How Ankles Break and How They Heal

If you’ve been unfortunate enough to break your ankle, you know how painful this common injury is. Though by no means catastrophic, a fractured ankle can be disabling for months and may require surgery. As with other fractures, the type and severity of the injury will determine treatment options and length of recovery. Unless you receive prompt and appropriate treatment, you may be left with permanent mobility issues. This makes it crucial to consult with an experienced foot and ankle orthopedic surgeon as soon as possible.

How did it happen?

Though broken ankles are often high-impact sports injuries, resulting from a twist and fall during vigorous activity, ankle fractures also can occur due to:

  • Car accidents
  • Missteps that result in a sharp twist of the ankle
  • Falls from a standing position, height, bicycle or motorcycle, or down a flight of stairs

Though breaking an ankle takes only seconds; recovery can be long and arduous.

Was I at increased risk for an ankle fracture?

While you are probably aware that your risk of injury, including ankle fracture, is heightened by your participation in sports such as basketball, football, gymnastics, tennis, hockey and soccer, you may not realize that the following factors also make you more likely to break your ankle:

  • Improperly fitted or unsupportive shoes
  • Inadequate warmup before vigorous exercise
  • Work in occupations that involve climbing, heavy lifting, working at heights
  • Working or living in a cluttered or poorly lit environment
  • Physical problems, such as poor vision or osteoporosis (decreased bone density) 

As you can see, both those who are athletic or very physically active and those who are handicapped or elderly are more likely to break a bone in the ankle or elsewhere in the body. Paying attention to your risk factors and taking preventive action, such as wearing proper shoes or using an assistive device to walk can help to keep you safe. 

How can I tell if I’ve broken my ankle?

Until you are examined and X-rayed, you may not know for certain whether your ankle is actually broken, but you will undoubtedly know that something is seriously wrong. Typically, those who have suffered broken ankles experience immediate extreme pain and inability to put weight on the injured leg. In some cases, however, the ankle may become completely numb.

Other symptoms of a broken ankle may include:

  • Pain that increases with movement
  • Extreme swelling, bruising and tenderness
  • Deformity of the region
  • Protrusion of bone through the skin (compound fracture)
  • Feeling faint or nauseated 

In some cases, patients actually hear the bone break — a snap or grinding noise at the instant of impact.

Should I wait and see if my injury improves with rest?

The short answer is no. If, after a few minutes, you remain unable to put weight on the injured ankle, and the ankle continues to swell, you need urgent care. Whether the preliminary diagnosis after X-rays is an ankle fracture or damage to a ligament or tendon, the next step is to be seen by a knowledgeable foot and ankle orthopedic surgeon. As a specialist in this particular field, he or she will be able to make a precise diagnosis and determine the best course of treatment. Remember, you want your ankle to heal properly and as quickly as possible. Also, you will want to prevent future complications like bone infection (osteomyelitis) and arthritis.

What type of treatment will I need while my broken ankle heals?

As noted, the type of treatment you require will depend on the nature and severity of the fracture. One way or another, a broken ankle will have to be immobilized during healing. If your break is minor, and your doctor determines that your ankle can bear some weight, you may be put into a walking cast for several weeks. On the other hand, if you have sustained a severe fracture and/or have been operated on, you will be put into a hard cast for several months. In either case, you may be prescribed anti-inflammatory medication.

The hard cast will not be removable, ensuring that the affected leg remains completely immobilized during recovery. If you require surgery for your broken ankle, the procedure is a delicate one that requires an orthopedic surgeon who specializes in foot and ankle surgical procedures. Your doctor will carefully reposition your bone(s) so everything is correctly aligned and fix them in place with surgical hardware like metal screws and plates. During the period that you are in a hard cast, you will have to use crutches or other assistive devices to get around.

Will I need rehabilitation after my broken ankle heals?

Yes. No matter what type of treatment your broken ankle requires, rehabilitation will be necessary to restore full mobility to your ankle, to strengthen surrounding muscles that have atrophied while immobilized, and to retrain you to resume normal physical activities like walking and climbing stairs in the safest possible way. The good news is that most broken ankles heal completely and most patients, once their bones knit, get back to their previous level of function.