The ankle is a complex joint made up of three bones: the tibia, fibula, and talus. It is supported by a series of ligaments on both sides of the ankle as well as ligaments that maintain the relationship between the tibia and fibula above the ankle. The joint is protected by a capsule filled with synovial fluid which enables the smooth movement the joint requires.

Ankle injuries are very common among people of all ages. An ankle fracture includes a break in the tibia or fibula above the ligament attachments leading to mechanical dysfunction of the joint.

Causes of Ankle Fractures

Ankle fractures typically occur from excessive rolling and/or twisting of the ankle. They can occur in sports when an athlete sustains a rotational force across the ankle, for example, jumping and landing on an uneven surface such as another player’s foot. For non-athletic related injuries, it can be as simple as stepping off a curb awkwardly or stepping into a hole or ditch causing the ankle to twist forcibly.

Symptoms

When an ankle fracture occurs, there is generally immediate swelling and pain around the ankle, along with impaired mobility. In less severe injuries the injured person is able to continue to walk and may believe that they only had a simple sprain. In severe fractures, the joint becomes unstable and there can be an obvious deformity at the ankle. Deformity indicates significant malalignment of the joint which can be harmful not only to the bone, cartilage and deep soft tissues, but also the skin around the ankle. In these cases, the joint and fractures must be reduced, or aligned, urgently to avoid further injury.

Diagnosis

Proper diagnosis of the ankle injury begins with a physical examination, followed by radiographs and sometimes with the addition of a CT scan of the injured area. Unless the fracture is severe enough to cause a deformity of the joint, it is very difficult to differentiate a broken ankle from other related injuries without this type of imagery. In some cases gravity stress radiographs can also be used to help guide treatment. This test is used to check the stability of the fracture and help the surgeon determine if surgery is necessary or not.

Surgical Treatment of Ankle Fractures

In cases of unstable injury patterns or significant malalignment it is most often treated optimally with surgical fixation of the fractured bones. This is carried out to improve the anatomical alignment, but to also facilitate more rapid healing and earlier rehabilitation. When the injury dictates that surgery is required, the fractured bone is accessed by making an incision over the fractured bone. At this point the surgeon will realign the fracture and use specially designed plates and screws to stabilize the fracture. The incision is then closed, and the operated ankle is immobilized with a splint or cast to protect the joint early on during the healing process.

Occasionally the fractured ankle must be supported temporarily with an external fixator or a minimally invasive frame on the outside of the leg to support the ankle prior to fixing the fracture on the inside.

Post-operative Care

After ankle surgery, you will receive detailed instructions from your surgeon. Typically, you will need to avoid putting weight on your ankle for generally six weeks. In some cases such as in diabetics or more complex injuries, this timeframe may be longer. Each injury and injured patient is unique and your surgeon will give you specific details for your situation.

Your surgeon will recommend a course of physical therapy to further assist in the healing process. Commonly after ankle fractures patients can develop stiffness and early mobilization and skilled care from a physical therapist under the direction of your surgeon can help mitigate this.

Make an Appointment to See an Ankle Specialist in Boise

If you have fractured your ankle, be sure to schedule an appointment with an ankle specialist in Boise. Dr. Flint of The Flint Foot and Ankle Institute is a foot and ankle specialist, along with being a board-certified orthopedic surgeon. Dr. Flint and his team will help you every step of the way, whether surgery is required or not.