Broken ankle
ICD codes: S82 What are ICD codes?
A sporting accident is mostly the reason: when someone twists their ankle too severely, the upper ankle joint can break. One or several bones may be affected. A broken ankle is a serious injury.
At a glance
- A broken ankle usually occurs while playing sports.
- If the foot rolls or twists excessively, the upper ankle joint may break.
- As a result, no weight can be put on the foot.
- A broken ankle is a serious injury that can affect one or several bones.
- The fracture normally heals without any problems after a while.
Note: The information in this article cannot and should not replace a medical consultation and must not be used for self-diagnosis or treatment.
What is a broken ankle?
If someone twists their ankle severely, it can result in a sprain of the ankle joint. When this happens, the muscles and soft tissue around the ankle are injured. Sometimes, the foot rolls or twists to such an extent that the ankle joint breaks. Doctors refer to this as an ankle joint fracture.
This is a serious injury. One or several bones of the ankle joint may be affected. With a broken ankle, the ligaments are also frequently torn and the cartilage damaged. A broken ankle normally heals easily after a while.
What are the symptoms of a broken ankle?
With a broken ankle, the foot swells up, is painful and bruises (hematomas) form. Walking is no longer possible and the foot can barely be moved. Sometimes the bones also shift position due to the fracture. This can lead to a malposition.
What are the causes of a broken ankle?
A broken ankle most commonly occurs while playing sports. For example, if someone falls accidentally or lands badly after a jump, the foot may roll or twist so severely that the joint breaks. Running on uneven ground or stumbling can also cause broken ankles.
How does a broken ankle develop?
It takes several days or weeks for the swelling to go down. It may take months until the ankle joint is fully healed. In the meantime, only a limited amount of weight can be put on the foot and it is difficult to move.
If weight is put on the foot too soon, the healing process may be disrupted. If in consequence the bone fracture does not heal properly, other treatments may be necessary. However, the foot can also lose strength and flexibility if it is immobilized for too long.
A broken ankle usually heals well. A possible long-term consequence is osteoarthritis. After a fracture, the ankle joint may also remain unstable. This increases the risk of injuring it by twisting it again.
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How is a broken ankle diagnosed?
For diagnosis, the doctor asks how the injury occurred. The foot and ankle are then examined to ascertain how severe the injury is. If it is suspected that the ankle joint could be broken, an X-ray is taken.
Sometimes the X-ray image does not lead to a clear diagnosis. Other images of the interior of the ankle joint are then obtained using other methods – for example with what is commonly called computed tomography (CT) or magnetic resonance imaging (MRI). Injuries to the articular cartilage and ligaments can often be detected better with magnetic resonance imaging.
How is a broken ankle treated?
With a broken ankle, the foot and ankle are initially immobilized, elevated and also cooled when necessary. Immobilization with the aid of casts, bandages, splints or orthoses is important to protect the joint and help it heal unhindered. They normally have to be worn for about 6 weeks. If bones have shifted through the fracture or if bones have slipped out of the joint, the doctor can reset them. Surgery is also possible in some cases.
People with a broken ankle can start to put weight on the joint again after a while to strengthen it. The right time to start light exercises or physiotherapy depends on the severity of the injury.
In individual cases, light exercises can be started as early as a few days after the fracture or surgery. Sometimes it is only possible when the splint or cast has been removed. As the foot is initially immobilized for an extended period when the ankle is broken, it may be advisable to prevent a possible thrombosis with injections.
A broken ankle doesn’t always require surgery. Factors that determine whether surgical intervention is required include:
- the severity of the fracture
- the site of the ankle fracture
- whether it is an open fracture
- whether vessels or nerves are injured
- whether the bone parts have shifted
If the joint is operated on, screws and plates can be inserted. They bind the broken bones and ensure that they grow back together.
The ankle joint is also immobilized with a splint, bandage or cast after an operation. Some bandages and splints can be removed. Depending on the individual situation, the screws and plates may be removed if the fracture has healed and the bones have grown back together.
You can find more detailed information, such as what helps you get back on your feet after a broken ankle, at gesundheitsinformation.de.
- Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF). Prophylaxe der venösen Thromboembolie (VTE). S3-Leitlinie. AWMF-Registernummer 003-001. 10.2015.
- Goost H, Wimmer MD, Barg A et al. Fractures of the ankle joint: investigation and treatment options. Dtsch Arztebl Int 2014; 111(21): 377-388. doi: 10.3238/arztebl.2014.0377.
- Javed OA, Javed QA, Ukoumunne OC et al. Surgical versus conservative management of ankle fractures in adults: A systematic review and meta-analysis. Foot Ankle Surg 2020; 26(7): 723-735. doi: 10.1016/j.fas.2019.09.008.
- Lin CW, Donkers NA, Refshauge KM et al. Rehabilitation for ankle fractures in adults. Cochrane Database Syst Rev 2012; (11): CD005595. doi: 10.1002/14651858.CD005595.pub3.
In cooperation with the Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen) (IQWiG).
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