Ankle Fractures

A common injury seen by podiatrists is a fractured ankle. Ankle fractures can range from mild partial breaks of the bone to complete breaks with movement of the bone into an abnormal position. Stress fractures are small cracks that occur in a bone due to overuse or activities that place high stress on the bone. This stress can cause the muscles to become fatigued and lessen their ability to absorb shock from impacts. When this happens, the shock is transferred to the bones, which can create a fracture.

Ankle fractures are most often caused by the ankle rolling inward or outward. Many people mistake an ankle fracture for an ankle sprain and end up in the emergency room, however, fractures and sprains can sometimes occur simultaneously.

Early diagnosis of any ankle injury is the key to prevent log-term problem, which can lead to chronic post-traumatic arthritis, ankle instability and chronic pain.

Symptoms of Fractured Ankle

An ankle fracture is accompanied by one or all of these symptoms:

• Pain at the site of the fracture, which in some cases can extend from the foot to the knee
• Significant swelling, which may occur along the length of the leg or may be more localized
• Blisters may occur over the fracture site. These should be promptly treated by a foot and ankle surgeon.
• Bruising that develops soon after the injury
• Inability to walk—however, it is possible to walk with less severe breaks, so never rely on walking as a test of whether a bone has been fractured
• Change in the appearance of the ankle – it will look different from the other ankle
• Bone protrusion and a change in the appearance of the ankle is a sign that usually involves immediate care and re-alignment of the fractured bones. Fractures that pierce the skin require immediate attention because they can lead to severe infection and prolonged recovery.

Treatment of Ankle Fractures

Once an ankle injury occurs it is important to have the ankle evaluated immediately by a foot and ankle specialist. Your doctor will suggest treatment depending on the severity of the injury and if and movement of the fracture has occurred. Evaluation can be done via x-rays, or CAT scan to assess the need for surgery versus cast immobilization. Sufficient follow-up on the patients’ part is imperative to allow for adequate healing to minimize post-injury pain and complications.

Treatment options include rest, taping of the foot and ankle, orthotic devices and crutches.

When is Surgery Needed?

For some ankle fractures, surgery is needed to repair the fracture and other soft tissue related injuries, if present. The foot and ankle surgeon will select the procedure that is appropriate for your injury.

If you are not able to get medical attention immediately, then make sure you:

• Rest: Stay off the injured ankle. Walking may cause further injury.
• Ice: Apply an ice pack to the injured area, placing a thin towel between the ice and the skin. Use ice for 20 minutes and then wait at least 40 minutes before icing again.
• Compression: An elastic wrap should be used to control swelling.
• Elevation: The ankle should be raised slightly above the level of your heart to reduce swelling.