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Broken Ankle

Broken ankle Potts FractureA broken ankle or fractured ankle can occur from a bad ankle sprain and is a fracture to one of the bones in the ankle.

Symptoms of a broken ankle

Most ankle fractures are acute traumatic injuries caused by a severe sprain or impact. Symptoms include sudden intense pain in the ankle with rapid swelling. Bruising is likely to appear over the next few hours. It will be virtually impossible to weight bear on the ankle with maximum pain located over the site of the fracture. An X-ray will confirm the diagnosis.

Broken ankle explained

The ankle joint consists of three bones; the tibia, fibula and the talus. Fractures can occur to any of these bones and be termed a broken ankle. The tibia is the larger of the two shin bones and forms the medial or inside part of the ankle. The most common tibia fracture occurs at the malleolus which is the bony part on the inside of the ankle.

The fibula is the smaller of the two shin bones which sits on the outside of the shin and forms the lateral or outer part of the ankle joint called the lateral malleolus.

The talus is the bone which sits on top of the foot and forms the ankle joint with the tibia and fibula. The Talus can be fractured too although this is far less common than a fracture at the bottom of the tibia or fibula.

The ankle can be broken in several different ways. The most common injury is where the ankle is rolled over to the side, as occurs with an ankle sprain. Sometimes with this movement there is only soft tissue damage, however in more forceful or rapid movements, a fracture can occur to either the lateral, medial or posterior malleolus. A fracture of the lateral or medial malleolus is known as a Potts Fracture with a lateral fracture being more common.

Extreme flexing or extending of the joint can also cause a fracture, as can an extreme force, such as landing from a height.

Stress fractures are also common in the ankle, especially to the talus. Stress fractures of the Talus occurs through repetitive over stressing of the bone, caused by abnormal foot biomechanics such as overpronation.

Treatment of a broken ankle

Broken ankle in plaster castThe treatment of each fracture should be decided upon on an individual basis. In all cases the ankle should be immobilized in a cast or brace and rested by non-weight bearing for between 1 and 8 weeks. Minor fractures such as a stress fracture may be treated with partial weight bearing in a walking boot or with a crutch.

Most ankle fractures are immobilized in a cast for around 6 weeks. This gives the bone time to heal without the stresses of movement or weight bearing. After this period, the cast is removed and provided no complications are suspected, a rehabilitation plan should be implemented immediately.

Wobble board exercisesMore complex cases may require a longer period of immobilization. A displaced fracture where one part of the bone has become dislodged may require reduction or even surgical fixation with metal pins or plates.

Once the ankle is out of the cast or brace and weight bearing is possible then ankle mobility strengthening exercises can begin. It will also be important to restore the proprioception or co-ordination of the limb with wobble balance board exercises.

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