What is a Broken Ankle?
A broken ankle also called an ankle fracture, is an injury to a bone or several bones in the ankle joint. Treatment for a broken ankle depends on the fracture. More severe injuries involving several fractures may cause significant pain and swelling and require ankle surgery. Full recovery from an ankle fracture can take weeks and sometimes months.
Sprained Ankle vs. Broken Ankle
Pain and swelling are symptoms of a sprained ankle and a broken ankle, but these are different types of foot injuries.
- A sprained ankle is an injury caused by stretching or tearing ligaments in the ankle. Ligaments are the “ropes” that keep the joints in place.
- A broken ankle is an injury caused by breaking at least one of the bones in the ankle. In addition to causing severe pain and swelling, a broken ankle may look twisted and feel numb.
Types of Ankle Fractures
There are three bones and many ligaments in the ankle. The bones that form the ankle joint are called the tibia, fibula, and talus. Ligaments, tendons, and muscles surround these bones and add stability to the lower leg.
The classification of the fracture depends on the bones involved in the injury.
Different types of ankle fractures are:
- Lateral malleolus fractures affect the bony knob on the outside of the ankle. This is the most common type of ankle fracture.
- Medial malleolus fractures affect the bony knob on the inside of the ankle
- Bimalleolar ankle fracture involves both bony knobs on the ankle
- Bimalleolar equivalent fracture affects both bony knobs on the outside of the ankle with damage to ligaments inside the ankle
- Posterior malleolus fracture affects a bony section on the back of the tibia
- Trimalleolar fracture is an injury in which the three parts of the ankle are broken
- Pilon fracture involves a section at the end of the tibia
- Maisonneuve fracture is an ankle sprain with a break at the upper part of your fibula
- Syndesmotic injury occurs when there is at least one fracture in the tibia or fibula and sprained ligaments in the syndesmotic joint
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Stages of Ankle Fracture Healing
Fractured ankle bones heal over time. Typically, new bone tissue forms within a few weeks of the injury, but complete healing can take longer, depending on the injury. Recovery may take longer if the ankle break is severe and if there is damage to the ankle area’s muscles, skin, and nerves.
The stages of broken ankle healing are:
- Inflammatory stage. After the break, the area of the broken bone becomes inflamed, swollen, and painful
- Reparative stage. Within about a week after the injury, a type of soft bone tissue is formed and holds the bone together. Over the next few weeks, the soft tissue becomes harder.
- Remodeling stage. Around six weeks after the injury, regular bone replaces the soft tissue. Over the next few months, the bone is reshaped and fully replaces the ankle bone from before the injury.
Signs & Symptoms of a Broken Ankle
Signs and symptoms of a broken ankle include:
- Sudden pain that can be severe
- Difficulty standing and walking
An orthopedic doctor can examine and diagnose an injured ankle and provide care to avoid complications.
What Causes a Broken Ankle?
A broken ankle may result from a fall or a twisting injury and can also be caused by a direct impact on the ankle. Causes of a broken ankle include:
- Tripping and falling
- Falling from a height, such as from a ladder
- Twisting, rotating, or rolling the ankle while walking or running
- Strong impact on the ankle when playing certain sports or in a car accident
Risk Factors for Ankle Fractures
Some situations increase the risk of a broken ankle, including:
- Playing sports: High-impact sports that involve sudden moves and direct blows or risk of falling, such as football, basketball, soccer, tennis, or gymnastics
- Work-related injuries, such as falls from ladders or other elevated equipment
- Recreational activities that increase the risk of falls or collision, including hiking, cycling, skating, skiing, and more
- Health issues that increase the risk of falling, especially in older age, include foot disorders, balance issues, arthritis, osteoporosis (decreased bone density), and Parkinson’s disease
When a broken ankle is treated right away, the ankle should heal without complications. Complications of a broken ankle are uncommon but may include:
- Bone infection (osteomyelitis). When the broken bones tear through the skin, the injury is called an open or compound fracture. The open wound increases the risk of infection if not treated promptly.
- Nerve or blood vessel damage. Injury to the ankle can damage nerves and blood vessels in the area of the broken bone and require immediate medical attention.
- Arthritis may develop in the ankle over time
Common safety measures can help prevent falls and ankle fractures, including:
- Footwear. Wearing proper shoes for sports, hiking, and other activities can prevent injury
- Equipment, such as a ladder, or bicycle, should be kept in good condition
- Workplace and home space. Well-lit, tidy, and well-organized space can prevent falls and injury
Trust NewYork-Presbyterian for Achilles Tendon Care
Orthopedics specialists at NewYork-Presbyterian Hospital and Columbia Orthopedics revaluate and treat every type of foot and ankle condition, from common foot issues to complex trauma and sports injuries that require advanced surgery.