During the past 30 years, doctors have noted an increase in the number and severity of broken ankles, due in part to an active, older population of “baby boomers”.  Almost one million people visited emergency departments in 1998 because of ankle problems.  The joint beneath the ankle known as the subtalar joint, is in close proximity, and can also be injured during traumatic episodes affecting the lower extremity.  A broken ankle can involve one or more bones, as well as injuring the surrounding connecting tissues (ligaments).

The ankle joint is composed of three bones:

·         The shinbone (tibia)

·         The outer bone of the lower leg (fibula)

·         The ankle bone (talus)

The leg bones form a scooped pocket around the top of the anklebone.  This lets the foot bend up and down.   Right below the ankle joint is another joint (subtalar), where the talus connects to the heel bone (calcaneus).  This joint enables the foot to rock from side to side.  Three sets of fibrous tissues (ligaments) connect the bones and provide stability to both joints.  The knobby bumps you can feel on either side of your ankle are the very ends of the lower leg bones.  The bump on the outside of the ankle (lateral malleolus) is part of the fibula; the smaller bump on the inside of the ankle (medial malleolus) is

Any one of the three bones that make up the ankle joint could break as the result of a fall, an automobile accident, a sports related injury, or other trauma.

Because a severe sprain an often mask the symptoms of a broken ankle, every injury to the ankle should be examined by a foot and ankle specialist.  Symptoms of a broken ankle include:

·         Immediate and severe pain

·         Swelling

·         Bruising

·         Tenderness to the touch

·         Inability to bear weight on the injured foot

·         Deformity, particularly if there is a dislocation as well as a fracture

A broken ankle may also involve damage to the ligaments.  Your doctor will order x-rays to find the exact location of the break.  Sometimes a CT (computed tomography) scan or an MRI will also be needed.

If the fracture is stable (without damage to the ligament of mortise joint), it can be treated with a leg cast or walking boot.  It takes at least 6 weeks for a broken ankle to heal, and it may be several months before you can return to sports at your previous competitive level.  Your doctor will schedule additional x-rays to be taken while the bones are healing, to make sure that changes or pressures on the ankle don’t cause the bones to shift.  If the ligaments are also torn, or if the fracture created a loose fragment of bone that could irritate the joint, surgery may be required to “fix” the bones together so they will heal properly.  The surgeon may use a plate and metal screws to hold the bone in place.  Usually, there are few complications, although there is a higher risk among diabetic patients and those who smoke.