Ankle fractures

If an ankle is fractured, the foot becomes swollen and painful, and can no longer support your weight. Bruises form, and it becomes nearly impossible to move the foot. Sometimes the bones also change position, causing them to become misaligned.

Ankle fractures usually occur during sports or exercise. For instance, your ankle might twist and break if you fall or land the wrong way after a jump. That can also easily happen when running on uneven ground or if you take a wrong step.

It takes several days or weeks for the swelling to go down completely, and it can take months for the ankle joint to fully recover from the fracture. Until then, the foot can't be moved much and can't carry much weight.

If you put strain on the foot too soon, the healing process may be disturbed, and the fracture might not heal properly. Then you might need more treatment. On the other hand, if you don't move your foot for too long, it could become less mobile and weaker.

Ankle fractures usually heal well. But they can lead to osteoarthritis over the long term. And the ankle may remain unstable, which increases the risk of twisting it again.

The doctor will first ask you about what happened, and then examine your foot and ankle to see how serious the injury is. If he or she suspects that the ankle is fractured, an x-ray of the ankle is taken. Sometimes x-rays don't lead to a clear diagnosis. Then a computed tomography (CT) scan, and perhaps a magnetic resonance imaging (MRI) scan, might be done too. Ligament and cartilage injuries can usually be seen better with MRI scans.

The foot and ankle are first immobilized (prevented from moving), elevated and cooled as needed. Immobilizing the joint helps to protect it and allow it to heal properly. If the bones have moved or slipped out of the joint, they can be put back into place by a doctor. Bandages, splints, braces and plaster casts are generally used for around six weeks.

After a while you can gradually start putting more strain on the joint and strengthening it. The point at which people are advised to start doing gentle exercises or physical therapy depends on how bad the injury is: Sometimes gentle exercises are already possible a few days after the injury or surgery, and sometimes they can only be done once the splint or plaster cast has come off. Because the foot is immobilized at first, injections to prevent thrombosis are sometimes used.

Surgery isn't always necessary for ankle fractures. Whether or not it's needed depends on many factors, including

• how severe the fracture is,
• what part of the ankle is broken,
• whether there's an open wound or break in the skin near the broken bone (an open fracture),
• whether blood vessels or nerves have been damaged, and
• whether the bone fragments have moved out of place.

Screws or plates may be used during surgery to hold bone fragments in place so they can grow together again.

After surgery, the ankle is immobilized using a bandage, splint or plaster cast. Some bandages and splints are removable, making it possible to already start doing gentle exercises during the immobilization phase. When the fracture has healed and the bones have grown back together, the screws and plates can often be removed, depending on the situation.

When people are ill or need medical advice, they usually go to see their family doctor first. You can read about how to find the right doctor in our "Health care in Germany" topic, and our list of questions can help you to prepare for your appointment.