Ankle fracture diagnosis, treatment, surgery and rehabilitation

Ankle fractures are one of the most common lower leg injuries. Also known as an ankle fracture, it can be a very painful injury that requires medical attention as soon as possible, as it may require treatment to heal properly. Walking with an ankle injury can make the injury worse, so if in doubt, check it out.

The ankle joint is made up of three different bones, any of which can break. Treatment options vary depending on the type and severity of the fracture, and recovery usually takes 6 to 10 weeks.

Overview of Ankle Injuries

Ankle Fractures - Treatment, Surgery and Rehabilitation

In the United States, more than 5 million ankle injuries occur each year [1]. They can range in severity from sprains (ruptured and torn ligaments) to broken ankles. An ankle fracture and a broken ankle are the same thing.

The ankle joint consists of three bones. The tibia and fibula are two long bones that extend from the knee to the ankle. The tibia, also known as the tibia, is the weight-bearing bone, the larger of the two. The fibula, or calf bone, runs parallel and helps stabilize the tibia. The third bone in the ankle is the talus, which is a small wedge-shaped bone at the top of the foot. It supports the tibia and fibula.

Any of these bones can break, but the most common ankle fracture occurs in the lateral malleolus, the part of the fibula just above the ankle joint [2].

If you break a bone and it remains in the correct position, it is called a nondisplaced ankle fracture. If the broken part of the bone has become separated or misplaced, it is called a displaced ankle fracture.

ankle injury

tibia

Often called the shinbone, it is the larger, weight-bearing bone in the lower leg.

fibula

The thinner of the two lower leg bones, parallel to the shinbone, helps support the larger bone.

talus

A small wedge-shaped bone near the top of the foot. It supports the tibia and fibula.

How does a sprained or broken ankle happen?

Ankle fractures are a common injury, usually caused by sudden trauma. This could be anything from a simple fall on an icy sidewalk to a sports injury or a car accident. Common factors that can lead to an ankle fracture include:

Ankle Fracture Recovery

• twist, spin or roll your ankle,
  
• A slip or trip that causes your ankle to hit the ground,
• The impact of motor vehicle accidents,
• Jump or fall from a height, with your ankles straight down,
• Put weights on your ankles.

A study of nearly 10,000 patients with ankle fractures [3] found that the two most common causes of injury were falls (61%) and exercise (22%). Years with cooler winters saw more cases, and women were at slightly higher risk than men. In addition, most ankle fractures occur in two distinct groups: young adults who are active in sports and high-intensity activities, and older adults who suffer from tripping injuries.

What are the symptoms of an ankle fracture?

The most common symptom of an ankle fracture is pain, which is usually immediate and severe. The pain may radiate up and down your leg and your foot. You may also experience some or all of the following symptoms.

• swollen ankle,
  
• bruising, redness, or discoloration anywhere on the lower leg,
• inability to put any weight on the injured ankle or foot,
• tenderness,
• Dizziness due to pain,
• Your feet may hang in unusual positions or look out of place,
• In some cases, you may see exposed bone, which is called an open or compound fracture.

An occasional small ankle fracture may not be very painful. Many people think that if you can walk with an injury, it won't be broken, but that's not always the case. If you continue to walk with a broken ankle, it can easily develop into a serious fracture, so if you have any symptoms, you must have your ankle checked by a doctor. If you can't see your doctor quickly, you may need to go to the emergency room, or, if your symptoms are severe and you can't get to the hospital on your own, call an ambulance.

Take care of your broken ankle right now

Ankle Fracture Surgery

Try not to put any weight on the injured leg while you wait to see your doctor. Support it with a cushion or clothing to help control swelling and keep it elevated. If your skin isn't broken, you can try wrapping it in a compression bandage or kitchen towel, then applying an ice pack or frozen pea bag every few hours for 15 to 20 minutes. However, it is important not to wrap it too tightly, as doing so can lead to further complications. Remember not to apply ice cubes directly to bare skin, and don't use ice cubes if the skin is broken.

If you can see the bone sticking out of the skin, don't try to push it back into place. Cover it with a clean dressing, cloth or towel and seek immediate medical attention. It's best not to eat or drink anything until you see a doctor in case you need surgery.

How to Diagnose an Ankle Fracture

The only way to know for sure if you have a broken ankle is to see a doctor. They will ask about your symptoms and the cause of your ankle injury and collect details about your medical history. They'll examine your ankle, and if they suspect it's broken, they'll order imaging tests to look at the bone in more detail.

X-ray

As the most commonly used imaging technique, X-rays can diagnose most ankle fractures. They will also determine the severity of the ankle fracture and if you have other fractures in your leg or foot.

CT scan

Computed tomography (CT) scans quickly and painlessly generate cross-sectional images of the ankle, ankle, and leg. A CT scan shows hard and soft tissue. This makes it very helpful in diagnosing ankle fractures, cartilage damage and dislocations.

NMR

Magnetic resonance imaging (MRI) scans are excellent at diagnosing ligament injuries, sprains, and stress fractures. MRI is not usually used for ankle fractures, but may be part of a more detailed examination performed by an orthopaedic surgeon.

Questions about ankle fractures

Receiving an ankle fracture diagnosis can be a stressful experience, so here's a quick list of questions you may want to ask your doctor to begin charting your recovery path.

• Do I have to have surgery? What are the risks?
  
• How soon can I go back to work?
• Do any of my lifestyle or medical conditions put me at risk for a longer recovery time?
• When can I start walking on my legs again?
• How soon can I resume normal activities?
• When can I return to sports or high-impact activities?

Treatment options for ankle fractures

Your treatment plan will depend on the type, location, and severity of the ankle fracture. You may need to wear a cast, splint, or walking boots for 6 to 10 weeks to keep the bone in place as it heals. During this time, you won't be able to carry any weight, which means you won't be able to put any weight on the injured leg at all. You will need to use mobility devices such as crutches, knee scooters or hands-free crutches to make this phase of your recovery as smooth and successful as possible.If you have a severe ankle fracture, you may need surgery. This is usually because the bone is broken or displaced in more than one place. Your doctor may want to have surgery as soon as possible, but if you have a lot of swelling, they may decide to splint your leg for a few days and wait for the swelling to subside.

The most common surgery for ankle fractures is open reduction and internal fixation (ORIF), which uses metal rods, plates, and screws to realign your bone or bones. The hardware usually stays in place even after your ankle heals and is only removed if it causes a problem. This type of surgery is usually performed under general anesthesia.

How long does it take for an ankle fracture to heal?

The recovery time for an ankle fracture is between 6 and 10 weeks. You may need to wear a cast, splint, or walking boots for the first six weeks, whether or not you have had surgery. Once your doctor approves you, you can start putting some pressure on your feet and slowly return to walking over a few weeks. You'll be wearing walking boots to help you when you take your first steps.

Once your ankle injury has healed, it's important to move your ankle in all directions regularly. This helps prevent stiffness and contractures, the tightening of muscles and tendons that cause joints to shorten and become very stiff. You may continue to experience swelling for up to a year after that, and your doctor will tell you when you can resume sports or high-intensity activities.

What can I expect during recovery from my ankle fracture?

Not being able to stand for weeks can be frustrating, but this period of non-weight-bearing activity is a critical part of the recovery process. Walking on a broken ankle too early can prevent it from healing properly and can make the injury worse. Fortunately, there are a few different mobile devices that can help you stay mobile during this challenging phase.

traditional crutches

Traditional crutches are readily available and relatively inexpensive. Many people use crutches after ankle surgery or when recovering from an ankle fracture. However, they are tiring to use and can cause pain in other parts of the body, especially the arms and hands. Traditional crutches are also restrictive because they require your hands and arms to concentrate. This means you can't carry anything. Because of these limitations, people are often tempted to walk on a fractured ankle prematurely, leading to further problems.

Knee scooter or knee walker

Knee scooters, also known as knee walkers, are another option for staying mobile while recovering from an ankle fracture. They are more effective than crutches and require less upper body strength. Knee scooters are great for riding on flat surfaces, allowing you to easily slide from point A to point B without feeling exhausted, but they're not great for stairs, slopes, or uneven terrain. The knee scooter still needs to be operated by hand, so still can't lift things. They are also bulky, which makes them difficult to transport. Navigating tight environments with a lap scooter can also be difficult.

Ankle Fracture Recovery Tips

Remember to rest and elevate your ankle as much as possible during recovery. Move your toes gently and bend your knees regularly to prevent muscle stiffness. As tempting as it may be, try not to put anything on the cast to scratch the itch. It can get stuck or damage your skin, increasing your risk of infection.

It is also important not to get the plaster wet, so a special protective cover is required when showering or bathing. Some people wrap the cast tightly in a plastic bag, although it's not as reliable. In the shower, balance the injured leg on a stool, or use a hands-free crutch.

Over-the-counter pain relievers such as acetaminophen (eg, Tylenol) or ibuprofen (eg, Advil, Motrin IB) can help relieve discomfort during the early recovery phase, but your doctor may prescribe stronger effective drugs. Before starting any medication, please consult your doctor to make sure they are safe for your unique medical needs.

Ankle Fractures FAQ

How long does it take for a broken ankle to heal?

Recovery from an ankle fracture takes about 6 to 10 weeks. During this time, you may need to wear a cast or boots. Most people are able to walk normally again and resume their daily activities in about three months. Endurance will improve over time and as your strength improves. Your doctor will tell you when you can resume exercising or other high-impact activities.

How long does it take to wear boots with a broken ankle?

After a broken or broken ankle, you may wear a cast or walking boots for about 6 to 10 weeks. After this, you'll likely wear boots for a few more weeks to support your ankle as you start putting weight on the injured ankle again.

When can you put weight on an injured ankle?

Your doctor will tell you when to put weight on your injured ankle. For most people, it's about two to six weeks later, although it may be less or more depending on the type and severity of the fracture. It's important to follow your doctor's orders and not put any weight on the leg too soon, as walking on a broken ankle too early can prevent it from healing.

How soon can I walk after an ankle fracture?

Most people slowly start putting weight on their legs around six weeks after an ankle fracture. The length of time depends on the severity of the injury, and it may take a few more weeks to return to normal walking. Ankle fractures usually take 6 to 10 weeks to heal. Conditions such as diabetes and nicotine use can significantly slow healing times and may even double the healing time of ankle fractures.

Can you fully recover from a broken ankle?

About three months after your ankle fracture, you should be able to return to your normal daily life. It can take several months to regain strength and range of motion in your ankle.