Broken Ankle What is the definition of a broken ankle? There are two bones that are commonly referred to as the ankle joint; the tibia and the fibula. When there is a break in one or both of these bones, it is considered a broken ankle. In orthopedics, the terms broken and fractured are used interchangeably and often describe the same injury. What causes a broken ankle and what symptoms are expected? There are many things that can happen that will result in a broken or fractured ankle. Four examples are falling, being injured while playing contact sports or exercising, and being hit in the ankle by someone or something. If an ankle is broken one may experience pain, tenderness, and swelling and sometimes a deformity in the ankle itself. Hours to days after the initial injury the skin on the ankle may look discolored or bruised. In addition, when an ankle fracture occurs one may hear a snapping or popping noise at the time of injury along with loss of movement to the ankle. In rare cases there may be an open wound in addition to the ankle fracture. How is a broken ankle diagnosed? A diagnosis of a broken ankle can be determined by the health care provider reviewing the symptoms, asking what caused the injury and by examination. In addition, different xray views of the bone will be ordered to determine the exact location of the fracture. The severity of the injury is determined by the type of fracture. 1. If the broken pieces of bone are still properly aligned, the fracture is considered nondisplaced. 2. If the broken pieces are not properly aligned, the fracture is considered a displaced fracture. 3. If one end of the bone has broken through the skin, the fracture is an open fracture. 4. If the bone does not break the skin, it is considered a closed fracture. 5. If a portion of the bone is pulled away from where it was originally attached by muscles or ligaments, it is an avulsion fracture. How do you treat a broken ankle? After an ankle is fracture, the immediate treatment is immobilization, elevation above the heart, wrapping it with an Ace wrap to provide compression and applying ice packs to the area. If the orthopedic surgeon determines that the bone is adequately aligned, a cast will be applied to the ankle. Depending on the severity of the fracture, one may begin to walk in the cast after a few weeks. However, if the bone is not able to be aligned properly, surgery may be done prior to putting the cast on. To help reduce swelling and inflammation, the ankle is to be kept elevated above the heart on pillows for the first 2 weeks after the injury. In addition, placing ice packs on top of the cast for 20 to 30 minutes every 3 to 4 hours for the first few days will help with the swelling. When should a health care provider be contacted? 1. If swelling above or below the fracture occurs and does not respond to elevation. 2. If the toenails and/or foot are discolored even after elevation. 3. If a loss of feeling in the skin occurs and does not resolve with elevation. 4. If pain is not improved by elevation or pain medication. 5. If a burning pain under the cast occurs. When can sports and normal activities be resumed? Timing of return to sport activities can be variable depending upon the type of fracture and will be determined by the orthopedic care provider. The primary goal of rehabilitation is to return to normal activities as safely as possible. If normal activities are resumed too soon, it may lead to more or permanent damage. During rehab, the ankle will be healing and the strength and range of motion will improve. The health care provider will determine the criteria that must be met prior to resuming activities. How can a broken ankle be prevented? There are many options and ways to prevent an ankle fracture: 1. When exercising, make sure the shoes that are worn fit properly and correctly. 2. Before and after participating in physical activities stretch to loosen the muscles. 3. If extremely tired, do not participate in recreational sports like football or baseball. 4. Before engaging in any strenuous activities think safety first.