Broken Ankle Symptoms, Causes, Pictures, Treatments, And Rehab

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HealthlineSubscribeEverything You Need to Know About Treating and Rehabbing a Broken Ankle

Medically reviewed by Gregory Minnis, DPT, Physical Therapy — Written by Kirsten Nunez — Updated on April 12, 2023

Symptoms
Broken or sprained?
Causes
Injury types
Seeking medical help
Treatment
Recovering from injury
Recovery tips
Summary

A broken ankle is also called a fractured ankle. It happens when one or more bones in the ankle joint break. If you’ve been injured, have pain, and can’t walk or move your foot, you may have broken your ankle.

The ankle joint is made up of the following bones:

The tibia is the larger bone in your lower leg. It’s also called the shinbone.
The fibula, also called the calf bone, is the smaller bone in your lower leg.
The talus is the small bone between the heel bone, or calcaneus, and the tibia and fibula.

A broken ankle is very painful.

Broken ankle X-ray photos

X-rays can show the location, type, and severity of your ankle break.

This will help your doctor determine the appropriate way to treat your injury.

Broken ankle symptoms

You might hear the bone break at the time of injury. It may sound like a snapping or grinding noise. According to the American Academy of Orthopaedic Surgeons (AAOS), other symptoms include:

severe pain
swelling
tenderness
bruising
difficultly walking or moving foot
difficulty bearing weight
foot that appears to be crooked or dislocated
dizziness, from pain
bone sticking out of the skin
bleeding, if the bone pierces the skin

Broken ankle symptoms vs. sprained ankle symptoms

A broken ankle isn’t the same as a sprained ankle. A sprained ankle happens when ligaments tear or stretch. Ligaments are tough tissue that connects one bone to another.

If your ankle is sprained, you’ll have pain and swelling. The type of sprain will determine the degree of pain and swelling: a grade 1 sprain will have a little swelling, but a grade 3 sprain may have significant swelling. You may or may not be able to put weight on your ankle just after the injury.

A broken ankle can be just as painful as, if not more painful than, a sprain. Right after breaking an ankle, you may or may not be able to walk or place weight on the ankle. It depends on the type and cause of the fracture (a motor vehicle accident versus a fall, for example). You may or may not have severe bruising and swelling.

The only way to determine if there is a fracture or sprain is to visit a doctor.

To diagnose your injury, your doctor will do different tests. They might include:

Physical exam. The doctor will examine your ankle for swelling and tenderness. If there is tenderness over a ligament, the injury is most likely a sprain. If tenderness is over the bone, it’s most likely a fracture. They might also move your foot around to determine your range of motion.
X-ray. An X-ray lets a doctor see the location, type, and severity of the break.
Stress test. A stress test determines if a sprained ankle needs surgery. A doctor will place pressure on the ankle and take an X-ray. If the joint opens up, this indicates a grade 3 tear that may need to be repaired.
CT scan. A CT scan provides more detailed images by taking multiple cross-sectional pictures of the ankle.
MRI scan. An MRI scan uses a magnetic field and radio waves to show the bones and surrounding tissue. It can help the doctor find fractures that don’t show up on X-rays. It can also see tears in the ligaments.

Broken ankle causes

A broken ankle occurs when too much force is placed on the ankle. The most common causes include:

Trips and falls. Losing your balance may lead to trips and falls, which can place excessive weight on your ankle. This might happen if you walk on an uneven surface, wear ill-fitting shoes, or walk around without proper lighting.
Heavy impact. The force of a jump or fall can result in a broken ankle. It can happen even if you jump from a low height.
Missteps. You can break your ankle if you put your foot down awkwardly. Your ankle might twist or roll to the side as you put weight on it.
Sports. High impact sports involve intense movements that place stress on the joints, including the ankle. Examples of high impact sports include soccer, football, and basketball.
Car collisions. The sudden, heavy impact of a car accident can cause broken ankles. Often, these injuries need surgical repair.
Overuse. Repetitive force or trauma to the ankle can cause a stress fracture, which is a small crack in the bone. This type of injury is often seen in runners and other athletes.
Trauma. Intense force to the ankle can cause crush injury and fracture. This could be caused by a heavy object falling on the foot or heavy machinery running over the ankle.

Types of ankle break injuries

The type and severity of an ankle break depends on the amount of force that caused it. According to the Hospital for Special Surgery, types of ankle break injuries include:

Lateral malleolus fracture

This break occurs at the bottom of the fibula. It involves the bony “knob” outside of your ankle called the lateral malleolus, according to a 2019 study.

Lateral malleolus fractures are the most common type of ankle break.

Nondisplaced vs. displaced ankle fractures

Penn Medicine says that ankle fractures are often categorized as either displaced or nondisplaced.

With a displaced fracture, fragments of the bones that are broken may be separated or misaligned.

On the other hand, with a nondisplaced fracture, the broken bones remain in the correct position and retain their usual structure.

Medial malleolus fracture

A medial malleolus fracture happens at the end of the tibia. A 2019 review indicates that it specifically affects the medial malleolus, which is the knob on the inside of your ankle.

Bimalleolar ankle fracture

A bimalleolar ankle fracture involves both knobs in the ankle, which include the fibula (lateral malleolus) and tibia (medial malleolus). Based on a 2022 review, these almost always require surgery to repair.

It’s the second most common type of ankle break.

Bimalleolar equivalent fracture

A bimalleolar equivalent fracture means that in addition to one of the malleoli being fractured, the ligaments on the inside of the ankle are injured.

Posterior malleolus fracture

According to a 2016 review, a posterior malleolus fracture occurs on the back of the tibia.

Usually, this break happens with lateral malleolus fractures. That’s because the posterior malleolus and lateral malleolus share ligament attachments.

Trimalleolar fracture

A trimalleolar fracture involves all three parts of the ankle, which include the medial (inside), lateral (outside), and posterior (back) malleoli. A 2021 review suggests that, like a bimalleolar fracture, this usually requires surgery.

Pilon fracture

The AAOS says that a pilon fracture occurs in the “roof” of the ankle, which is at the end of the tibia. It’s also called a plafond fracture.

Pilon fractures are usually caused by high impact injuries like falls or car accidents.

Maisonneuve fracture

A Maisonneuve fracture, according to a 2020 study, includes two injuries: an ankle sprain and a break in the upper part of the fibula. The break is located near the knee.

This injury happens when you fall while rotating, causing the foot to awkwardly hit the ground. It’s most common in gymnasts, dancers, and skiers.

Syndesmotic injury

This injury affects the syndesmosis joint, which is located between the fibula and tibia. It’s held in place by ligaments.

If only the ligament is injured, it’s also called a high ankle sprain.

However, a 2016 review suggests that most syndesmotic injuries include a ligament sprain and at least one fracture.

Bosworth fracture

A Bosworth fracture is a type of fracture dislocation in which part of the fibula lodges behind the tibia.

According to a 2018 study, it occurs when the foot is rotated externally while supinated, meaning that weight is placed on the outer edges of the feet.

This type of fracture is very rare and usually requires surgical intervention.

Open ankle fracture

Open ankle fractures occur when there is a wound or break in the skin near the ankle. Typically, this occurs when a fragment of bone breaks through the skin during injury.

This type of fracture is treated differently than closed ankle fractures and often requires antibiotics to lower the risk of infection.

What to do if you break your ankle

If you think you have a broken ankle, visit a doctor as soon as possible.

Meanwhile, the National Health Service (NHS) says that you can do several other things to take care of yourself, including:

Keep weight off your foot. Elevate your ankle and prop it up on cushions.
Apply ice. This will minimize pain and swelling.
Apply pressure. If you’re bleeding, wrap the wound with a clean dressing.

If an auto collision or injury caused your broken ankle, or if the bone is sticking out of the skin, get medical help immediately.

Broken ankle treatment

Every injury is different. According to the NHS, the best treatment depends on the type and seriousness of your ankle break.

Ice

You can apply ice to reduce pain and swelling right after the injury. Wrap it in a towel before placing it on the skin.

Walking boot, cast, or splint

A small 2017 study suggests that mild ankle breaks can be treated with a walking boot, cast, or splint. These treatments keep the bone in place as it heals.

For more serious injuries, you’ll need to get surgery before using a boot, cast, or splint.

Crutches

Crutches help you walk around without bearing weight on the injured ankle. You can use them while wearing a boot, cast, or splint.

Reduction

If your broken bone has moved out of place, your doctor might need to physically move it back into position. This nonsurgical treatment is called closed reduction.

Before the procedure, you might receive a muscle relaxant, sedative, or general anesthesia to control the pain.

Surgery

Experts recommend surgery for severe ankle breaks that can’t heal with a boot, cast, or splint.

A surgeon may use metal rods, screws, or plates to realign the bone. This will keep the bone in place as it heals. The procedure is called open reduction internal fixation (ORIF).

After this procedure, the surgeon may order imaging tests like X-rays or CT scans to make sure they’ve repaired the fracture properly, according to a small 2020 study.

Broken ankle recovery time

The AAOS says that broken ankles generally heal within 6 to 12 weeks. Injuries that don’t need surgery may heal in 6 weeks. During this time, your doctor may take regular X-rays to check on the bone.

Injuries that need surgery can take 12 weeks or longer to heal. Your total recovery time depends on your injury, age, and overall health.

Broken ankle recovery tips

During recovery, it’s important to follow your doctor’s recommendations. This will help your broken ankle heal properly. Here’s what you can do to ensure a smooth recovery:

Avoid pressure. Try not to use your injured foot. When you walk or move, don’t apply weight on your ankle until your doctor allows you to do so.
Rest. Don’t carry heavy items or play sports. If you need to go somewhere, ask family or friends. Your doctor will tell you when it’s safe to use your ankle.
Physical therapy. When your bones start to heal, your doctor might have you do physical therapy. A physical therapist can show you how to exercise your ankle. These moves will strengthen the ankle bones.
Eat healthy. Like all injuries, a broken ankle needs enough nutrients to heal. Eating a balanced diet will support recovery.
If you smoke, consider quitting. Smoking slows down bone healing. Cigarette smoke has ingredients that disrupt your body’s ability to make new bone tissue. Quitting smoking can be difficult, but a doctor can help you create a smoking cessation plan right for you.
Attend follow-up appointments. During recovery, visit the doctor regularly. They’ll need to check that your bone is healing correctly.

Broken ankle — can you still walk?

Typically, a minor ankle fracture won’t prevent you from walking. You might even be able to walk right after the injury.

If you have a serious break, you’ll need to avoid walking for a few months. As your ankle gets better, you can slowly return to your usual activities.

The takeaway

A broken or fractured ankle occurs when one or more bones in your ankle break. These bones include the tibia, fibula, and talus.

Usually, ankle breaks are caused by falls, high impact sports, car accidents, or injuries that place excessive force on the ankle.

Treatment depends on the severity of the break. If you have a minor ankle break, you might get a walking boot, cast, or splint. If it’s serious, you might need surgery to realign the bone.

Recovery can take 6 to 12 weeks. Severe ankle breaks that need surgery may take longer.

How we reviewed this article:

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Abbasian M, et al. (2020). Reliability of postoperative radiographies in ankle fractures.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7547165/
Aiyer AA, et al. (2019). Management of isolated lateral malleolus fractures.https://pubmed.ncbi.nlm.nih.gov/30278012/
Amaha K, et al. (2017). Shorter recovery can be achieved from using walking boot after operative treatment of an ankle fracture.https://www.sciencedirect.com/science/article/pii/S2214687316302679
Ankle fractures (broken ankle). (n.d.).https://www.hss.edu/condition-list_ankle-fractures.asp
Broken ankle. (2019).https://www.nhs.uk/conditions/broken-ankle/
Carter TH, et al. (2019). Medial malleolar fractures: Current treatment concepts.https://pubmed.ncbi.nlm.nih.gov/31038989/
Crist B. (2021). Ankle fractures (broken ankle).https://orthoinfo.aaos.org/en/diseases--conditions/ankle-fractures-broken-ankle
Githens MF, et al. (2020). Pilon fractures of the ankle.https://orthoinfo.aaos.org/en/diseases--conditions/pilon-fractures-of-the-ankle/
Foldager CB, et al. (2018). Bosworth fracture dislocation of the ankle: Two case reports with perioperative illustration.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6178141/
Foot fracture and ankle fracture treatments. (n.d.).https://www.pennmedicine.org/for-patients-and-visitors/find-a-program-or-service/orthopaedics/foot-and-ankle-pain/foot-fracture-and-ankle-fracture-treatments
Kašper Š, et al. (2020). Maisonneuve fracture.https://pubmed.ncbi.nlm.nih.gov/32349489/
Koujan K, et al. (2021). Bimalleolar ankle fractures.https://pubmed.ncbi.nlm.nih.gov/32965925/
Melanson SW, et al. (2021). Acute ankle sprain.https://www.ncbi.nlm.nih.gov/books/NBK459212/
Odak S, et al. (2016). Management of posterior malleolar fractures: A systematic review.https://pubmed.ncbi.nlm.nih.gov/26100091/
Pflüger P, et al. (2021). Current management of trimalleolar ankle fractures.https://pubmed.ncbi.nlm.nih.gov/34532077/
Schnetzke M, et al. (2016). Management of syndesmotic injuries: What is the evidence?https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5112340/
Sop JL, et al. (2021). Open fracture management.https://www.ncbi.nlm.nih.gov/books/NBK448083/
Wire J, et al. (2021). Ankle fractures.https://www.ncbi.nlm.nih.gov/books/NBK542324/

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Medically reviewed by Gregory Minnis, DPT, Physical Therapy — Written by Kirsten Nunez — Updated on April 12, 2023

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