Ankle Fracture: Anatomy, Types, Diagnosis and Treatments

16th September 2019
Have you ever fractured your ankle? If you don't know much about this type of injury, we'll explain why an ankle fracture happens and how to treat it.

An ankle fracture is one of the most common injuries in sports. In addition, it’s also the most frequent condition in traumatology. Almost all ankle fractures affect one of the malleoli. The malleoli are the bony projections found there and are the equivalent to the tibia and fibula joint in the foot.

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Ankle anatomy

To correctly understand what types of ankle fractures you can suffer from, it’s important to understand the anatomy of this joint. Here are the three main bones:

  • Tibia: this is the most prominent and bulky bone of the joint, and is located on the inner side of the leg.
  • Fibula: accompanies the tibia and extends from the knee.
  • Astragal: a bone in the foot that both the tibia and fibula are attached to.
Anatomy of bones involved in ankle fracture

Image courtesy of Wikipedia Commons

As we mentioned before, fractures usually affect one or more malleoli. The malleoli are the bony projections on the ankle.

  • The medial malleolus is located on the inner part of the ankle and is part of the end portion of the tibia.
  • The posterior malleolus is located at the back of the joint and is also part of the end portion of the tibia.
  • Finally, the lateral malleolus is located on the outside of the ankle and is part of the end of the fibula.

Types of ankle fractures

There are many types of ankle fractures when it comes to sports injuries since each activity in and of itself is a risk factor if not performed properly, following the advice of a professional. There are several classifications of sports injuries:

  • Lauge-Hansen classification: distinguishes between the different fractures according to the process that produces the injury.
  • Danis-Weber classification: categorizes injuries according to where the fibula fracture occurs. This type of classification takes into account the level the injury occurred at and uses the fibrous tissue that joins the tibia and the fibula (syndesmosis) as a reference.
  • Herscovici classification: distinguishes between the different fractures that can occur in the distal tibia (medial/internal malleolus or lower portion of the tibia that connects to the foot) according to the level they occur at.

Symptoms of an ankle fracture

We must bear in mind that these types of injuries are typical of certain sports. The most common symptoms of an ankle fracture are very specific and distinctive, especially if they occur while you’re practicing sports.

First, you’ll notice an intense and sudden pain after an abrupt movement or trauma. The area will become red and swollen in a matter of minutes and we’ll notice pain both when walking and putting weight on it. It’s even possible to feel strong discomfort simply when touching the area lightly.

Diagnosing an ankle fracture

After the injury occurs, you must have a confirmed diagnosis. In order to do that, you’ll need to visit the doctor as soon as possible. A medical professional will be able to assess your injury and identify the type of fracture. In addition, the doctor will also evaluate how far the injury extends and the most appropriate treatment.

The doctor will begin the diagnosis process by touching and palpating the area. Next, the medical professional will have x-rays made of the injured area. Occasionally, if there’s a possibility that you’ve broken your ankle, your doctor will perform a CT scan in order to assess the extent of your injury.

An ankle fracture is one of the most common injuries in the lower extremities.

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Treatment of an ankle fracture sports injury

First of all, it’s necessary to emphasize the importance of injury prevention. Obviously, you won’t need to treat an ankle fracture if it never occurs.

Therefore, you need to stay informed and learn about everything that may be important to know in order to use the correct technique when practicing sports or exercising.

If you happen to notice discomfort in the ankle area, it’s a good idea to take a few days rest and go to a physical therapist to evaluate your condition.

The treatment will depend on the type of ankle fracture that has occurred. For example, if you don’t have a serious break or bone detachment, your doctor will probably use a more conservative treatment. On the other hand, if you have complications such as a serious break or bone detachment, surgery will most likely be necessary.

Conservative treatment

The patient should be reassessed frequently in case bone detachment occurs later on. Your doctor will place a cast or splint, and in some cases, you may need to use a walking boot. You’ll use the cast or splint for as long as it takes the bone to heal properly.

Normally, this may take longer than two months, during which time you won’t be able to put weight on your foot, so you’ll need to use crutches. After six months, you can resume playing sports or exercising.

Physical therapy is conservative treatment for ankle fracture

Surgical treatment

This kind of treatment will depend on the type of fracture you’ve suffered. Generally, the surgeon will insert a metal plate kept in place by screws. This procedure will help keep the fibula and joint stable. In other cases, your doctor can perform an intervention of the distal tibia. In this case, the surgeon will insert screws as well.

If there’s a ligament injury associated with the fracture, it should be sutured during the same procedure. You can resume playing sports or exercising after about two months.

We must also emphasize the importance of physical therapy treatment. It’s essential that you perform mobility and joint strengthening exercises during your recovery. This will help ensure that the ankle regains all its functions.

Having a healthy ankle is essential for playing sports but also helps to prevent other injuries.

  • Ankle Fractures (Broken Ankle). 2019 [cited 16 March 2019]. Available from: https://orthoinfo.aaos.org/en/diseases–conditions/ankle-fractures-broken-ankle/
  • Guillén, Isabel. 2019. Fracturas de Tobillo. Clinica CEMTRO. Available from: https://www.clinicacemtro.com/traumatologia/unidad-de-tobillo-y-pie/fractura-de-tobillo/