Ankle Fractures. What you need to know!

Understanding Ankle Fractures: Causes, Symptoms, and Treatment

Ankle fractures are a common injury that can occur as a result of accidents, falls, or even intense physical activity. Whether you're an athlete or someone simply going about their daily routine, understanding how ankle fractures happen, how to recognize them, and how to treat them is crucial for recovery and prevention.

What Is an Ankle Fracture?

An ankle fracture is a break or crack in one or more of the bones that make up the ankle joint. This joint is made up of three primary bones:

• The tibia (shinbone)

• The fibula (the smaller bone on the outside of your lower leg)

• The talus (a bone that sits between the tibia and fibula and forms part of the joint with the leg bones)

The fractures may vary in severity, from small cracks (called hairline fractures) to more complex breaks involving the displacement of bones or damage to surrounding ligaments. The type of fracture and how it affects the ankle joint determines the treatment approach and recovery process.

Common Causes of Ankle Fractures

Ankle fractures often result from trauma or sudden movements. Some of the most common causes include:

1. Twisting or Rolling the Ankle: A misstep while walking, running, or playing sports can cause the ankle to twist unnaturally, resulting in a fracture.

2. High-Impact Trauma: Falling from a height, car accidents, or sporting injuries like tackling in football can apply excessive force to the ankle joint.

3. Overuse or Repetitive Stress: Athletes who engage in sports involving running, jumping, or sharp turns may be at higher risk for stress fractures in the ankle.

4. Osteoporosis: In older adults, the bones may become brittle and more prone to fractures, even from minor falls or impacts.

Symptoms of an Ankle Fracture

The symptoms of an ankle fracture can vary depending on the severity of the injury but commonly include:

• Pain and Tenderness: Pain is usually immediate and can be intense, especially when trying to move the ankle or put weight on it.

• Swelling and Bruising: Ankle fractures often cause visible swelling, which may spread to the foot and lower leg. Bruising around the ankle joint is also common.

• Deformity: In more severe cases, the bone may shift out of alignment, making the ankle appear deformed or bent in an abnormal direction.

• Inability to Walk or Bear Weight: A person with an ankle fracture may have difficulty walking or standing due to pain and instability in the joint.

• Numbness or Tingling: If nerves around the ankle are affected, the person may experience numbness or a tingling sensation.

Types of Ankle Fractures

Ankle fractures are classified in different ways, but one common classification is based on the location and number of bones involved:

1. Lateral Malleolus Fracture: The lateral malleolus is the bony prominence on the outside of the ankle. This is the most common type of ankle fracture, often caused by rolling the ankle outward.

2. Medial Malleolus Fracture: This occurs on the inner side of the ankle, affecting the medial malleolus bone. It may occur when the ankle rolls inward or experiences a direct blow.

3. Bimalleolar Fracture: This type of fracture involves both the medial and lateral malleolus. It often results from significant trauma, like an ankle sprain or car accident.

4. Trimalleolar Fracture: This is a more severe fracture involving the lateral, medial, and posterior malleolus. It often requires surgical intervention to restore proper alignment and function.

5. Pilon Fracture: A less common but very serious fracture that involves the weight-bearing part of the tibia. Pilon fractures usually occur from high-impact trauma and may require complex surgical treatment.

How Are Ankle Fractures Diagnosed?

To diagnose an ankle fracture, a healthcare provider will typically begin with a physical examination to assess pain, swelling, bruising, and alignment. If a fracture is suspected, X-rays are usually ordered to confirm the presence of a fracture and determine its location and severity.

In some cases, CT scans or MRI scans may be needed to evaluate complex fractures, especially if there is concern about damage to surrounding ligaments or soft tissues.

Treatment Options for Ankle Fractures

Treatment for an ankle fracture depends on the type and severity of the fracture. There are two primary approaches: non-surgical and surgical.

1. Non-Surgical Treatment

For less severe fractures, the doctor may recommend conservative treatments:

• Rest and Immobilization: The injured ankle may be placed in a cast, brace, or boot to immobilize the joint and prevent movement during healing. The patient will typically need to avoid bearing weight on the ankle for a period of time.

• Ice and Elevation: Applying ice and elevating the foot can help reduce swelling and pain in the initial stages after the injury.

• Pain Management: Over-the-counter pain medications like ibuprofen or acetaminophen can help manage discomfort.

2. Surgical Treatment

For more serious fractures, or those where the bones have become displaced or misaligned, surgery may be required. Surgical options include:

• Open Reduction and Internal Fixation (ORIF): This is the most common surgical procedure for ankle fractures. During this procedure, the surgeon realigns the fractured bones and uses screws, plates, or rods to stabilize them while they heal.

• External Fixation: In cases where ORIF is not feasible, an external frame may be used to stabilize the ankle externally.

• Arthrodesis: In rare cases of severe, complex fractures with joint damage, the doctor may recommend fusion surgery to fuse the ankle bones together. This is typically a last-resort procedure when other treatments are not effective.

Rehabilitation and Recovery

Regardless of whether the fracture is treated surgically or non-surgically, rehabilitation is crucial for full recovery. After the bone has healed sufficiently, a physical therapy program will help restore strength, flexibility, and balance to the injured ankle. This often involves:

• Range of Motion Exercises: Gentle exercises to improve the movement of the ankle joint.

• Strengthening Exercises: To rebuild the muscles around the ankle, which may have weakened during immobilization.

• Weight-Bearing Exercises: Gradually increasing the amount of weight the ankle can bear.

Recovery times can vary, but typically, non-surgical fractures may take 6 to 8 weeks to heal, while more complex fractures may require several months.

Preventing Ankle Fractures

While some ankle fractures are inevitable, there are steps you can take to reduce your risk:

• Wear supportive footwear: Choose shoes that provide proper arch support and cushioning, especially during physical activities.

• Strengthen the ankle: Regular exercises can help improve balance and strength in the muscles around the ankle.

• Be cautious of your environment: Avoid walking on uneven surfaces or in areas with slippery conditions.

• Stretch before physical activity: Warming up properly can help prevent sudden movements that might result in an ankle injury.

Conclusion

Ankle fractures can be painful and challenging, but with the right treatment and care, most individuals can make a full recovery. If you suspect you’ve fractured your ankle, it’s important to seek medical attention promptly to ensure proper diagnosis and treatment. By following a careful rehabilitation plan and taking preventive measures, you can reduce the risk of future injuries and return to your daily activities or sports with confidence.

As always we are here for your foot and ankle fracture needs. Call our office at 972-726-6464 to be seen by Dr. Pajouh for your foot and ankle fractures! 

Have you ever had an ankle injury? How did you manage the recovery process? Let us know in the comments!