Ankle injuries are the most common sports-related injury. An ankle fracture is a break in one or more bones that make up the ankle joint. Sometimes ligaments may also be damaged. Ankle fractures are most often caused by motor vehicle accidents, rolling or twisting of the ankle, and by tripping or falling. People participating in sports such as basketball, football, soccer and skiing are at a high risk of developing ankle fractures.
The ankle joint is made up of three bones: The tibia, fibula, and talus which sits between the heel bone (calcaneus) and the tibia and fibula.
The tibia and fibula also have specific parts that help to form the ankle. The inside part of the tibia is called the medial malleolus. The posterior malleolus is formed by the back part of the tibia. And the end of the fibula is the lateral malleolus. You can often see and feel the medial and lateral malleolus on your own ankle.
The ankle is actually made up of two parts joints. The ankle joint where the three bones of the ankle meet. And the syndesmotic joint, which is the joint between the tibia and fibula. It is held together by ligaments.
There are several ligaments that help to make the ankle stable. These can be damaged from an ankle fracture.
An ankle fracture is named by the area of the bone, or bones that are broken. For example, a fracture of the fibula is called a lateral malleolus fracture. If both the fibula and tibia are broken, it is called a bimalleolar fracture. Trimalleolar would be when all three bones are fractured.
Most often, ankle fractures are caused by significant twisting or rotation of the ankle. Tripping or falling can lead to fractures. Ankle fractures can also result from injury in car accidents.
Symptoms and Diagnosis
Common symptoms of an ankle fracture include pain and swelling around the ankle, bruising, tender to touch, inability to walk on the leg, and deformity if the ankle is dislocated.
Following an ankle injury it is important to have the ankle evaluated by Dr. Faucett for proper diagnosis and treatment. Diagnosis is made based on the history of injury and physical examination of the ankle. In addition, the surgeon may order X-ray of the ankle to determine the extent of the injury.
Treatment varies with the type and severity of the injury. If the ankle fracture is stable and the bones are not too displaced, the fracture may be treated conservatively without surgery. Immediate treatment generally involves placing the ankle in a splint until the swelling goes down. Once the swelling has decreased, a brace or short cast to support the ankle and ensure the bones and ligaments heal. Patients are often advised not to put weight on the ankle.
If there are multiple bones involved, if they are significantly out of placed or the joint is unstable, surgery is often recommended. The surgical treatment can vary depending on the nature of the fracture. During surgery, the bones are first reduced or repositioned into their normal alignment. They are held together with special screws and metal plates attached to the outer surface of the bone. In some cases, a screw or rod inside the bone may be used to keep the bone fragments together while they heal.
Following surgery, you will likely be in a splint that is left on for the first week or two. You’ll be transitioned into a boot that you can remove for physical therapy exercises. The type of fracture and repair will determine when you can start to put weight on the leg. Physical therapy will be necessary several months following surgery to regain strength and stability in the ankle. It may be recommended that you wear an ankle brace for several months while participating in sports.