Broken Ankle: causes, symptoms and treatments

Updated 3/20/2023
Dr. Baravarian discusses ankle fractures, their treatment, and way to avoid complications.

The ankle consists of three bones (tibia, fibula, and talus) and if any are broken bones, you have a broken ankle. If only the ligaments give way, you have an ankle sprain, which only involves the soft tissue.

 

Under-treated ankle fractures (and stress fractures) are one of the most common orthopedic injuries and have lead to an alarming increase in early-onset ankle instability, arthritis, and permanent range of motion issues. 

 

Getting the right diagnosis and medical advice can make all the difference in your outcome. When it comes to your ankle, it is better to be safe now, than sorry later.

Diagnosing a Broken Ankle

 

The symptoms of a broken ankle are basically the same as a sprain. Even if you cannot bear weight while walking because of severe pain, it does not tell us what is wrong. From the outside, sprains and fractures appear very similar. 

 

It is wise to always treat serious ankle injuries as if they are broken until you get your injured ankle bones x-rayed and find out otherwise. 

 

It's what is going on inside the ankle that will tell us, thus you can always expect to have an x-ray. It is also important to always have follow-up care when it is requested. You simply do not want to ignore the severity of the fracture.

 

Non-surgical Treatments for a Broken Ankle

 

Ankle fractures that don’t have gapping or angulations/rotation at the fracture site are usually treated with an ankle brace and possibly physical therapy. These usually do not require surgery. 

 

Doctors often prescribe the RICE treatment for self-care at home to help heal and alleviate ankle pain. This includes:

 

Rest

Stay off the ankle as much as possible to prevent further injury and reduce foot pain.

 

Ice and Compression 

Cold compresses (ice packs) are most effective the first 24 hours after the injury to decrease swelling and shorten the time that you can begin weight-bearing.

 

Elevation

To help limit swelling and for pain management and to help decrease swelling of ankle bone breaks, we often recommend non-steroidal anti-inflammatory such as Ibuprofen. It is important to never take these on an empty stomach, always take them with food to help prevent GI bleeding.

 

 

Surgical Treatment Options for a Broken Ankle

Ankle fractures often require surgical repair to replace the fractured pieces to normal anatomic alignment and put the ankle joint in the correct position. There are several reasons why an ankle fracture will require surgery. 

 

If the fracture is displaced or angulated, and the ankle joint is no longer aligned, surgery is required to realign the ankle joint. It is essential to align the ankle fracture to within 2 millimeters of the original position for optimal long-term results. 

 

Ankle fractures will require surgery if the ankle is broken in several places (called a bi-malleolar or tri-malleolar fracture). These types of ankle fractures are very unstable and will require surgery to stabilize the joint. If these injuries are not stabilized with surgery, the bones will likely shift, causing a malalignment of the joint, which may lead to post-traumatic arthritis in the ankle.

 

Intraarticular fractures of the ankle

An intraarticular fracture of the ankle is a fracture that crosses into the surface of the joint. They always involve some cartilage damage and can lead to arthritis in the joint. With these fractures, it's especially important that the anatomy is returned to its normal position and alignment.

 

Bimalleolar ankle fracture

A bimalleolar ankle fracture occurs when there is a break to both the medial malleolus (inner side of the ankle) and the lateral malleolus (outer side of the ankle). Because both sides of the ankle are injured, the ankle joint becomes unstable and is susceptible to damage and early ankle arthritis if left untreated. 

 

Ankle reconstructive surgery

Post-Traumatic Foot and Ankle Reconstruction refers to a set of surgical procedures aimed at restoring the normal function, alignment, and appearance of the foot and ankle following a traumatic injury or damage caused by severe conditions. Trauma to the foot and ankle can result from accidents, sports injuries, or degenerative diseases, leading to deformities, fractures, dislocations, or joint damage.

 

Sometimes, your body heals bones or ligaments improperly, which could be caused by your bones no longer lining up properly or the tendons are not aligned properly, or are too loose. This can then cause more injuries such as chronic ankle instability and an increased risk of future ankle issues. 

 

The main goals of post-traumatic reconstruction of the foot and ankle are to:

 

Restore alignment and stability 

Proper alignment and stability are crucial for normal foot and ankle function. Surgeons use various techniques to correct deformities and repair fractures or dislocations, such as internal fixation (screws, plates, rods) or external fixation (pins and wires with an external frame).

 

Repair or replace damaged joints

Depending on the extent of the injury, surgeons may perform joint fusions (arthrodesis) to eliminate joint motion and relieve pain, or replace damaged joints with artificial ones (arthroplasty).

 

Preserve or restore motion

In some cases, preserving or restoring motion in the foot and ankle is necessary for optimal function. Tendon transfers, ligament reconstructions, or other soft tissue procedures can be performed to improve mobility.

 

Manage chronic pain and inflammation

Post-traumatic reconstruction can help manage pain and inflammation caused by damaged or inflamed tissues. This may involve removing bone spurs or inflamed tissues or addressing nerve issues, such as decompression or nerve release.

 

Improve appearance 

While the primary focus is on functionality and not cosmetic foot surgery, reconstructive surgery can also improve the cosmetic appearance of the foot and ankle, helping patients feel more comfortable and confident.

 

The specific procedures and techniques used in post-traumatic reconstruction of the foot and ankle depending on the patient's unique situation, the type and severity of the injury or condition, and the desired outcome. The recovery process can vary significantly and may involve physical therapy, pain management, and ongoing follow-up care to ensure the best possible outcome.

 

Why UFAI is your Best Choice for Foot and Ankle Care


Using the most advanced techniques, some of which we helped develop, has allowed us to maintain the highest success rates in the nation for ankle injuries. Our goal is to quickly get you back on your feet, utilizing the least invasive treatments possible.

 

Patients are our number one priority. Beginning with the ease of making your appointment, our family-friendly office staff is with you every step of the way. We have our own x-ray, musculoskeletal ultrasound, and even an MRI and 3D CT and many of our facilities.

 

We also offer orthotic and brace manufacturing as well as on-site physical therapy services and state-of-the-art operating rooms. This means you will rarely have to go from one specialist to the next, cutting down on your travel needs and wasted time.

 

While most orthopedic surgeons focus on all the bones and joints in the body, only spending a fraction of their time on the foot and ankle, UFAI's surgeons choose to treat foot and ankle conditions as their lifework.

 

Podiatric foot and ankle surgeons concentrate exclusively on the foot and ankle from day one of medical school. After medical training, they begin a rigorous three-year surgical residency. What sets podiatric surgical residents apart from general orthopedic residents is they specialize in the foot and ankle while most (though not all) ortho residents do not.

 

Years of training and decades of experience and research is why the foot and ankle surgeons at UFAI have the highest success rates in the United States, literally helping thousands get back on their feet and back to their life.

  • Foot and Ankle Surgeon at University Foot and Ankle Institute
    Dr. Justin Franson, DPM, University Foot and Ankle Institute, Foot and Ankle Surgeon

    Dr. Justin Franson, DPM, is a Board Certified Podiatric Foot and Ankle Specialist and Diplomate of the American Board of Podiatric Surgery. He attended the School College of Podiatric Medicine in Chicago, graduating in 2001. Dr. Franson then accepted a three-year residency program at the Greater Los Angeles VA and UCLA County Hospital. 

     

    Dr. Franson specializes in several areas including total ankle replacement and sports medicine. Treating athletes and weekend warriors like himself brings him a lot of joy. Dr. Franson keeps active with running marathons, triathlons, hiking, basketball, and golf.

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