What are the different types of ankle fractures. How do ankle fractures occur. What are the symptoms of a broken ankle. What treatment options are available for ankle fractures. How long does it take to recover from an ankle fracture. Can ankle fractures be prevented.

Types of Ankle Fractures: Understanding the Different Breaks

Ankle fractures can occur in several ways, involving one or more of the three main bones that make up the ankle joint: the tibia, fibula, and talus. Understanding the different types of fractures is crucial for proper diagnosis and treatment.

Lateral Malleolus Fracture

This type of fracture involves the lower end of the fibula, also known as the lateral malleolus. It’s one of the most common ankle fractures.

Medial Malleolus Fracture

A medial malleolus fracture affects the inner part of the tibia at the ankle joint.

Posterior Malleolus Fracture

This fracture occurs at the back of the tibia at the ankle joint.

Bimalleolar Fracture

A bimalleolar fracture involves breaks in both the lateral malleolus (fibula) and the medial malleolus (tibia).

Trimalleolar Fracture

This severe type of fracture involves breaks in all three malleoli: lateral, medial, and posterior.

Syndesmotic Injury

While not a fracture itself, a syndesmotic injury often accompanies ankle fractures and involves damage to the ligaments that connect the tibia and fibula.

Common Causes of Ankle Fractures: How Do They Happen?

Ankle fractures can occur due to various reasons, ranging from everyday accidents to high-impact sports injuries. Understanding these causes can help in prevention and prompt treatment.

• Twisting or rotating the ankle
• Rolling the ankle
• Tripping or falling
• Impact from a car accident
• Landing awkwardly from a jump
• High-impact sports injuries

Do certain activities increase the risk of ankle fractures? Yes, activities that involve sudden changes in direction, jumping, or potential for falls can increase the risk. These include sports like basketball, football, and skiing, as well as activities like dancing or even walking on uneven surfaces.

Recognizing the Symptoms: Signs of a Broken Ankle

Identifying the symptoms of an ankle fracture is crucial for seeking timely medical attention. While symptoms can vary depending on the severity and location of the fracture, there are some common signs to watch for:

• Immediate and severe pain
• Swelling and bruising
• Difficulty or inability to bear weight on the affected foot
• Visible deformity or misalignment of the ankle
• Tenderness to touch
• Limited range of motion
• In severe cases, bone protruding through the skin (open fracture)

Can you still walk with a broken ankle? While it may be possible to walk with certain types of ankle fractures, it’s not recommended. Attempting to walk on a broken ankle can worsen the injury and lead to complications. It’s best to seek immediate medical attention if you suspect an ankle fracture.

Diagnosis and Imaging: Confirming an Ankle Fracture

Accurate diagnosis of an ankle fracture is essential for proper treatment. Healthcare professionals use a combination of physical examination and imaging techniques to confirm and assess the extent of the fracture.

Physical Examination

A doctor will carefully examine the ankle, checking for swelling, bruising, deformity, and points of tenderness. They may also assess the range of motion and stability of the joint.

X-rays

X-rays are the primary imaging tool for diagnosing ankle fractures. They provide clear images of the bones and can reveal the location and severity of the fracture.

CT Scan

In some cases, a computed tomography (CT) scan may be necessary to get a more detailed view of the fracture, especially if it’s complex or involves the joint surface.

MRI

Magnetic resonance imaging (MRI) may be used to assess soft tissue damage, such as ligament or tendon injuries that often accompany ankle fractures.

How long does it take to diagnose an ankle fracture? The initial diagnosis can often be made within a single doctor’s visit, typically lasting 30 minutes to an hour. However, more complex cases may require additional imaging and consultation, which can extend the diagnostic process.

Treatment Options: From Conservative Care to Surgery

The treatment for an ankle fracture depends on the type and severity of the break. Treatment options range from conservative approaches to surgical intervention.

Conservative Treatment

For stable fractures without significant displacement, non-surgical treatment may be sufficient. This typically involves:

• Immobilization with a cast or boot
• Rest and elevation of the affected limb
• Ice therapy to reduce swelling
• Pain management with medications
• Gradual weight-bearing as healing progresses

Surgical Treatment

More severe or unstable fractures may require surgical intervention. Surgical options include:

• Open reduction and internal fixation (ORIF): Using plates, screws, or rods to realign and stabilize the fractured bones
• External fixation: In cases of severe soft tissue damage, an external frame may be used to hold the bones in place
• Arthroscopic surgery: For some fractures, minimally invasive techniques may be used to repair the damage

What factors determine the need for surgery? The decision for surgery depends on factors such as the stability of the fracture, the degree of displacement, the involvement of the joint surface, and the patient’s overall health and activity level.

Recovery and Rehabilitation: The Path to Healing

Recovery from an ankle fracture is a gradual process that requires patience and dedication. The timeline and rehabilitation protocol can vary depending on the severity of the fracture and the treatment method used.

Typical Recovery Timeline

1. Initial healing (6-8 weeks): The bone begins to knit back together
2. Progressive weight-bearing (8-12 weeks): Gradual return to normal activities
3. Strengthening and mobility exercises (3-6 months): Regaining full function and strength
4. Full recovery (6-12 months): Return to pre-injury level of activity

Rehabilitation Exercises

As healing progresses, a physical therapist may recommend exercises to:

• Improve range of motion
• Strengthen ankle and leg muscles
• Enhance balance and proprioception
• Gradually return to normal walking patterns

How can you speed up recovery from an ankle fracture? While it’s important not to rush the healing process, you can support recovery by:
– Following your doctor’s instructions carefully
– Attending all physical therapy sessions
– Maintaining a healthy diet rich in calcium and vitamin D
– Avoiding smoking and excessive alcohol consumption
– Gradually increasing activity as advised by your healthcare team

Complications and Long-term Effects of Ankle Fractures

While many ankle fractures heal without significant issues, there are potential complications and long-term effects that patients should be aware of:

Immediate Complications

• Infection (especially in open fractures)
• Compartment syndrome (a painful condition caused by pressure buildup in the muscles)
• Blood clots

Long-term Effects

• Chronic pain or stiffness
• Post-traumatic arthritis
• Malunion (improper healing of the bone)
• Nerve damage
• Limited range of motion

Can ankle fractures lead to permanent disability? While most people recover well from ankle fractures, severe cases or those with complications can result in long-term mobility issues or chronic pain. However, with proper treatment and rehabilitation, permanent disability is relatively rare.

Prevention Strategies: Minimizing the Risk of Ankle Fractures

While not all ankle fractures can be prevented, there are steps you can take to reduce your risk:

• Wear appropriate footwear for your activities
• Maintain good balance and coordination through regular exercise
• Strengthen ankle and leg muscles
• Be cautious on uneven surfaces
• Use proper technique and equipment in sports
• Address any underlying conditions that may affect bone health, such as osteoporosis

Are some people more prone to ankle fractures? Yes, certain factors can increase the risk of ankle fractures:
– Age (both older adults and children during growth spurts)
– Osteoporosis or other conditions affecting bone density
– Participation in high-risk sports or activities
– Previous ankle injuries
– Poor balance or coordination

By understanding the types, causes, symptoms, and treatment options for ankle fractures, individuals can make informed decisions about their care and take steps to prevent these injuries. Remember, if you suspect an ankle fracture, it’s crucial to seek immediate medical attention to ensure proper diagnosis and treatment. With the right care and rehabilitation, most people can recover from ankle fractures and return to their normal activities.

What’s the best way to break your own leg?

Necati Bahadir Bermek/iStock/Getty Images Plus

Slate’s archives are full of fascinating stories. We’re republishing this article because it remains a reader favorite. It was originally published March 9, 2009.

Spanish authorities arrested a man wearing a cast of compressed cocaine at the Barcelona airport last Wednesday. The would-be trafficker had a genuine fracture of two bones below the knee; police are now investigating whether the injury was self-inflicted. What’s the safest way to break your own leg?

Immobilize your ankle and knee and use a heavy instrument with minimal surface area. It takes a surprising amount of pressure to break your shin. (In fact, the weight of an average American man would not be sufficient to fracture a leg, even if the mass were concentrated on a spot the size of a quarter.) To do the trick, you’ll first want to strap the leg to a fixed object—a cinderblock, maybe—below the knee and above the ankle. That will prevent your joints from buckling before the tibia breaks. Then you’ll want to choose the heaviest, smallest weapon with which you can reliably hit your target—a hammer would be more effective than a mallet, for example. The wound is likely to be quite unpleasant, so you might consider drugs to alleviate the pain. (Cocaine wouldn’t be a good choice, though—its analgesic effects are highly localized.)

According to news reports, the Chilean smuggler had an open fracture of the shin, meaning that the tibial shaft had cracked and broken through the skin. Open fractures in this area tend to be either spiral-shaped—caused by torsional forces such as twisting after falling from a great height—or transverse. The amount of force required to produce these injuries depends on a number of factors, including the location of the impact, the thickness of the soft tissue around the tibia, the condition of the bone, and the area across which the force is spread. As a rough estimate, it would take 218 pounds of pressure to produce a tibial fracture in a healthy adult using a hammer. You could decrease the force requirement by choosing a tool with less surface area, such as a hatchet—then again, you’d be increasing the risk of soft tissue damage and significant blood loss. In any case, it might be hard to generate that amount of force with your knee and ankle strapped down, so you may need the help of a friend.

There have been some reports of people breaking their own tibias without help. In 2008, an Australian kayaker who had become trapped in his boat by a fallen log leveraged his body weight (supported by the tremendous force of the current) to snap his tibia against the rim of the boat’s cockpit. The break enabled his trapped leg to collapse so he could escape the boat.

You may have heard stories about surgeons having to “re-break” bones that healed improperly after an initial fracture. Orthopedists don’t use blunt force to this end. Instead, they move the soft tissue aside and cut the bone using a very narrow power saw. In cases where complicated nerves or extensive vasculature border the cutting area, they will finish the cut with an osteotome, a kind of surgical chisel used to penetrate only a couple of millimeters. They would also use general anesthesia or a regional pain blocker with heavy sedation to dull the considerable pain.

Bonus Explainer: How do you compress cocaine into a cast? Dissolve it in liquid and pour the solution into a cast-shaped mold. The cocaine can then be recovered by chemical extraction with about 80 percent efficiency, depending on the process. Some news reports describe the cast as being “made entirely of compressed cocaine.” It would be possible to create a cast from relatively pure (greater than 90 percent) cocaine, but that would require the use of both a cast-shaped mold and a cast-shaped press.

Got a question about today’s news? Ask the Explainer.

Explainer thanks Robert Campbell of Mercy Medical Center and Stephen M. Pribut of George Washington University Medical School.

• Medicine

• From the Archives

Ways to Break the Ankle and Possible Complications

December 13, 2022December 13, 2022

Whenever a bone in your body cracks or breaks, it results in a fracture. Three dissimilar bones in your ankle are prone to fracture: tibia, fibula and talus. Tibia is the bigger of the main two bones in your lower leg and the fibula is basically the thinner bone of the main two bones in your lower leg. Both these bones can be felt at the outside of your ankle. The talus refers to a wedge-shaped little bone located very deep inside your ankle and is positioned between the end points of fibula, tibia and your heel bone. When pressure is applied on these bones, it can result in an ankle fracture. Let us find out the answer to the question ‘how to break the ankle’ in this article.

How to Break Your Ankle

1. Car accidents can often result in crushing injuries that can result in ankle fracture or even can break it for good.
2. Falling and tripping can break the bones in your feet and ankles. Also, if you jump from a height and land on your feet, it can result in ankle injuries.
3. Impact from heavy weights: When heavy weights fall on your foot, they can break your ankle.
4. Missteps: Sometimes, when you miss a step while climbing up the stairs or walking down, you can break your ankle.
5. Overuse: The weight-bearing bones in your feet and ankles are prone to stress. Strong, repetitive forces or overuse like running for long distances can result in tiny cracks in them. Moreover, stress fracture and bone thinning conditions like osteoporosis can also result in overuse of the bone, leading to ankle injuries.
6. Ice skating: Ice skating is another answer for the question “how to break your ankle”. When you do ice skating, you often fall on slipper and wet surface, trip time and again, or step into holes. These things can result in terrible ankle fractures and injuries.
7. Falling off the ladder: If you fall off the ladder, then you may break your ankle. A hit or fall to the ankle can easily break one or all the three major bones in the ankle joint. The injury may become intense at some point and can affect about two dozen bones in the foot.
8. Other ways to break your ankle

• When kicking the football, if you miss it and land the foot on the floor, it can result in ankle fracture.
• When you place the foot down in a wrong manner, stub toes on the furniture, twist the ankle or apply wrong pressure on the foot, you can break your ankle and lead to ankle fractures.
• If you want to break your ankle on purpose, then you should wedge the foot in things that restrict your foot’s movement. For instance, you should place it between two furniture pieces and then jump very quickly. Your foot won’t be able to move which would result in ankle injury, but it will hurt.

Now that you know how to break your ankle, let’s move on to discuss the complications you need to watch out for.

• Broken bones may result in loss of blood supply and result in their collapse, death, or can even result in those bones being reabsorbed in your body.
• Damage can affect the neighboring tissues.
• Sharp pieces of bone can sever or compress the nearby nerves or blood vessels.
• The surgeon might have to re-break the bones for aligning them surgically.
• The broken bone pieces may start rejoining while they are still unaligned.

If you don’t seek medical help right away, these complications can exacerbate.

When to See a Doctor

You need to pay a visit to a doctor under the following circumstances:

• If the pain worsens or isn’t improving by taking painkillers;
• If you develop medical problems that prevent you from walking properly;
• If you want to fly after undergoing an ankle surgery, you should consult your GP on the right time to fly.

You might need to return to the hospital if:

• There is numbness or pins and needles in the toes.
• The skin surrounding your foot or ankle turns blue.
• Ankle becomes badly swollen.
• A foul-smelling discharge oozes out from the surgical wound/point on your foot or ankle.
• You have problems with the plaster cast on your foot.

These problems are symptoms of issues with the blood supply to your ankle and the nerves in the ankle and should be treated timely.

Leg Fracture

You have a broken leg. The fracture is treated with a splint, plaster or a special boot. The fracture will take 4 to 6 weeks to heal. If you have a severe fracture, you may need surgery to treat it.

Home care

Follow these guidelines for home care:

• You will be given a splint or cast, a special boot or other device to keep your leg in place. Unless otherwise instructed, use crutches or a walker when walking. Do not step on the injured foot until you have received permission from your doctor to do so. (You can rent crutches or a walker from many pharmacies or surgical or orthopedic supply stores.)

• To reduce pain and swelling, keep your leg elevated. When you go to bed, put a pillow under your injured leg. When sitting, position your injured leg so that it is at waist level. This rule is very important to observe during the first 2 days (48 hours).

• Apply an ice pack to the injury. Apply an ice pack for 20 minutes every 1 to 2 hours during the first day to reduce pain. You can prepare an ice pack by wrapping a plastic bag of ice cubes in a thin towel. Make sure that when the ice melts, the plaster / splint / boot does not get wet. You can apply an ice pack directly over the splint or cast. For the next 2 days, continue to apply an ice pack 3-4 times a day. Then use an ice pack as needed to reduce pain and swelling.

• The cast/longuet/boot must always be kept dry. During washing, do not immerse the cast/longuet/boot in water. To prevent water from entering, wrap the bandage with a plastic bag, securing it at the top with a rubber band. If the boot, fiberglass splint or splint gets wet, you can dry it with a hair dryer.

• If you have not been prescribed other medicines, you can take acetaminophen (acetaminophen) or ibuprofen (ibuprofen) to reduce pain. If you have chronic liver disease or kidney disease, talk to your doctor before taking these medicines. You should also consult your doctor if you have had a stomach ulcer (stomach ulcer) or gastrointestinal bleeding (GI bleeding).

• If you experience itching, do not apply any creams under the cast or insert any objects.

Follow-up

See your doctor again in 1 week or as directed. This is necessary to make sure that the bone is healing properly. If a splint has been applied, it can be replaced with a plaster cast at the next visit to the doctor.

If x-rays have been taken, they will be reviewed by a radiologist. You will be informed of any results that may affect your treatment.

When to seek medical attention

Contact your healthcare provider immediately if any of the following occurs:

• There is a crack in the dressing

• Cast or splint is wet or soft

• GRP or splint stays wet for more than 24 hours

• Dressing has a foul odor or stains from wound discharge

• Feeling of tightness or pain under a cast or splint is aggravated

• Toes become swollen, cold, blue, numb, or tingly

• You can’t move your toes

• The skin around the dressing turns red

• Temperature 101 ºF (38. 3 ºC) or higher, or as directed by your healthcare professional

© 2000-2022 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

Was this helpful?

Yes
no

Tell us more.

Check all that apply.

Wrong topic—not what I was looking for.

It was hard to understand.

It didn’t answer any of my questions.

I still don’t know what to do next.

other.