Broken Ankle

What Is a Broken Ankle (Ankle Fracture)? 

A broken ankle occurs when there’s a break (fracture) in one or more bones that make up your ankle joint. 

Ankle fractures are the fourth most common type of broken bones in adults. But children can break their ankles, too. Your ankle joint connects your lower leg and foot. It helps you move your foot, maintain balance and walk.

Three bones meet up to form your ankle joint:

• Ankle bone (talus) in the back part of your foot
• Calf bone (fibula) on the outer side of your lower leg
• Shinbone (tibia) on the inner side of your lower leg

What are the types of ankle fractures?

Your doctor determines the type of ankle fracture based on several factors. Types of ankle fractures include:

• Nondisplaced ankle fracture: The fractured ankle bone or bones are still in the correct place in the joint.
• Displaced ankle fracture: You have one or more breaks in one or more ankle bones. The ankle joint may also be out of place (dislocated). 
• Open (compound) ankle fracture: Broken ankle bones poke through your skin, increasing your risk of infection. This type of fracture is a medical emergency that requires surgery.

What does a broken ankle feel like?

Signs of a broken ankle depend on the severity of the break. You may not be able to put weight on the affected foot and have severe ankle pain.

A small crack in a bone, called a stress fracture, can feel like an ankle sprain. You may have mild pain that doesn’t affect your ability to stand and walk. An ankle sprain occurs when the ligaments that connect bones in the ankle joint stretch too much or tear. An ankle fracture and sprain can occur together.

Common signs of an ankle fracture include:

• Ankle pain or an ankle that’s tender to the touch
• Bruising and swelling in the ankle
• Inability to walk or put weight on the injured leg 
• Joint or bone that looks out of place (if there’s a dislocation)
• Numbness or cool sensation in the affected ankle or foot

When should you see a medical professional?

A stress fracture and ankle sprain cause similar symptoms. Without proper treatment, the fracture can worsen, causing a serious break.

Depending on your symptoms, you should:

• See your primary care physician for ankle pain that doesn’t greatly affect your ability to stand or walk.
• Go to your nearest emergency department for severe ankle pain that makes it impossible to put weight on your foot.
• Call 9-1-1 if a bone pokes through skin (open fracture). Emergency medical responders can safely stabilize the ankle and prevent further bone damage. They may also start IV antibiotics to lower your risk of infection. 

What causes a broken ankle?

Twisting your ankle while walking or playing a sport can cause bones in your ankle to break.

Common causes of ankle fractures include:

• Colliding with an object or person
• Falling down a flight of stairs or off a ladder
• Impact from a vehicle accident 
• Rolling or twisting your ankle
• Tripping over an object

Are you at risk for a broken ankle?

Anyone can have a broken ankle, but it's more common in adults than in children.

These factors increase your risk:

• Engaging in activities that roll your ankles, such as hiking, running, skiing and skating
• Obesity
• Osteoporosis 
• Playing high-impact sports, such as soccer, basketball, football and gymnastics
• Previous ankle sprain or injury
• Smoking
• Wearing ill-fitting or nonsupportive shoes
• Working in a job that requires climbing ladders, such as painting, tree trimming and electrical work

How do doctors diagnose a broken ankle? 

Your doctor will perform a physical exam to check for ankle pain, swelling and signs of dislocated bones.

You may also get one or more of these imaging tests:

• X-ray: An X-ray shows the location of broken and displaced bones. You may get a stress X-ray, which takes place while lying on your side or standing to put stress on the ankle.
• CT scan: A CT scan provides cross-sectional images of the ankle joint. These images can be helpful if you need surgery.
• MRI: An MRI can show damage to ligaments, tendons, cartilage and other connective tissues in your ankle.

How do doctors treat a broken ankle?

Treatments for a broken ankle depend on the type and severity of the fracture.

Your doctor will review the best treatment option for your unique diagnosis. Treatments for ankle fractures include:

Nonsurgical treatments for ankle fractures

If you have a stress fracture or nondisplaced ankle fracture, your doctor may recommend a cast, ankle brace or walking boot. These orthopedic devices hold broken bones in the correct place while they heal. You may also need to use crutches or a knee scooter to keep weight off the ankle.

Ankle surgery for a broken ankle

Displaced and open ankle fractures require surgery. Depending on the severity of the fracture, your surgeon may use plates, screws and rods to hold the bones in place and stabilize the ankle joint. You may have a cast or walking boot and use crutches or a scooter while the bones heal.

Depending on your diagnosis and needs, you may see one of these surgical specialists:

• Foot and ankle surgeon
• Orthopedic surgeon
• Orthopedic trauma surgeon

What’s the outlook when you have a broken ankle?

It can take six to 12 weeks for a broken ankle to heal. A full recovery can take up to two years.

Most people resume their usual activities approximately three to four months after finishing treatment. After the fracture heals, your doctor may recommend physical therapy to strengthen the ankle and improve your range of motion. Unfortunately, an ankle fracture increases your risk of developing osteoarthritis in the ankle later on.

Can you prevent a broken ankle? 

Yes, certain actions can help lower your risk of breaking an ankle. 

You can:

• Avoid walking or running on uneven surfaces.
• Do strengthening exercises, such as calf raises, to help stabilize the ankle joint.
• Engage in activities to improve balance, such as yoga and tai chi.
• Use ankle tape or wear an ankle brace if you have a history of ankle sprains or injuries.
• Warm up, cool down and stretch when participating in physical activities. 
• Wear properly fitting, supportive shoes appropriate for your chosen activity.