An ankle fracture is a break in one, or more, of the bones that form the ankle joint.
There are three bones that make up the ankle joint – the tibia (shinbone), the fibula (smaller bone of the lower leg) and the talus (bone found between the heel bone and the tibia/fibula). There are also multiple ligaments found at the ankle joint that help keep the ankle stable. When speaking in terms of ankle fractures there are three boney areas that we refer to – the medial malleolus (the inside protrusion of the tibia that we associate with the ankle), the lateral malleolus (the outside protrusion of the fibula that we associate with the ankle) and the poster malleolus (the back part of the tibia). Ankle fractures are classified according to the area of the bone that is broken (i.e. medial malleolus fracture). If two of these malleoli are broken, we refer to this as a bimalleolar fracture. Bimalleolar fractures most often include the medial and lateral malleoli. Trimalleolar fractures involve a fracture to all three of the malleoli. The severity of the fracture involves the number of breaks that have occurred, stability of the ankle joint, and if ligamentous injury is present. The most common ligamentous injury seen with ankle fractures is a syndesmotic injury. The syndesmosis joint can be found between the two bones of the lower leg (tibia and fibula) which are held together by ligaments (for isolated syndesmotic injuries, please see “Ankle Sprains” in our “Conditions” section). Ankle fractures can be caused by direct impact to the area, twisting or rotating the ankle, “rolling” the ankle, or tripping/falling. Symptoms can include severe and immediate pain, bruising, swelling, tenderness, inability to bear weight, or an obvious deformity. X-rays are often the first imaging tool when diagnosing an ankle fracture and its severity. Nonsurgical treatment may be utilized by your doctor if the ankle remains stable and the fractured bones are still in anatomic alignment or if the patient is not a surgical candidate. In these cases, a CAM boot or a cast will be applied and non-weight bearing measures are taken to allow the fracture to heal. Serial x-rays are then used to ensure proper fracture healing occurs. If the fracture is more severe where displacement has occurred, the ankle joint is unstable, dislocation of the ankle joint is present, multiple bones are involved, or ligamentous injury is present surgical intervention with hardware placement may be required (see “Ankle ORIF” for more information).
Every patient receives an in-depth consultation to devise a treatment plan that is right for their problem. Our specialists prefer non-operative and non-invasive treatments whenever possible, including physical therapy, medications, and/or injections. When we require surgery, we will then use minimally invasive surgical techniques to fix your problem, whether it is fixing a broken bone or repairing a tendon. Our goal is always to get you back to living your life normally as soon as possible.