Dr. Bob discusses broken ankles and treatment options.
What is Broken Ankle?
The ankle consists of three bones: the tibia (shin bone), fibula, and talus (ankle bone). If any of these bones are fractured, you have a broken ankle. If only the ligaments give way, you have an ankle sprain.
Under-treated ankle fractures are among the most common orthopedic injuries and have caused a concerning increase in early-onset ankle instability, arthritis, and permanent range of motion issues.
Obtaining the correct diagnosis and medical advice can significantly influence your outcome. When it comes to your ankle, it’s better to be safe now than to be regretful later.
It is always wise to treat serious ankle injuries as though they are broken until you receive a diagnosis from a foot and ankle specialist. Getting the right diagnosis for your injured ankle is essential for appropriate treatment and for preventing future complications.
What can cause a broken ankle?
A broken ankle can result from various factors, usually associated with sudden trauma or stress on the ankle bones, which include:
Falls
Falling, particularly when it involves twisting or rolling the foot, can result in a broken ankle. This is common in everyday situations, such as tripping on uneven ground or experiencing more severe falls, like from a ladder or a height.
Impact or trauma
Direct blows to the ankle, such as being struck by an object or being in a car accident, can cause fractures. High-impact sports like football and hockey also carry a risk of ankle fractures due to collisions.
Overuse or stress fractures
Repetitive stress on the ankle, commonly observed in athletes, can lead to stress fractures. These are small cracks in the bone that develop over time.
Missteps or uneven surfaces
Walking or running on uneven surfaces can lead to missteps that place unusual stress on the ankle, potentially resulting in fractures.
Osteoporosis or weakened bones
In individuals with osteoporosis or other conditions that weaken bone strength, even minor stresses and strains can result in ankle fractures.
How is a broken ankle diagnosed?
The symptoms of a broken ankle are essentially the same as those of a sprain. Even if you can’t bear weight while walking due to severe pain, this does not clarify what is wrong. Externally, sprains and fractures look very similar.
Dr. Baravarian has a complete set of diagnostic tools to determine if your ankle is broken. The process includes:
Medical History and Symptom Assessment
How did the injury happen, and what symptoms are you experiencing? We want to know about the nature of the pain, any swelling, any sounds heard during the injury, and your ability to bear weight on the affected leg.
Physical Examination
During the physical exam, Dr. Bob will examine the ankle area for tenderness, swelling, bruising, and deformities, as these may indicate a fracture. They will also evaluate your ankle’s range of motion and check for signs of nerve or blood vessel damage.
Imaging tests
X-rays are the most common and initial imaging test used to diagnose a broken bone. For more complex fractures, a CT scan may be ordered, providing detailed images of the bone and helping assess fractures that are difficult to see on X-rays. Though less common for initial diagnosis, an MRI might be used to evaluate associated injuries to ligaments, tendons, or other soft tissues around the ankle.
Stress test
In some cases, Dr. Baravarian may perform a stress test to determine the necessity of surgery. This involves gently applying pressure to the ankle and taking an X-ray to check for bone separation.
Assessment of other injuries
To ensure he is thoroughly addressing your issue, Dr. Baravarian will also examine for any other injuries to the foot, heel bone, lower leg, or knee, particularly if the trauma is significant.
What non-surgical treatments are available for a broken ankle?
Ankle fractures that do not exhibit gapping or angulation/rotation at the fracture site typically do not require surgery. Instead, Dr. Bob manages them with an ankle brace and possibly physical therapy.
The aim of non-surgical treatment is to alleviate ankle pain and allow the joint to heal. Depending on the severity of the fracture, Dr. Baravarian may recommend:
- Rest: Stay off the ankle as much as possible to prevent further injury and reduce foot pain.
- Ice and compression: Cold compresses (ice packs) are most effective during the first 24 hours after the injury to reduce swelling and shorten the time until you can begin weight-bearing.
- Elevation: To help limit swelling and manage pain, non-steroidal anti-inflammatory drugs such as ibuprofen are often recommended to decrease swelling from ankle bone breaks.
- Immobilization: Restricting the joint with a walking boot, cast, or splint keeps it in place, allowing it to heal properly and preventing further damage.
- Crutches assist you in walking without putting weight on the injured ankle.
What are the surgical options for treating a broken ankle?
Fractured ankles often require surgical repair to restore the fractured pieces to their normal anatomic alignment and position the ankle joint correctly. There are several reasons why an ankle fracture may need surgery.
An angulated or displaced fracture—where the ankle joint is misaligned—requires surgery to realign the ankle joint. It’s essential to align the ankle fracture within 2 millimeters of the original position to achieve optimal long-term results.
Surgery is necessary for ankle fractures if the ankle is broken in multiple places, known as a bi-malleolar or tri-malleolar fracture. These types of fractures are very unstable and require surgical intervention to stabilize the joint. Without surgery to stabilize these injuries, the bones are likely to shift, leading to joint malalignment, which may result in post-traumatic arthritis in the ankle.
What is ankle reconstructive surgery?
Post-traumatic foot and ankle reconstruction involves a series of surgical procedures aimed at restoring normal function, alignment, and appearance of the foot and ankle after a traumatic injury or damage resulting from severe conditions. Trauma to the foot and ankle can occur due to accidents, sports injuries, or degenerative diseases, leading to deformities, fractures, dislocations, or joint damage.
Sometimes, your body heals bones or ligaments improperly. Your bones may not line up correctly, tendons might be misaligned, or the tendons could be too loose. Any of these issues can lead to further injuries, such as chronic ankle instability and an increased risk of future ankle problems.
The main goals of post-traumatic reconstruction of the foot and ankle are to:
Restore alignment and stability
Proper alignment and stability are essential for normal foot and ankle function. Surgeons employ various techniques to correct deformities and repair fractures or dislocations, including internal fixation (screws, plates, rods) or external fixation (pins and wires with an external frame).
Repair or replace damaged joints
Depending on the severity of the injury, surgeons may perform joint fusion (arthrodesis) to eliminate joint motion and relieve pain, or they may replace damaged joints with artificial ones (arthroplasty).
Preserve or Restore Motion
In certain situations, maintaining or restoring movement in the foot and ankle is essential for optimal function. Procedures such as tendon transfers, ligament reconstructions, and other soft tissue interventions can be performed to enhance mobility.
Manage Chronic Pain and Inflammation
Post-traumatic reconstruction can assist in managing pain and inflammation. This may involve removing bone spurs or inflamed tissue, or addressing nerve issues such as decompression or nerve release.
Enhance Appearance
Although the primary focus is on functionality rather than cosmetic foot surgery, reconstructive surgery can also improve the cosmetic appearance of the foot and ankle, helping patients feel more comfortable and confident.
The specific procedures and techniques for post-traumatic reconstruction of the foot and ankle depend on the patient’s unique situation, the type and severity of the injury or condition, and the desired outcome. The recovery process can vary significantly and may involve physical therapy, pain management, and ongoing follow-up care to ensure the best possible results.
Why is Dr. Baravarian your best choice for foot and ankle care in Los Angeles?
By employing the most advanced techniques, some of which he helped develop, Dr. Bob has achieved the highest success rates in the nation for ankle injuries. His goal is to quickly get you back on your feet, using the least invasive treatments possible.
Patients are Dr. Baravarian’s top priority. Starting with the convenience of scheduling your appointment, a welcoming office staff supports you every step of the way. Dr. Bob has his own X-ray machine, musculoskeletal ultrasound, and offers MRI and 3D CT services at many of the facilities.
Dr. Bob also provides orthotic and brace manufacturing, along with on-site physical therapy services and state-of-the-art operating rooms. This means you will seldom need to move from one specialist to another, reducing your travel requirements and minimizing wasted time.
Why is a foot and ankle specialist a better choice for care than an orthopedic surgeon?
While most orthopedic surgeons concentrate on all the bones and joints in the body, dedicating only a fraction of their time to the foot and ankle, Dr. Baravarian has chosen to make the treatment of foot and ankle conditions his life’s work.
Podiatric foot and ankle surgeons focus exclusively on the foot and ankle from the very first day of medical school. After completing their medical training, they enter a demanding three-year surgical residency. What distinguishes podiatric surgical residents from general orthopedic residents is their specialization in the foot and ankle, whereas most (though not all) orthopedic residents do not specialize in these areas.
Years of training, combined with decades of experience and research, contribute to Dr. Bob having the highest success rates in the United States, helping literally thousands get back on their feet and return to their lives.
To schedule a consultation, please call (855) 557-5400 or make an appointment online.
Dr. Bob Baravarian is conveniently located in Los Angeles, near Cedars-Sinai Medical Center, providing expert foot and ankle care for patients throughout Southern California.
Ankle fracture FAQs
What are the different types of ankle fractures?
Here are some of the common types of ankle breaks:
Lateral Malleolus Fracture: This refers to a fracture of the fibula, the smaller of the two bones in the lower leg. It is the most common type of ankle fracture and often occurs when the foot rolls either inwards or outwards.
Medial Malleolus Fracture: This involves a break in the tibia at the medial malleolus, which is the bony prominence on the inside of the ankle. It may occur alone or in conjunction with other ankle fractures.
Posterior Malleolus Fracture: This type of fracture involves the back portion of the tibia at the level of the ankle joint.
Bimalleolar Fractures: A bimalleolar ankle fracture occurs when there is a break in both the medial malleolus (inner side of the ankle) and the lateral malleolus (outer side of the ankle). As both sides of the ankle are injured, the ankle joint becomes unstable and is vulnerable to damage and early ankle arthritis if left untreated.
Trimalleolar Fracture: In this severe type of fracture, all three parts of the ankle malleoli (lateral, medial, and posterior) are broken. It typically results from high-impact trauma and often requires surgical repair.
Pilon Fracture: This fracture affects the weight-bearing part of the tibia and can cause significant damage to the soft tissue and the ankle joint. It is typically caused by high-energy impacts, such as a fall from a height or a car accident.
Syndesmotic Injury: Also known as a “high ankle sprain,” this refers to an injury of the syndesmosis, the ligaments connecting the tibia and fibula. Although it is not a fracture, it is often associated with ankle fractures and can complicate the healing process.
Avulsion Fracture: This occurs when a small fragment of bone is detached by a tendon or ligament. It’s common in sports injuries.A stress fracture in the ankle is a small crack in the bone that develops from repetitive force, often due to overuse in sports.
Open fracture: Also known as a compound fracture, an open fracture occurs when the broken bones penetrate through the skin. This type of injury requires immediate medical attention (a trip to the emergency room) and often necessitates surgical treatment. The urgency arises from the fact that the exposed wound allows external materials, dirt, and debris to enter and contaminate the fracture site, significantly increasing the risk of infection.
Can you walk on a broken ankle?
Yes, it’s possible to walk on a broken ankle, especially with minor or hairline fractures, but doing so can worsen the injury and lead to long-term damage. If you suspect a fracture, it’s important to stop walking on it and seek medical evaluation right away.
How to tell if ankle is broken or sprained?
A sprained ankle usually involves soft tissue pain, swelling, and limited movement, while a broken ankle often causes sharp pain over the bone, difficulty bearing weight, or visible deformity. Because symptoms can overlap, only an X-ray can confirm if it’s a fracture—so it’s best to see a doctor if you’re unsure
