Ankle fracture
An ankle fracture is a break of one or more of the bones that make up the ankle joint. Symptoms may include pain, swelling, bruising, and an inability to walk on the injured leg. Complications may include an associated high ankle sprain, compartment syndrome, stiffness, malunion, and post-traumatic arthritis.
| Ankle fracture | |
|---|---|
| Other names | Broken ankle |
| Fracture of both sides of the ankle with dislocation as seen on anteroposterior X-ray. (1) fibula, (2) tibia, (arrow) medial malleolus, (arrowhead) lateral malleolus | |
| Specialty | Orthopedics |
| Symptoms | Pain, swelling, bruising, inability to walk |
| Complications | High ankle sprain, compartment syndrome, decreased range of motion, malunion |
| Usual onset | Young males, older females |
| Types | Lateral malleolus, medial malleolus, posterior malleolus, bimalleolar, trimalleolar |
| Causes | Rolling the ankle, blunt trauma |
| Diagnostic method | X-rays based on the Ottawa ankle rule |
| Differential diagnosis | Rheumatoid arthritis, gout, septic arthritis, Achilles tendon rupture |
| Treatment | Splinting, casting, surgery |
| Frequency | ~1 per 1000/year |
Ankle fractures may result from excessive stress on the joint such as from rolling an ankle or from blunt trauma. Types of ankle fractures include lateral malleolus, medial malleolus, posterior malleolus, bimalleolar, and trimalleolar fractures. The Ottawa ankle rule can help determine the need for X-rays. Special X-ray views called stress views help determine whether an ankle fracture is unstable.
Treatment depends on the fracture type. Ankle stability largely dictates non-operative vs. operative treatment. Non-operative treatment includes splinting or casting while operative treatment includes fixing the fracture with metal implants through an open reduction internal fixation (ORIF). Significant recovery generally occurs within four months while completely recovery usually takes up to one year.
Ankle fractures are common, occurring in over 1.8 per 1000 adults and 1 per 1000 children per year. In North America this figure increases to more than 14 in ever 10,000 patients admitted to the Emergency Room. They occur most commonly in young males and older females.