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How does an ankle break?

Ankle injuries are quite common, particularly in people who take part in physical sports and activities. In the UK alone, there are around 45,000 moderate to severe ankle sprains per annum.


Your ankle contains three bones: the tibia, the fibula and the talus. When one or more of these is cracked, chipped or snapped, it is referred to as a break or fracture and this happens due to:

  • trauma from the force of hard impacts

  • long-term damage to bones, soft tissues and ligaments


Ankle fractures often occur from sports that involve jumping and quick movements or from accidents such as falling down the stairs. These cause the bone to be twisted or rolled to an abnormal point that the bone(s) can no longer handle.


How is an ankle tested for a broken bone?

If you’re unsure that your ankle is broken, you’ll be checked with a physical examination for the following:

  • if swelling occurred immediately after the injury’

  • if the range of mobility is heavily restricted

  • if blood has gathered around the joint (hemarthrosis)

  • if there is a visible irregularity in the shape of the bones (perhaps the foot is not in the right position or the bone may be showing)


Diagnostic tests can get a closer look at the exact location. This will allow your specialist to clarify the type of ankle fracture you have. An X-ray is the standard first test, particularly when the ankle feels painful when pressed and the patient can’t put their weight on their foot. In some cases, an x-ray isn’t necessary. The Ottawa ankle rules are guidelines that specialists can follow to determine if an x-ray should be conducted.


If an x-ray does not gather enough information, an MRI scan may be conducted to get a more thorough look at the ligaments. If a fracture has already been identified, a CT scan might be used for an even more thorough look.


What medical treatment is there for a broken ankle?

After injuring your ankle to the point that it may be broken or is clearly broken, the best actions you can take until you get to a doctor are resting an ice pack on it and elevating the foot. Stable fractures can often be managed non-surgically. The unstable ones mostly require surgery.


Non-surgical methods

The ankle is realigned and a plaster cast or a splint used to hold the joint for around 2-3 weeks. If the break is minor, a soft compression bandage may be all that’s necessary if not, the next stage is a cast or splint.


Physiotherapy is beneficial for all patients regardless of the type of treatment they have previously received. Particularly in cases of severe ligament sprains and fractures, it helps turn a good recovery into a complete one. Furthermore, it reduces the risk of ongoing problems.


Surgical treatment

If the fracture is more complex, surgical treatment may be necessary. This could be in the form of specially designed plates that are put into the bone and whether these will be removed or not after recovery depends on the patient’s lifestyle. The plates will be removed if they interfere with activity and/or cause pain. Some people have a risky lifestyle and are more likely to have a physical injury and these people would be more likely to have it removed.

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