Ouch! You have a broken ankle!
Broken ankles, also called ankle fractures, occur quite frequently – especially in the winter when there is ice around. We are also seeing more broken ankles as people remain more active into their later years than they have in previous generations.
What is a broken ankle?
There are three main bones about the ankle. A broken ankle may involve any one of these bones or a combination. In general, the more bones that are involved the more severe the injury. If part of one of the bones is broken you may be able to still walk. But if more than one bone is involved the ankle is typically too unstable to support movement.
What bones are involved in a broken ankle?
The main bone of the ankle is the tibia. The bump on the inside of the ankle, called the medial malleolus, is part of the tibia. The smaller bone on the outside of the ankle is called the fibula and its bump is called the lateral malleolus. These two bones are held tightly together by a ligament called the syndesmosis. Between these two bones is the talus. Strong ligaments attach the medial and lateral malleoli to the talus. Sometimes these ligaments may be injured in addition to the bones if you have a broken ankle.
How do I know if I have a broken ankle?
A broken ankle can occur if you twist your foot awkwardly while walking, step on something slippery, or sustain an impact to your foot such as in a car accident or from a fall. It can be difficult to tell the difference between a bad ankle sprain or a broken ankle. Typical symptoms include pain with walking or the inability to walk or bear any weight at all. Signs of a broken ankle include swelling, bruising, tenderness to the touch or even deformity.
What should you do if you think you have a broken ankle?
It can be difficult to tell the difference between an ankle sprain and a broken ankle. This is why you should be evaluated by a physician. The physician will likely order x-rays and in some cases further imaging studies such as a stress x-ray which is used to evaluate a syndesmosis injury, a CT scan, or an MRI.
Most ankle fractures can be treated without surgery, but some do require surgery to heal correctly. You and your doctor will discuss your treatment options to figure out what is best for your injury. You may be sent home in a temporary splint, a brace, boot or cast. Once you get home you should elevate your ankle to about the level of your heart when you are lying down. When sitting up you can prop it on pillows or an ottoman or table. If you do not have a very bulky dressing on you should apply ice or frozen peas for 20 minutes per hour allowing about 40 minutes between sessions to prevent burns. Never put ice directly on your skin – wrap it in a light towel or t-shirt. Make sure you understand your treatment plan, including whether or not you are allowed to put weight on your ankle, and schedule a time to follow up with your physician.