Broken Ankle Q & A

 
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Ankle Fractures (Broken Ankle)

Cases of ankle fractures have increased dramatically in the past 25 years.
— Dr. Elton

We live in a population that is increasingly active. Fueled by the large number of active folks who aren't letting the aging process slow them down, cases of ankle fractures have increased dramatically in the past 25 years. 

So what exactly is a broken ankle, and how long does it take to recover from the injury?

What Is a "Broken Ankle"?

When we reference a "broken ankle", we are talking about what is known technically as an "ankle fracture". Essentially, this means that a bone in the ankle joint is broken. 

Fracturing your ankle may consist of a single break in a single bone, or more than one break. So, the impact on your daily life (and athletic pursuits) will vary depending on whether you have a simple break which will prohibit you from walking, or several fractures that could have you out of commission for a few months.

Let's put it this way: more bones broken = more instability. 

This stands to reason. If your injury includes more than one broken bone, it's going to take a bit longer to recover.

We also have to take into consideration whether ligaments have been damaged. The function of the ligaments in the ankle are to keep the bones and joints of the ankle in their proper position. 

How Many Bones are There In The Human Ankle?

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Let's talk about the specific bones we have to worry about. Our ankles have the following three bones:

  • The tibia, otherwise known as the "shin bone". This bone forms the medial (inside) portion of the ankle if we look at it from the front (anterior).

  • The Fibula, which is a smaller bone located in the lower leg. This bone forms the lateral (outside) portion of the ankle

  • The Talus, which is a smaller bone located between the tibia and fibula and the calcaneus (otherwise known as the heel bones). The talus forms the "underneath" section of the ankle.

Within the tibia and fibula are these specific areas of interest:

  • The inside portion of the tibia, otherwise known as the "medial malleolus"

  • The back portion of the tibia, otherwise known as the "posterior malleolus"

  • The ending section of the fibula, or the "lateral malleolus."

We identify and classify ankle fractures based on the section of  the bone which has been broken.

  • Fractures occurring at the end of the fibula are called a lateral malleolus fracture,

  • If the tibia and fibula are both broken, we call it a bimalleolar fracture.

The two ankle joints

Ankle fractures may involve two joints. The tibia, fibula, and talus all meet at a certain point- and this is called the "ankle joint." Between the tibia and fibula is a second joint, known as the "syndesmosis joint." The syndemosis joint is held together by ligaments.

Some frequent Causes of broken and sprained ankles

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If you are a competitive athlete, you've probably either experienced (or know a teammate or a competitor who has experienced) at least a slight ankle injury.  

All the cutting and changing direction that is a part of competitive sports such as basketball, football, and soccer puts people in prime position to have the ankle joint injured. Tripping and falling, rolling the ankle by stepping or landing awkwardly, or twisting and rotating the ankle can all cause damage. 

For sports such as skiing, snowboarding and ice hockey we have the added element of equipment (skates, skis, boots) that keep the ankle rigid while the body moves at high speeds along slick, fast surfaces (ice, snow).  These sports all have their inherent risks, but the ankles are particularly susceptible to injury because of the risk of unexpected bumps and crashes. 

Common Symptoms of a Broken Ankle

A broken ankle will definitely be painful. However, a severe sprain and a broken ankle will often carry very similar symptoms. That's why x-rays are quite important when we evaluate the injury. 

Here are some common symptoms of the broken ankle:

  • Immediate, severe pain

  • Swelling

  • Bruising

  • Tender to touch

  • Cannot put any weight on the injured foot

  • Deformity ("out of place"), particularly if the ankle joint is dislocated as well

I hurt my ankle - so what next?

As mentioned, we often can't tell the severity of the sprain immediately. However, when you come in to have your injury evaluated, here's what will usually happen.

Your doctor will go over your medical history, talk to you about how it happened, and give your ankle a physical evaluation. 

Next up, he or she may use imaging tests to further evaluate the injury:

Imaging Tests

If your doctor suspects an ankle fracture, he or she will order additional tests to provide more information about your injury.

X-rays. 

Basic X-rays are used frequently as a reliable diagnostic tool to identify ankle fractures. By evaluating the X-ray, your specialist will be able to ascertain whether the bone is broken and/or displaced. If there are broken bone fragments, he/she can also locate those.  

Stress test.

If more information is needed, your doctor can order a stress test, which

Depending on the type of ankle fracture, the doctor may put pressure on the ankle and take a special x-ray, called a stress test. This x-ray is done to see if ankle fractures require surgery.

Computed tomography (CT) scan. 

A CT scan will generate an image that shows us a cross-section of the ankle. It is helpful when the fracture is also impacting the ankle joint.

Magnetic resonance imaging (MRI) scan. 

MRI scans give us high-res images that we can use to evaluate not only the bones, but also the ligaments and tissue that are present in and around the ankle joint.