor, it is important not to place any pressure on your ankle. Keep it elevated and apply ice packs to the affected area. Over-the-counter medication can be used for pain relief.
Medical care
Depending on the severity or type of fracture, your GP will suggest a splint or a cast to immobilise the site and allow it to heal. The fracture’s type and severity will also impact the duration the cast or splint will need to be worn.
Ideally, the doctor will align the bone before the cast is fitted. If this can’t be done in the clinic or emergency department, surgery will be required. Surgery is almost always required for compound fractures (where the bone is exposed through the skin).
Your GP can refer you to Dr Ward for surgical care. Typically, surgery involves use of plates and screws. If the syndesmosis is injured (a dislocation), then use of an innovative ‘tight-rope’ will be used to repair the ligament injury.
Following surgery or fitting of a cast or boot, it’s important to limit weight bearing on the ankle until the fracture is stable.
Ankle fractures may take 6-10 weeks to heal, sometimes longer for severe injuries.
Ankle fractures are significant injuries and complete recovery can take up to 12 months. There is potential for long-term complications including ongoing pain and joint instability. The likelihood that you will develop some form of arthritis of the ankle also increases.
If you have any concerns, please seek a referral to Dr Ward for an assessment.