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 kinds of ankle fractures. The type of fracture depends on which bone breaks and how it breaks.

Ankle fractures are common in both children and adults.

What are the symptoms of an ankle fracture? — Symptoms of an ankle fracture include:

●Pain

●Swelling

●Stiffness

●Bruising or blistering of the skin

●Being unable to walk or put weight on the ankle

An ankle fracture can also make the ankle look crooked.

Is there a test for an ankle fracture? — Yes. The doctor or nurse will ask about the injury and symptoms, and do an exam. They might also order an X-ray of the ankle. But for some types of ankle injury, X-rays are not needed.

Some people need other imaging tests, such as a CT or MRI scan. Imaging tests create pictures of the inside of the body.

How are ankle fractures treated? — Treatment depends on the type of ankle fracture and how severe it is.

Treatment for a mild ankle fracture usually involves:

●Resting the ankle

●Raising the ankle above the level of the heart, for example, by propping it up on pillows – This is helpful only for the first few days after an injury.

●Putting ice on the ankle – 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 your 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 an injury.

●Wearing a splint, brace, or cast – With some braces and casts, people are able to put weight on their ankle and walk around. With other braces and casts, people are not allowed to put weight on their ankle or walk around.

Treatment for an ankle fracture also includes medicine to treat the pain. Doctors can prescribe a strong pain medicine if people have a lot of pain or a severe fracture. For mild fractures, doctors usually recommend that people take an over-the-counter pain medicine. Over-the-counter medicines include acetaminophen (sample brand name: Tylenol), ibuprofen (sample brand names: Advil, Motrin), and naproxen (sample brand name: Aleve).

A severe ankle fracture is treated with surgery. During surgery, the doctor will put the ankle bones back in position. To do this, they 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 the skin.

For adults, doctors sometimes recommend working with a physical therapist (exercise expert) after the ankle fracture heals. Physical therapists teach people exercises and stretches to strengthen the muscles, help the joints move more easily, and improve balance. Your doctor or physical therapist might also suggest exercises for you to do at home. Children usually heal fully without needing physical therapy.

How long do ankle fractures take to heal? — Ankle fractures take weeks to months to heal, depending on the type of fracture.

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

Can I do anything to improve the healing process? — Yes. It is important to follow all of the doctor's instructions while the fracture is healing. This includes instructions about when to put weight on the ankle.

Doctors also usually recommend that people with a fracture:

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

●Avoid getting their cast or splint wet, if they have a cast or splint that shouldn't get wet.

●Stop smoking. Fractures can take longer to heal if people smoke.

When should I call the doctor or nurse? — After treatment, the doctor or nurse will tell you when to call them. In general, you should call them if:

●You (or your child) get a fever, chest pain, or have trouble breathing.

●Pus drains out of the cut from the surgery, or the skin around the cut looks redder.

●The pain is severe, or the pain or swelling gets worse.

●The foot or toes get numb, or the toes look blue or purple.

●The splint is too tight or too loose.

●The cast gets damaged or wet, and it's not supposed to get wet.

More on this topic

Patient education: Fractures (The Basics)
Patient education: Caring for your cast (The Basics)
Patient education: Caring for your child's cast (The Basics)
Patient education: Using 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: Quitting smoking (Beyond the Basics)
Patient education: Calcium and vitamin D for bone health (Beyond the Basics)