Kevin D. Martin, DO, FAAOS,
Orthopedic Foot and Ankle Surgeon
Associate Professor of Surgery
A broken ankle, also known as an ankle fracture, is one of the most common lower leg injuries. It can be very painful and needs to be seen by a medical professional as soon as possible because it may need treatment to heal properly. Walking on a broken ankle can make the injury worse so if in doubt, get it checked out.
Our guide covers the main causes and symptoms of a broken ankle, treatment options and recovery tips, and when to start walking after a broken ankle. It also answers some of the most commonly asked questions about this injury.
|Your Guide To Recovery|
|How do broken ankles occur?|
|What are the symptoms of a broken ankle?|
|Immediate care of your broken ankle|
|How to diagnose a broken / fractured ankle|
|Treatment options for an ankle break / fracture|
|Broken ankle recovery time|
|What can I expect during my broken ankle recovery?|
Over five million ankle injuries occur each year in the United States(1). They range in severity from a sprain (where the ligaments give way and tear) to a broken ankle. An ankle break and an ankle fracture are the same thing.
The ankle joint is made up of three bones. The tibia and fibula are the two long bones that run from your knee down to your ankle. The tibia, also known as the shinbone, is the weight-bearing bone and is the thicker and larger of the two. The fibula, or calf-bone, runs parallel and helps to stabilize the tibia. The third bone is the talus, a small wedge-shaped bone located deep in your ankle that supports both the tibia and the fibula.
Any one of these bones can break. However, the most common ankle fracture is known as lateral malleolus, which occurs in the fibula, just above the ankle joint. This accounts for around 55% of all ankle fractures(2).
If you break a bone but it remains aligned in the correct position, this is known as a non-displaced ankle fracture. If the fractured parts of the bone have become separated or misaligned, it’s called a displaced ankle fracture.
Broken ankles are a common injury and are usually caused by a sudden trauma. This could be anything from a simple fall on an icy sidewalk to a sporting injury or car accident. Common things that can cause a fractured ankle include:
A study of nearly 10,000 patients with ankle fractures(3) found that the two most common causes of injury were falls (61%) and sports (22%). Years with colder winters saw more cases and the risk was slightly higher for women than for men. Additionally, most ankle fractures occur in two distinct groups; young adults active in sports and high impact activities, and elderly people due to trip and fall injuries.
The most common symptom of a broken ankle is pain, which is usually immediate and intense. The pain may radiate up and down your leg and even down into your foot.
Other symptoms of an ankle fracture or break are:
Occasionally a small ankle fracture or break may not feel that painful. It’s widely assumed that if you can walk on an injury then it’s not broken but this isn’t always the case. If you continue to walk on a broken ankle it can easily develop into a more major break so it’s important to get checked out by a doctor if you have any symptoms. If you can’t see your own doctor quickly you may need to go to an emergency room or, if your symptoms are severe and you can’t get to a hospital on your own, call an ambulance.
While you’re waiting to see a doctor, try not to put any weight on your injured leg. Keep it elevated, propped up with cushions or clothes, to help control the swelling. If your skin isn’t broken, you could try wrapping it with a compression bandage or kitchen towel and applying an ice pack or bag of frozen peas for 15-20 minutes every couple of hours, however, it’s essential that you do not wrap it too tight, as this can cause further complications. Remember not to apply ice directly to your bare skin, and do not apply ice if the skin is broken.
If you can see a bone protruding through the skin, don’t try to push it back into place. Cover it with a clean dressing, cloth or towel and seek medical attention immediately. It’s best not to eat or drink anything until you’ve seen a doctor in case you need surgery.
The only way to determine whether you have a broken ankle is to see a doctor. They will ask about your symptoms and how you injured your ankle, as well as taking some details about your medical history. They will examine your ankle and if they suspect a broken ankle, you’ll have an X-ray taken so they can see the bones in more detail. They may also suggest a CT scan, which is a more sensitive imaging test.
Here’s an overview of the different tests you may have:
The most commonly used imaging technique, X-rays can diagnose most ankle fractures. They will also determine the severity of the ankle fracture and whether there are any additional fractures in your leg or foot.
A CT (CAT, Computed Tomography) scan produces a cross-sectional image of the ankle, ankle joint, and leg quickly and painlessly. A CT scan shows both hard and soft tissues. This makes it very helpful in diagnosing ankle fractures, cartilage injuries and dislocations.
An MRI (Magnetic Resonance Imaging) scans are very good at diagnosing ligament injuries and sprains and stress fractures. MRIs are not typically performed for ankle fractures but may be part of a more detailed examination by an Orthopedic surgeon.
Here are a few questions you may want to ask your doctor after being diagnosed with an ankle fracture:
Your treatment plan will depend on the type, location, and severity of your ankle fracture. You’ll probably need to wear a cast, splint, or walking boot for around 6-10 weeks which keeps your bones in place while they heal. During this time, you’ll be non-weight bearing, which means you can’t put any weight on your injured leg at all, so you’ll need to use a mobility device like crutches, a knee scooter, or a hands-free crutch.
If you have a serious ankle break, you may need surgery. This is usually because the bone is broken in more than one place or has moved out of position. Your doctor will probably want to operate as soon as possible but if you have a lot of swelling, they may decide to put your leg in a splint for a few days and wait for this to subside.
The most common surgery for a broken ankle is open reduction and internal fixation (ORIF), which uses metal rods, plates and screws to realign your bone. These generally stay in place even after your ankle has healed and are only removed if they cause any problems. This type of surgery is usually performed under general anasthetic.
The recovery time for a broken ankle is around 6-10 weeks. Whether you have surgery or not, you’ll probably need to wear a cast, splint or walking boot for around the first six weeks. Once your doctor has given you the go ahead, you can start putting some pressure on your foot, slowly building up to walking again over a period of a few weeks. You’ll wear a walking boot to help support you while you take your first steps.
Once your broken ankle has healed, it’s important to work on moving your ankle frequently in all directions. This helps prevent stiffness and contractures. Your doctor will tell you when it’s okay to return to sports or high impact activities. You may continue to experience some swelling for up to a year afterwards.
Being off your feet for weeks on end can be incredibly frustrating but this is a crucial part of your recovery. Walking on a broken ankle too early can prevent it from healing correctly and may make your injury worse. Fortunately, there are now a few different mobility devices to choose from which can help you to stay mobile. They are:
Traditional crutches are easy to get hold of and relatively inexpensive. Many people use crutches after ankle surgery or while recovering from an ankle fracture. However, they are tiring to use and can cause pain in other parts of your body, particularly your arms and hands. They are also restrictive because you can’t carry anything, which prevents you from getting on with normal day to day activities. Because of these limitations, people are often tempted to walk on a broken ankle too soon, causing further problems.
Knee scooters or “knee walkers” are another option to stay mobile while recovering from a broken ankle. They are more efficient than crutches and require less upper body strength. They are great on flat surfaces as you can scoot easily from point A to point B without getting exhausted, but they don’t work on stairs, slopes or uneven terrain. You also need to use your hands to operate the scooter so you still can’t carry things around, and they are bulky which makes them difficult to transport. It’s also difficult to navigate tight environments when on a knee scooter.
The iWALK2.0 is a hands-free crutch that enables you to walk around unaided with full use of your hands and arms. It functions like a temporary lower leg so that you can go about your daily life as usual, while recovering from a broken ankle. It can be used on stairs, slopes, uneven terrain, and in the shower. A 2019 medical study(4) found that nine out of 10 patients prefer the iWALK2.0 to traditional crutches.
During your recovery, remember to rest and elevate your ankle whenever possible. Gently move your toes and bend your knee regularly to prevent your muscles from getting stiff. As tempting as it is, try not to put anything down your cast to scratch an itch. It may get stuck or cause damage to your skin, increasing the risk of infection.
It’s really important that you don’t get your cast wet, so you’ll need to use a special protective cover when you shower or bathe. Some people use a plastic bag wrapped tightly around the cast, although this isn’t as reliable. In the shower, balance your injured leg on a stool or use a hands-free crutch.
Over the counter painkillers such as acetaminophen (e.g. Tylenol) or ibuprofen (e.g. Advil, Motrin IB) can help with any discomfort you feel during the early stages of recovery but if you’re in a lot of pain, your doctor may prescribe stronger medication. Before starting any medication, talk to your doctor to ensure they are safe for your unique medical needs.
Here are the most commonly asked questions about a broken ankle:
It takes around 6- 10 weeks to recover from a broken ankle. During this time, you will probably need to wear a cast or boot. Most people are able to walk normally again and resume their everyday activities by around three months – endurance improves over time and as your strength improves. Your doctor will tell you when it’s okay to return to sports and other high-impact activities.
You’ll probably wear a cast or walking boot for around 6-10 weeks after an ankle break or fracture. After this, you’ll probably continue to wear a boot for another few weeks to support your ankle as you start to bear weight again.
Your doctor will tell you when it’s okay to put weight on your broken ankle. For most people, it’s after around 2-6 weeks although it may be less or more depending on the type and severity of your fracture. It’s really important not to put any weight on your leg before this as walking on a broken ankle too early can prevent it from healing.
Most people get the green light from their doctor to slowly start putting weight on their leg around six weeks after breaking their ankle, although this may be less or more depending on your injury. It can take a few more weeks before you’re walking around normally again. It generally takes 6-10 weeks for a broken ankle to heal. Conditions like diabetes and nicotine use can slow the healing time significantly, potentially even doubling the amount of time it takes to heal from a broken ankle.
You should be able to resume your normal daily routine around three months after breaking your ankle. It can take several months to regain strength and range of motion in your ankle.
After ankle surgery you’ll probably need to be non-weight bearing for at least six weeks. Most people use crutches after ankle surgery but other mobility devices to consider include a knee scooter and hands-free crutch.
|The information above is for informational purposes only and is not intended to prevent, treat, or diagnose any illness or disease. We aim to provide the highest quality information, so if you have any questions on the information above, we welcome your feedback!|