Broken ankle

A broken ankle is a completely or partially broken bone on one or both sides of the ankle. Features of a broken ankle include pain, swelling, and being unable to walk on the affected leg.

Doctors also refer to a broken ankle as an ankle fracture.

How does a broken ankle occur?

Almost always a fall or accident is the cause of an ankle fracture. In a one-sided fracture it is usually the fibula that breaks, although the tibia can also break.

People who play contact sports such as soccer or rugby have an increased risk of an ankle fracture. People with a history of bone demineralization (osteoporosis) also have a higher risk of fractures due to weakened bones.

Symptoms of a broken ankle

Usually the moment of the break during the fall or accident is felt or even heard. Almost immediately there is severe (pressure) pain over the broken bone and pain with ankle movement. The ankle may swell and turn blue. One of the hallmarks of a broken ankle is the inability to stand and walk on the affected leg.

How is the diagnosis of a broken ankle made?

Based on the patient's history and physical examination, it will quickly become clear that the problem is a broken ankle. Almost as standard when an ankle fracture is suspected, the ‘Ottawa Ankle Rules’ are applied. These are specific questions and tests to distinguish between an ankle sprain (sprained ankle) and an ankle fracture.

When a fracture is suspected, a röntgenfoto is taken. The fracture line is usually clearly visible, allowing an estimate of the severity of the fracture.

Classification of ankle fractures
The type of ankle fracture can be classified based on location, using the so-called Weber classification. To determine the severity, associated injuries are also evaluated. For example, are there bone fragments protruding through the skin (open fracture), is the fracture displaced (dislocation), or are there multiple breaks (comminution)?

In ankle fractures with multiple breaks, it is determined whether the bone fragments are still aligned. In a stable fracture, in which the bones are aligned, treatment often consists of casting and rest. In an unstable fracture, where the bones are not aligned, the chance of poor healing is high. That makes surgery necessary.

Treatment of a broken ankle

Treatment depends entirely on the type and severity of the fracture. In a stable fracture with a high chance of natural healing, the bones are usually allowed to grow back together with a period of casting and rest. In an unstable fracture, the broken bone is surgically fixed with fixation materials. Examples include metal plates, screws, wires, or pins that ensure the bone fragments heal in a good position.

A physical therapist is closely involved in recovery, both for stable and unstable fractures. It is very important to restore range of motion, muscle strength, and load tolerance during rehabilitation. Possible treatments used by the physical therapist include mobilization techniques, massage, medical taping, and exercise therapy.

Find a physical therapist to help you recover from a broken ankle.