What are the Fractured Ankle Causes, Symptoms, and Treatments?

Ankle fractures can occur in people of all ages but typically fractured ankle causes more severity often in adults; in fact, they are the fourth most common type of fracture in adults. The symptoms & severity of a fractured ankle can however range from a simple break in one bone, which may not hinder you from walking to a more severe fracture which may even require surgery. 

Anatomy

Three bones make up the ankle joint: 

  • Tibia — the shinbone
  • Fibula — the smaller bone of the lower leg
  • Talus — the small bone that sits between the heel bone and the tibia and fibula

Doctors determine the ankle fractures by observing the fractured ankle symptoms and examining the area of the bone that is broken or how much a bone has displaced from its original position.

Two joints are involved in ankle fractures:

  • Ankle joint- it is where the tibia, fibula, and talus meet. The ankle joint is essential for maintaining posture and ambulation. 
  • Syndesmosis joint- it is the joint between the tibia and fibula, which is held together by ligaments.

Causes of Ankle Fracture

Different types of injuries can result in ankle fractures. Here are some of the fractured ankles causes:

  • Playing sports, particularly where you are likely to get hit on your ankle or twist your ankle, such as football.
  • Impact during a motor vehicle accident.
  • Tripping, rolling, or falling from a significant height.
  • Twisting or rotating your ankle while running.

Fractured Ankle Symptoms

Common symptoms of a fractured ankle include:

  • Swelling and bruising
  • Tenderness to touch
  • Sudden and severe pain
  • Numbness in foot

Fractured Ankle Treatments and Diagnosis

After inquiring about the cause of your ankle injury, the doctor will usually do a physical examination of your foot, ankle, and leg. If your doctor suspects any fractured ankle symptoms, he will suggest an imaging test, either an X-ray or a CT scan to diagnose and evaluate better. Most common ankle fractures can be diagnosed with X-rays to confirm whether any bone is broken or has been displaced. A CT scan is sometimes done to evaluate the extent of the injury to the ankle joint. It further provides detailed and cross-sectional X-ray images of the ankle.

Fractured ankle treatments then depend on the type and severity of the injury.  Medical treatment is of two different types, one is a non-surgical treatment and the other is surgical treatment. Non-surgical treatment is where the treatment of a fractured ankle can be done with a short leg cast or walking boot. This can be either a non-displaced medial or lateral malleolus fracture which means that the bone has not been displaced and can be treated without surgery. 

On the other hand, surgical treatment is required in case of a displaced medial or lateral malleolus fracture. Ankle fractures are treated with a surgery called open reduction internal fixation (ORIF).  If the fracture is large and extends into the ankle joint, it can surgically be repaired by installing metal plates, wires, or screws to keep your ankle bones stable while the bones heal. 

Treatment for Fractured Ankle at Home (First Aid) 

Now imagine, one fine morning you are all charged and energized for a deep house cleaning session. You want to clean the ceiling fans so you climb up a ladder and get busy cleaning, along with your favorite music playing on your earphones. You suddenly lose balance and slip, resulting in twisting your ankle.  Now you are in a situation where you are on your own so you have to manage immediate self-care while you wait for professional medical help.

What to do?

  • First and foremost, sit in a position that exerts minimum pressure on your foot. 
  • Next, apply an ice pack for at least 20 minutes to help you numb the pain and keep the swelling to a minimum.
  • Wrapping a sprained ankle:  This step is called compression. Lightly compress both the ankle and the surrounding area and wrap it with a gauze bandage lightly.  Do not try to align the bones.
  • Manage pain and inflammation:  Get an over-the-counter pain medication such as ibuprofen or aspirin.
  • In case of any severe injury such as protruding bone, do not push it back into place. One of the best practices for wound dressing is to cover the area with a sterile gauze pad and wait for medical help. 

Difference Between a Stress Fracture and a Broken Ankle

When you have hurt your ankle, it is hard to tell at that time if you have a stress fracture or a broken ankle. The basic difference between the two is that a stress fracture is a very small crack in your bone, whereas a bone fracture is a medical term for a broken ankle where the fracture changes the shape of your bone. 

What causes a broken ankle?

Broken ankles are usually caused by a rotational injury, where the ankle twists or turns while walking or running, such as during a sports activity. They can also be caused by a high-force impact, such as from a fall or an automobile collision.

What causes a stress fracture?

Stress fractures can happen from repetitive trauma and are commonly observed in athletes, particularly long-distance runners or hikers.

How can I tell if my ankle is broken?

It is not easy to tell if the pain in your ankle is due to a sprained ankle or a broken ankle. Here are some symptoms to look out for

Broken ankle symptoms

  • Sudden severe pain in your ankle
  • The ankle is bruised and swollen
  • You cannot bear weight on your ankle
  • It hurts on touching your ankle

Stress fracture ankle symptoms

  • Pain, swelling, or arching at the site of fracture
  • Pain that begins after starting an activity and then subsides with rest
  • Tenderness or “pinpoint pain” when touched on the bone
  • Pain occurs even at rest, during normal activity, or during  everyday walk.

How Long Does it Take to Recover From a Broken Ankle?

The broken ankle recovery time in total is about six weeks for the bones to completely heal.  For the first couple of weeks, patients are in a splint and are suggested to elevate the limb 90% of the day. One of the best broken ankle recovery tips is to elevate whenever possible and avoid weight-bearing activities. After 10 to 14 days, the sutures are removed and patients are typically placed into a removable boot. This allows patients to start moving the ankle and to shower. At the six-week visit, X-rays are obtained. Assuming the bone is healed; patients are then allowed to start weight bearing and to begin physical activity. 

Recovering from a stress fracture

During the phase of healing, the doctors recommend you alternate your activity and rest days to allow your body to ease back into fitness. You are told to slowly increase how often and how vigorously you exercise. If the activity that caused the stress fracture is started too quickly, you may develop a larger fracture that is harder to heal. If you re-injure the bone, it can lead to long-term problems, and the stress fracture might never heal properly. 

Another common confusion among people is the difficulty to distinguish between an ankle sprain and an ankle fracture.  The question is can twisting your ankle cause a fracture or sprain? The answer to this question is that both ankle sprains and fractures result from similar activities, such as tripping, falling, or twisting, and occur when the ankle is stressed at an angle. The difference is that sprains result when there is damage to the ligament, whereas ankle fractures require a break in the bone.

Both sprains and fractures can cause pain, swelling, and bruising. Here are some symptoms to consider when trying to figure out if your ankle injury is a sprain or fracture:

 Ankle sprain symptoms:

  • Mild to moderate pain
  • Ankle instability
  • Some swelling and bruising

Fractured ankle symptoms:

  • Inability to bear weight on your ankle (both immediately and after several hours/days)
  • Swelling and bruising are typically obvious and immediate
  • Deformity of the ankle
  • Moderate to severe pain upon injury, along with numbness

Prevention

Preventing ankle fractures can be difficult or let’s just say they are inevitable, considering that many are a result of regular “slip and fall” incidents.  Proper footwear may reduce such accidents, especially while playing different sports. Being careful in your activities is another way of preventing an ankle injury.