Patient education: Ankle fracture (The Basics)

What is an ankle fracture? — A "fracture" is another word for a broken bone. An ankle fracture is when a person breaks a bone in the ankle. The ankle bones include 2 lower leg bones called the tibia and fibula, and 1 foot bone called the talus (figure 1).

There are different types of ankle fractures, depending on which bone breaks and how it breaks. When a bone breaks, it might crack, break all of the way through, or shatter.

An ankle fracture can happen because of:

●A sports injury or other accident

●Twisting the foot or ankle

●Falling or jumping from a height

What are the symptoms of an ankle fracture? — Symptoms depend on which bone breaks and the type of break it is. Common symptoms can include:

●Pain, swelling, or bruising over the area

●The area looking abnormal, bent, or not the usual shape

●Not being able to move or put weight on that foot

●Numbness in the area of the broken bone

If a fracture injures a nerve, this can also cause symptoms in nearby areas. For example, a break to the lower leg bone might cause pain, tingling, or weakness in the foot or ankle.

Is there a test for an ankle fracture? — Yes. The doctor or nurse will ask about your symptoms, do an exam, and take an X-ray.

They might also do other imaging tests, such as a CT, MRI, or ultrasound. Imaging tests create pictures of the inside of the body.

How are ankle fractures treated? — Treatment depends, in part, on the type of ankle fracture and how serious it is. The goal is to have the ends of the broken bone line up with each other so the bone can heal.

If the ends of the broken bone are already in line with each other, the doctor will put on a cast, splint, brace, or walking boot to limit ankle movement. This will keep the bone in the correct position so it can heal. Some fractures are placed in a cast right away. Other fractures are not put in a cast until after the swelling goes down.

If the ends of the broken bone are not in line with each other, the doctor will need to line them up:

●Sometimes, they can move the bone to the correct position without doing surgery, and then put a cast, splint, or brace on. This is called "closed fracture reduction."

●For more serious fractures, they might need to do surgery to put the bone back in the correct position. This is called "open fracture reduction." During surgery, the doctor can:

•Use screws, pins, rods, or plates to fix the bones inside the body

•Put pins or screws through the skin and into the bones, and then attach the pins or screws to a bar that is outside of the skin

How long do ankle fractures take to heal? — Most ankle fractures take weeks to months to heal. The doctor or nurse will talk to you about when to return to things like work, sports, or other activities.

Healing time also depends on the person. Healthy children usually heal much more quickly than older adults or adults with other medical problems.

How do I care for myself at home? — To care for yourself or your child at home:

●Follow the doctor's instructions for wearing the ankle splint, brace, or cast. This supports and protects the bone as it heals.

●Do not get a cast wet unless the doctor says that it's waterproof.

●Follow instructions about putting weight on the ankle. Some people are not allowed to put any weight on the ankle. Others are allowed to put a little weight on the ankle. Often, people will use crutches or a walker to help them move around.

●Follow instructions for limiting activity and movement until the bone is healed. The doctor or nurse will tell you what activities are safe to do.

●Prop the injured leg on pillows, keeping it above the level of the heart. This might help lessen pain and swelling.

●The doctor might recommend an over-the-counter pain medicine. These include acetaminophen (sample brand name: Tylenol), ibuprofen (sample brand names: Advil, Motrin), and naproxen (sample brand name: Aleve).

●Some people get a prescription for stronger pain medicines to take for a short time. Follow the instructions for taking these medicines.

●Ice can help with pain and swelling:

•Put a cold gel pack, bag of ice, or bag of frozen vegetables on the injured area every 1 to 2 hours, for 15 minutes each time. Put a thin towel between the ice (or other cold object) and the skin.

•Use the ice (or other cold object) for at least 6 hours after the injury. Some people find it helpful to ice longer, even up to 2 days after their injury.

●Eat a healthy diet that includes plenty of calcium, vitamin D, and protein (figure 2).

●If you smoke, try to quit. Broken bones take longer to heal if you smoke.

●Some people need to work with a physical therapist (exercise expert) after their fracture heals. The physical therapist will suggest exercises and stretches to strengthen the ankle muscles and keep them from getting stiff.

When should I call the doctor or nurse? — Call for advice if:

●There is less feeling or movement in the toes.

●The ankle becomes swollen or starts to hurt more.

●The skin becomes red or irritated around the cast, or the redness starts to spread up the leg.

●The splint or cast feels too tight and uncomfortable, or the toes turn pale, blue, or gray.

●There is a bad smell or drainage coming from the splint or cast.

●The cast feels too loose, you notice a crack in the cast, or the cast becomes soft.

●The cast gets wet, and it is not supposed to get wet.

More on this topic

Patient education: Fractures (The Basics)
Patient education: How to care for your cast (The Basics)
Patient education: How to care for your child's cast (The Basics)
Patient education: How to care for a splint (The Basics)
Patient education: How to use crutches (The Basics)
Patient education: Giving your child over-the-counter medicines (The Basics)
Patient education: Calcium and vitamin D for bone health (The Basics)
Patient education: Quitting smoking (The Basics)

Patient education: Cast and splint care (Beyond the Basics)
Patient education: Quitting smoking (Beyond the Basics)
Patient education: Calcium and vitamin D for bone health (Beyond the Basics)