Broken ankle

If someone twists their ankle severely, it can result in a sprain of the ankle joint. When this happens, the muscles and soft tissue around the ankle are injured. Sometimes, the foot rolls or twists to such an extent that the ankle joint breaks. Doctors refer to this as an ankle joint fracture.

This is a serious injury. One or several bones of the ankle joint may be affected. With a broken ankle, the ligaments are also frequently torn and the cartilage damaged. A broken ankle normally heals easily after a while.

With a broken ankle, the foot swells up, is painful and bruises (hematomas) form. Walking is no longer possible and the foot can barely be moved. Sometimes the bones also shift position due to the fracture. This can lead to a malposition.

A broken ankle most commonly occurs while playing sports. For example, if someone falls accidentally or lands badly after a jump, the foot may roll or twist so severely that the joint breaks. Running on uneven ground or stumbling can also cause broken ankles.

It takes several days or weeks for the swelling to go down. It may take months until the ankle joint is fully healed. In the meantime, only a limited amount of weight can be put on the foot and it is difficult to move.

If weight is put on the foot too soon, the healing process may be disrupted. If in consequence the bone fracture does not heal properly, other treatments may be necessary. However, the foot can also lose strength and flexibility if it is immobilized for too long.

A broken ankle usually heals well. A possible long-term consequence is osteoarthritis. After a fracture, the ankle joint may also remain unstable. This increases the risk of injuring it by twisting it again.

For diagnosis, the doctor asks how the injury occurred. The foot and ankle are then examined to ascertain how severe the injury is. If it is suspected that the ankle joint could be broken, an X-ray is taken.

Sometimes the X-ray image does not lead to a clear diagnosis. Other images of the interior of the ankle joint are then obtained using other methods – for example with what is commonly called computed tomography (CT) or magnetic resonance imaging (MRI). Injuries to the articular cartilage and ligaments can often be detected better with magnetic resonance imaging.

With a broken ankle, the foot and ankle are initially immobilized, elevated and also cooled when necessary. Immobilization with the aid of casts, bandages, splints or orthoses is important to protect the joint and help it heal unhindered. They normally have to be worn for about 6 weeks. If bones have shifted through the fracture or if bones have slipped out of the joint, the doctor can reset them. Surgery is also possible in some cases.

People with a broken ankle can start to put weight on the joint again after a while to strengthen it. The right time to start light exercises or physiotherapy depends on the severity of the injury.

In individual cases, light exercises can be started as early as a few days after the fracture or surgery. Sometimes it is only possible when the splint or cast has been removed. As the foot is initially immobilized for an extended period when the ankle is broken, it may be advisable to prevent a possible thrombosis with injections.

A broken ankle doesn’t always require surgery. Factors that determine whether surgical intervention is required include:

• the severity of the fracture
• the site of the ankle fracture
• whether it is an open fracture
• whether vessels or nerves are injured
• whether the bone parts have shifted

If the joint is operated on, screws and plates can be inserted. They bind the broken bones and ensure that they grow back together.

The ankle joint is also immobilized with a splint, bandage or cast after an operation. Some bandages and splints can be removed. Depending on the individual situation, the screws and plates may be removed if the fracture has healed and the bones have grown back together.

You can find more detailed information, such as what helps you get back on your feet after a broken ankle, at gesundheitsinformation.de.