All you need to know about ankle fracture

Three factors are interpreted for increased incidences of ankle injuries – slippery surfaces, sports and high heels. It is, however, possible to hurt your ankle at other places and situations. Even a casual walk around the neighbourhood can make you trip and fall, sometimes leading to an ankle fracture. According to a study by the Indian Journal of Medical Research, more than 69% of people in Delhi between the age group 35-68 suffer from a high risk of bone fractures. The incidence of ankle fracture alone is 187 fractures per 100,000 in a year. 

In this article, Dr Anuj Chawla, foot and ankle specialist at the CK Birla Hospital will explore everything you need to know about a fractured ankle and the possible causes leading to such high incidence.  

What is an ankle fracture?

Ankle fracture happens when a bone in the ankle joint gets broken. This injury is also referred to as a broken ankle. A fractured ankle can range from a tiny crack in the bone to a complete dissociation where your bone peaks out of the skin. 

An ankle joint is structured with three bones – tibia which forms the medial and posterior malleolus; fibula which forms the lateral malleolus and talus. A fracture is characterised based on the bone that has been affected. 

There are various types of ankle fractures. The fractures which involve only one bone can be medial or lateral malleolus fractures. The fractures that involve two or three malleoli are called bimalleolar and trimalleolar fractures respectively. Apart from the broken bones, the ankle fractures may be associated with injury to a ligament called syndesmosis which binds the lower end of tibia and fibula together.

How is a fractured ankle caused?

Ankle fractures are caused by abnormal twisting, rolling, tripping or trauma of the ankle. Some of the common causes for a fractured ankle include:

• Trips and falls 
• Misbalanced steps 
• Impact of a jump or fall 
• Sports Injuries
• Car accidents 

While everyone can suffer from a fractured ankle, some people are more likely to experience this injury. If you play high-impact sports such as basketball, gymnastics, football and more, your chances of having a broken ankle increase. Walking on uneven surfaces can result in more trips and falls. Decreased bone density or conditions such as osteoporosis can also raise your possibility of ankle fractures. 

What are fractured ankle symptoms?

Your pain-bearing capacity can sometimes misinterpret a fracture. You should look out for the following fractured ankle symptoms:

• Sudden throbbing pain at the ankle
• Swelling 
• Visible dislocation in the foot
• Bruising 
• Tenderness
• Deformity 
• Difficulty in walking 
• Dizziness
• Bleeding (if the bone pierces the skin)
• Difficulty in lifting your own weight 

The location and extent of swelling in a broken ankle will depend on the type and location of the fracture. 

How are fractured ankle symptoms different from an ankle sprain?

As mentioned above, the pain management capacity of individuals can, sometimes, cause misunderstanding about an injury. So how do I know if I have broken my ankle?

An ankle sprain is an injury of tendons and ligaments. When the ankle ligaments tear or stretch, they can cause pain and swelling. Pain and swelling are also fractured ankle symptoms. 

Your healthcare provider will be able to diagnose your injury properly. You should note that the severity of symptoms is immense when an ankle is broken while an ankle sprain can be easily managed.

Also, watch the video as Dr Anuj Chawla – Foot & Ankle Specialist at the CK Birla Hospital, sheds some light on ankle fractures and the steps you can take to minimise its impact.

What is an ankle fracture treatment?

Your healthcare provider will first assess your injury before providing ankle fracture treatment. He/she will physically evaluate the mobility of your foot by moving it in different positions. Your doctor will ask you about your symptoms. 

Your doctor will order a few imaging tests to precisely diagnose the condition. The following tests are indicated in case of a fractured ankle:

• X-rays: An X-ray is the most effective imaging tool to visualise a broken ankle. Most diagnoses are complete with the help of an X-ray. 
• MRI scan: Sometimes, when the crack is too small, it can be missed on X-rays. In such cases, your doctor may advise MRI scan for diagnosis. 
• CT Scan- For complex fractures which might require a surgery, the doctor may advise further investigation by CT Scan to assess the fracture in greater detail.

Ankle fracture treatment depends upon the location of the fracture and severity of symptoms. Conservative treatment is offered in mild cases. If your ankle is stable, your hairline ankle fracture can recover by non-surgical means. While treating the ankle fracture non-operatively, immobilisation in a rigid cast or boot for 6-8 weeks is undertaken. 

Most of the times, ankle fracture surgery is performed to treat the joint. Surgery is performed to reduce the displaced fragments to their original place and then fixing it with plates and screws. This method is also called as Open Reduction and Internal Fixation. 

Physical therapy is important for recovery from a fractured ankle. You should consult a verified physical therapist for your treatment. Physical therapy is critical for restoring and improving the strength of your bones.

What is the fractured ankle recovery time?

Fractured ankle recovery time depends upon the severity of your condition. If you have had a procedure to correct a broken ankle, you can expect recovery within 8-12 weeks. You are expected to follow your doctor’s guidelines and provide complete rest to experience a quick recovery.

What are the broken ankle recovery tips?

Based on your injury, your doctor will offer you relevant broken ankle recovery tips. Practice the following tips during recovery:

• Do not use your injured foot – You should make sure to immobilise your injured ankle. Do not put any weight on your injured leg. 
• Take plenty of rest – Sufficient rest and sleep during your healing. 
• Keep your limb elevated-  limb elevation under 1-2 pillows help in reduction of swelling specially during the first 2 weeks
• Move your toes regularly- active toe movement also helps in pumping the blood away from the feet and hence reduction of swelling. 
• Take physical therapy – You should make sure to get regular physical therapy until after you have recovered fully. 
• Take a healthy diet – Your diet during your recovery should be loaded with nutrients.
• Do not smoke – Smoking cigarettes can interfere with your healing process as it restricts the flow of nutrients and oxygen to your joints.

Can you walk on a fractured ankle?

Since the ankle fracture affects your joint, it is not advisable to put weight on your broken ankle for the first few weeks. Your ability to walk depends upon the type and seriousness of the fracture you have encountered. If your fracture is mild and hairline, your doctor may allow you early weight bearing and walking on your ankle. 

However, a serious broken ankle will take time in recovery and delay walking. Walking on a broken ankle too soon may result in unbearable pain or discomfort from the slightest of movement.

How to start walking after a broken ankle?

Your doctor will assess and supervise your recovery. He/she will suggest when you can walk after a broken ankle. 

Your physiotherapist will provide support in this process. He will help improve your movement of ankle and bone strength. You can also choose to start walking with the help of walker, cane or crutches.

The concluding note 

Ankle fracture is not an uncommon condition, but it requires urgent medical intervention. An untreated fractured ankle can cause several health complications such as arthritis, persistent pain, ligament injury, nerve damage and more.

To learn more about musculoskeletal health, consult Dr Anuj Chawla at the CK Birla Hospital. 

FAQs

Ques: Can you walk on an ankle fracture?

Ans: The ability to walk after an ankle fracture depends upon the severity of fracture. If the fracture is minor, you may be able to walk soon. If it is serious, you will be advised to rest until the injury is healed.

Ques: How long does it take to heal a fractured ankle?

Ans: On average, it takes nearly 8-12 weeks for ankle fractures to heal completely. The recovery period may vary based on your overall health and age. 

Ques: Do you need a cast for a fractured ankle?

Ans: Yes, your ankle will be placed in a cast for nearly 4-8 weeks to promote healing.

Ques: What happens if a fracture is left untreated?

Ans: An untreated fracture can lead to bone deformity, muscle and ligament damage, arthritis and persistent pain.