The Orthopaedic Clinic

Ankle Fracture


Overview Diagnosis
  Treatment Options

Overview

The three ankle bones are:

  • tibia (shin bone)
    the main bone of the lower leg that runs along the inside of the leg

  • fibula
    the smaller bone of the lower leg that runs along the outside of the leg

  • talus (ankle bone)
    the bone that provides the connection between the leg and the foot

    The ankle joint is supported by three groups of ligaments, which provide stability to the joint. A fracture can injure these ligaments as well.
    An ankle fracture can occur when the joint is forced beyond its normal range of motion or there is a direct blow to the bone itself. This is caused by trauma to the joint. Trauma includes:

  • falls
  • twists
  • blows
  • collisions

    You may increase your chance of suffering an ankle fracture if you have any of these risk factors:

  • advancing age
  • postmenopause
  • decreased muscle mass
  • osteoporosis
  • participation in certain sports, such as basketball, football, soccer and skiing

    Diagnosis

    Symptoms of ankle fractures include:

  • immediate and severe pain
  • swelling
  • bruising around the injured area
  • tenderness when touching the ankle area
  • inability to put weight on the injured foot without pain

    The doctor will ask about your symptoms, physical activity, and how the injury occurred. The doctor will also examine the injured area. Tests may include:

  • x-rays
    X-rays use radiation to take a picture of structures inside the body, especially bones. It is used to look for a break in the bone.

  • bone scan
    This is a scan that involves injecting a bone-seeking nuclide into a vein and then performing a scan of the area. The test locates places in the bone where unusual amounts of bone repair activity are occurring.

    Treatment Options

    Treatment will depend on the severity of the injury. Treatment involves:

  • putting the pieces of the bone back into position, which may require anaesthesia and/or surgery
  • keeping the pieces together while the bone heals itself

    Devices that may be used to hold the bone in place while it heals include:
  • a cast (may be used with or without surgery)
  • a metal plate with screws (requires surgery)
  • screws alone (requires surgery)
  • a rod down the middle of the bone (requires surgery)

    The doctor may prescribe pain medication depending on the level of pain. Your doctor will order more x-rays while the bone heals to ensure that the bones have not shifted position.

    When your doctor decides you are ready, start range-of-motion and strengthening exercises. You may be referred to a physical therapist to assist you with these exercises. Do not return to sports activity until your ankle is fully healed. It takes at least six to eight weeks for even a simple ankle fracture to heal. It will be several months before you can return to intense physical activity.

    Prevention
    To help prevent ankle fractures:

  • Do not put yourself at risk for a trauma to the ankle.
  • Eat a diet rich in calcium (pdf file) and vitamin D.
  • Do weight-bearing exercises to build strong bones.
  • Build strong muscles to prevent falls and to stay active and agile.

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