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An ankle fracture refers to the breaking of one or more bones within the ankle joint. Fractures can vary in severity, ranging from a single fracture that doesn’t necessarily prevent walking to multiple fractures that may require surgical intervention.
Fractures have the potential to lead to significant mobility and lifestyle obstacles. For instance, individuals who are unable to support their weight on an injured ankle often face limitations in performing basic daily tasks such as walking, driving, engaging in sports, and fulfilling work responsibilities.
Fractured ankles can be classified based on the degree of bone fragment displacement from their normal positions:
An ankle fracture is accompanied by intense pain and additional symptoms like swelling, bruising, tenderness to touch, and an inability to put weight on the injured foot. Deformity, numbness, and coolness in the foot can also occur.
Ankle fractures can result from various activities, but they are often sustained due to:
The treatment approach for an ankle fracture depends on the type of break.
Non-displaced fracture
A non-displaced fracture refers to a broken bone where the pieces remain aligned and in their normal position. In the case of a non-displaced fracture, your doctor may recommend the use of a short leg cast or a walking boot (also known as a moon boot) to facilitate the recovery process. To ensure optimal healing, they will closely monitor your progress by conducting periodic X-rays. It is crucial to follow their guidance and refrain from putting weight on your ankle for a designated period, typically spanning a few weeks.
Medial Malleolus Fracture
The medial malleolus refers to the lower part of the shinbone. A fracture occurring in this area is specifically termed a medial malleolus fracture. While it is feasible to experience isolated fractures of the medial malleolus, it is more frequent for these fractures to occur alongside fractures in other areas of the ankle. no treatment option is outlined here
Lateral Malleolus Fracture
This is a fracture at the lower end of the calf bone (fibula). The typical treatment approach involves methods similar to those used for non-displaced fractures, such as applying a short leg cast or a walking boot (moon boot). Unlike non-displaced fractures, the patient can usually bear weight on the ankle without significant discomfort.
Posterior Malleolus Fracture
A fracture of the lateral malleolus, which is the bone on the outside of the ankle, is commonly treated using a short leg cast or a walking (moon) boot. Since this kind of fracture tends to be stable in nature, patients are often able to bear weight on the injured ankle.
Bimalleolar Fracture and Bimalleolar Equivalent Fracture
This injury affects two bones: the shinbone (tibia) and the calf bone (fibula), which converge at the lower part of the leg. In the case of a stable bimalleolar fracture, your ankle might require immobilisation using a cast, which will restrict you from placing any weight on it. During the time you’re in the cast, periodic X-rays will be conducted to ensure that the bones maintain their correct alignment.
Trimalleolar Fracture
In a trimalleolar fracture, the outer portion of the ankle joint, known as the posterior malleolus, is broken in addition to the two main parts of the joint. This type of injury can cause instability, increasing the risk of joint dislocation. Generally, the fractured bones have the potential to realign naturally. However, if proper alignment doesn’t occur, surgery may be necessary for correction.
Syndesmosis Injury
A syndesmosis refers to a group of ligaments that stabilise the small joint located between the calf bone (fibula) and the lower end of the shinbone (tibia). Injuries affecting these ligaments (without involving tendons) are called high ankle sprains and usually don’t require surgery. However, the recovery period for such injuries can be longer than usual.
Surgical treatment for ankle fractures varies based on the type of break.
Non-displaced fracture
This type of ankle fracture typically does not require surgical intervention.
Medial Malleolus Fracture
If your medial malleolus fracture is misaligned, surgery may be necessary for realignment using one or two screws. In more severe cases where the fracture extends into the ankle joint, a plate and screws may be used for stabilisation.
Lateral Malleolus Fracture
Surgery is performed for a displaced lateral malleolus fracture. The procedure involves repairing the damage with a plate and screws. After surgery, it’s important to avoid weight-bearing on the ankle for several weeks to promote proper healing.
Posterior Malleolus Fracture
Surgical intervention is required for large and misaligned posterior malleolus fractures. Typically, screws are placed in the lower part of the shinbone (tibia) from front to back to facilitate proper healing.
Bimalleolar Fracture and Bimalleolar Equivalent Fracture
A bimalleolar fracture affecting both sides of the ankle usually requires surgical treatment. This entails using a plate and screws to stabilise the fracture. A bimalleolar equivalent fracture involves ligament damage on the inside of the ankle, resulting in a bone break and potential partial ankle dislocation. Repositioning the joint and restoring the bone are essential.
Trimalleolar Fracture
Generally, trimalleolar fractures can align naturally, but surgical intervention is necessary if proper alignment does not occur.
Syndesmosis Injury
Surgery is needed for a syndesmosis injury involving both a ligament sprain and a fracture. Surgeons use screws to stabilise and repair the injury. These screws can be removed after the healing process is complete.
For further inquiries or to arrange a consultation, please contact Professor Al Muderis’ office at +61 2 88829011 or book an appointment online.
X-ray facilities at all locations | Urgent appointments available if necessary.
Professor Munjed Al Muderis is an orthopaedic surgeon and a clinical professor at Macquarie University and The Australian School Of Advanced Medicine. He specialises in hip, knee, trauma and osseointegration surgery. He is a fellow of the Royal Australasian College of Surgeons and Chairman of the Osseointegration Group of Australia.