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Ankle Fractures

A fracture in the ankle can occur in one or more of the bones, and can occur in conjunction with soft tissue injuries.  The ankle joint consists of the tibia (shin bone in the lower leg), fibula (long bone on the outside in lower leg) and the talus (bone in the foot).  There are three specific landmarks on the bones that help classify different types of fractures.  The medial malleolus (part of the tibia - bump on inside of ankle), lateral malleolus (part of the fibula - bump on outside of ankle) and posterior malleolus (back portion of the tibia – unable to see due to the Achilles tendon).


If you have suffered an ankle fracture, it is likely that you fell or twisted your ankle.  Often times a loud pop is heard followed by immediate pain.  Other symptoms include moderate to significant swelling and bruising, point tenderness, inability to walk and an obvious deformity compared to the uninjured side.  The best way to diagnose an ankle fracture is x-ray.  Your doctor can properly identify the type of fracture and determine the appropriate course of treatment.

As previously stated, there are many different types of ankle fractures.  A lateral malleolus fracture is when the bump on the outside of the ankle is broken.  A medial malleolus fracture is when the bump on the inside of the ankle is broken.  A posterior malleolus fracture is when the back side of the shin bone is broken at the level of the ankle.  Any of these fractures can occur alone or in a combination.  A bimalleolar fracture is when two or more bones are broken – most commonly the medial malleolus and lateral malleolus.  Finally, a trimalleolar fracture indicates all three malleoli are involved.


If the broken fragments are not aligned, surgery may be required to put a plate and screws in the ankle to stabilize the area.  For both the bimalleolar and trimalleolar, surgery is usually recommended because they are inherently unstable fractures and will need some form of internal fixation.  Regardless of conservative versus surgical intervention, a period of immobilization and non-weight bearing is likely followed by transitioning to partial then full weight bearing.  Additionally, a period of rehabilitation is recommended for improving range of motion, restoring strength and proprioception (balance).