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Ankle fracture and sprain

Person running on track hurt sprained ankle

​When you have an ankle injury, knowing whether it’s a break or a sprain is important to getting you back on your feet. If left untreated, ankle injuries can cause chronic pain and limit your mobility. 

A sprained ankle happens when you stretch or tear a ligament—the tissue that connects two bones and stabilizes your joints. With a mild sprain, your ligament is overextended but the ankle joint remains stable. If it’s a severe sprain, your ligaments may tear completely and separate from the bone.

A broken or fractured ankle occurs when one or more of the bones in your ankle chips off, cracks or breaks completely. A pilon fracture is a break in your tibia and fibula—two bones in the lower leg that are part of your ankle. Fractures are often caused by a fall or a car accident. 

When a break occurs in the bone (fibula) on the outside of the lower leg, it’s called a lateral malleolar fracture. It is a common ankle injury caused by twisting or rolling of the foot and ankle or a direct blow to the ankle.

There are two main types of fractures. With a closed fracture, the bone is broken but your skin remains intact. If the broken bone pokes through the skin or is exposed by a deep wound it’s an open fracture, it is treated as an emergency.

Ankle fracture and sprain symptoms

Symptoms of an ankle sprain or fracture may include:

  • Bruising or redness

  • Difficulty using your ankle

  • Numbness or weakness

  • Pain

  • Swelling

  • Obvious deformity or injury

Ankle fracture and sprain diagnosis

Your doctor will examine your ankle and foot, check for tenderness and range of motion, and discusses your pain or discomfort. 

Diagnostic tests may include:

  • Bone scan—a radiology procedure used to look at the skeleton to find areas of physical and chemical changes in bone.

  • Computed Tomography scan of your bones (CT scan)—an imaging test that uses X-rays and a computer to make detailed images of the ankle joint.

  • Magnetic Resonance Imaging (MRI)—uses a magnet, radio frequencies and a computer to produce highly detailed pictures of the ankle.

  • X-ray—uses electromagnetic energy beams to take pictures of the ankle bones and their surrounding soft tissues. An ankle X-ray is primarily used to exclude a fracture.

Ankle fracture and sprain treatment

The treatment required for an ankle sprain or break is determined by the severity of the injury or damage and your age, health and goals for recovery. Often your treatment will consist of some amount of immobilization (splint, cast, boot, brace), crutches, RICE and physical therapy. Additional treatment depends on your type of injury, how quickly your body recovers and how well you tolerate pain.

Treatment may include:

  • Ankle fracture open reduction and internal fixation—a type of surgery used to set broken ankles.

  • Crutches, a brace or a wheelchair to aid in movement.

  • Limited movement—reduced activity.

  • Medications—non-steroidal, anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, and aspirin for pain control.

  • Physical therapy—exercises and stretches to improve your quality of movement.

  • Splint or cast to immobilize the ankle area.

  • Surgery—to repair the bones and put them back into place. Ankle fracture open reduction and internal fixation surgery uses screws, metal plates, wires, or pins to keep the bones aligned so they can heal.

  • Traction—a steady pulling action used to stretch ankle area in a certain direction.

Orthopedic specialists at The Christ Hospital Health Network have the knowledge, skill and experience to diagnose and treat your injured ankle so you can get back to your active life.