Ankle Fracture Information

Ankle fractures are among the most common bone and joint injuries. 

The ankle joint is made up of three bones:

  • Tibia – the shinbone
  • Fibula – smaller bone of the lower leg
  • Talus – a small bone that sits between the calcaneus (the heel bone) and the tibia and fibula


An ankle fracture is a break to one or more of these bones. Ankle fractures range from a simple break in one bone, which may not prevent walking, to multiple fractures that force the ankle joint out of place and may require no weight bearing for several months. The more bones that are broken the more unstable the ankle will become. Depending on the severity of the injury, ligaments that hold the ankle bones and joint in position may also be damaged.


An ankle fracture is classified according to the specific area of the tibia and fibula to which the break occurs. These classifications include:

  • Medial malleolus – inside part of the tibia
  • Posterior malleolus – back part of the tibia
  • Lateral malleolus – bottom end of the fibula

If both the tibia and fibula are broken it is classified as a bimalleolar fracture. If all medial, posterior and lateral malleoli are broken it is a trimalleolar fracture.


Common Causes of Ankle Fractures:

  • Twisting or rotating the ankle side to side
  • Tripping or falling which cause the ankle to roll inwards or outwards
  • Direct and extreme force applied to the joint such as landing on it from a high height
  • Extreme flexing or extending of the joint


Ankle Fracture Symptoms

It can be difficult to differentiate between a severe ankle sprain and a fractured ankle as the pain of both can feel quite similar. A sprained ankle is a result of damage to only the ligaments that support the joint and not the bones themselves.

Common symptoms of a fractured ankle include:

  • Immediate severe pain at the site of the fracture
  • Swelling
  • Bruising
  • Tender to the touch
  • Unable to put weight through the injured foot. However, sometimes it is possible to walk with a less severe break so it is not ideal to rely on weight baring ability as a test of whether the bone is fractured or not
  • Obvious physical deformity, particularly if the joint is dislocated in addition to the fracture 


Compound Ankle Fractures

A compound fracture or open fracture, is an injury that occurs when there is a break in the skin around the broken bone. This is more serious than a simple fracture with a high risk of infection as the fracture site is exposed to outside dirt and bacteria. Although it is often the case, a bone does not necessarily need to break through the skin to be classified as a compound fracture; if the fracture site is exposed at all it is considered a compound fracture.

Compound fractures are treated and stablised with surgery to minimise the risk of an infection developing which can prevent the bone from healing.


Surgical Procedure 

If the fracture has caused the ankle joint to become unstable surgery is recommended as the best course of action.


During the procedure the bone fragments are first reduced (repositioned) into their normal alignment. The bones are then positioned and held together by a plate attached to the outer bone using pins and screws. In some cases a screw or rod inserted into the bone may be used to keep the bone fragments together while they heal.