Ankle Fracture

An ankle fracture is a common injury that is most often caused by the ankle rolling inward or outward. A fracture is a  partial or complete break in a bone. An ankle fracture can range from the less serious “avulsion” injury (small pieces of bone that have been pulled off) to severe shattering-type breaks of the tibia and fibula. An injury can also be a combination of both.

Unfortunately, many people mistake an ankle fracture for an ankle sprain, but they are quite different and therefore require an accurate and early diagnosis.

An ankle fracture is accompanied by one or all of these symptoms:

• Pain at the site of the fracture, which in some cases can extend from the foot to the knee.
• Significant swelling may occur along the length of the leg or may be more localized.
• Blisters may occur over the fracture site. These should be promptly treated by a foot and ankle surgeon, and should never be popped or treated at home.
• Bruising that develops soon after the injury.
• Inability to walk; however, it is possible to walk with less severe breaks, so never rely on walking as a test of whether a bone has been fractured.
• Change in the appearance of the ankle. It will look different from the other ankle.
• Bone protruding through the skin — a sign that immediate care is needed. Fractures that pierce the skin require immediate attention because they can lead to severe infection in the bone and prolonged recovery.

Following an ankle injury, it is important to have the ankle evaluated for proper diagnosis and treatment. If you are unable to see Dr. Neitzel right away, go to the emergency room and then follow up with her as soon as possible for a more thorough assessment.

During your appointment, Dr. Neitzel will ask you questions about your medical history, symptoms, how the injury occurred, medications you are taking, and conduct a physical examination of your ankle, foot, and lower leg. In addition, she may order x-rays and other imaging studies to determine the extent of the fracture.

The ankle is made up of three bones: the tibia (shinbone), the fibula (smaller bone in the lower leg), and the talus, a small bone that rests between the calcaneus (heel), the tibia, and the fibula. Treatment of ankle fractures depends on the location of the fracture, and whether other parts of the foot, ankle, and lower leg are involved.

Nonsurgical Treatment

Treatment of ankle fractures depends upon the type and severity of the injury. To start, Dr. Neitzel will want you to follow the R.I.C.E. protocol:

Rest. Stay off the injured ankle. Walking may cause further injury.

Ice. Apply an ice pack to the injured area, placing a thin towel between the ice and the skin. Use ice for 20 minutes and then wait at least 40 minutes before icing again.

Compression. An elastic wrap should be used to control swelling.

Elevation. The ankle should be raised slightly above the level of your heart to reduce swelling.

Additional treatment options include:

Immobilization. Certain fractures are treated by protecting and restricting the ankle and foot in a cast or splint. This allows the bone to heal.

Prescription Medications. To help relieve the pain, Dr. Neitzel may prescribe pain medication or anti-inflammatory drugs.

Surgical Treatment

For some ankle fractures, surgery is needed to repair the fracture and other soft tissue related injuries, if present. 

Dr. Neitzel will select the procedure that is appropriate for your injury such as those discussed below.

Fibula Fractures

The fibula is the most commonly fractured ankle bone. If the ankle joint is not displaced and the fracture only involves the fibula, it can often be treated with casting. Healing usually takes up to 6 weeks, and the patient will need to avoid putting weight on the ankle while the bone heals.

If the ankle bones are displaced from the fibula fracture, the fracture will need to be surgically corrected.  Typically, fixation devices like plates and screws are used to hold the bone in place so that they heal properly.

Tibial Fractures

Tibial fractures usually occur in the inner part of the tibia or at the back of the tibia. Tibial fractures that occur in the inner part of the tibia often need to be fixed with hardware. In some cases, fractures at the back of the tibia do not need to be addressed unless the bones are significantly displaced, then surgical fixation may be necessary. Surgical fixation may be achieved with screws, plates and screws, or tension wiring, depending upon the nature of the fracture.

Follow-Up Care

No matter what type of treatment you receive for an ankle fracture, it is important to follow Dr. Neitzel’s instructions after treatment. Failure to do so can lead to infection, deformity, arthritis, and chronic pain.

Dr. Neitzel offers a full range of nonsurgical and surgical treatments for ankle fractures. If you would like to learn more about our services or to schedule an appointment, please call (360) 286-0404.