Causes

A broken, or fractured, ankle is frequently caused by twisting your ankle but can occur from more significant accidents. Knowing the way the injury occurred is useful to our surgeons as it helps them understand the nature of the fracture and warns them of the amount of injury the overlying skin and tissue has suffered. This will be relevant to the timing of any surgery. Usually it is obvious that you have broken your ankle but sometimes it can be seen as a nasty sprain for a few days until it doesn’t improve.

Diagnosis

The diagnosis is made by carefully touching the ankle and correlating what our surgeons find with your X-rays. Occasionally a CT scan may be required to help our surgeons understand the configuration of a complex injury. Our expert surgeons may arrange for standing X-rays to be taken if you are able to take some weight on the ankle. This helps them understand the stability of your injury.

Treatment

The treatment required depends on the nature of the fracture and whether the injury is stable or unstable. If the injury is stable the position will not change with you putting weight through the ankle. These injuries can safely be managed without surgery and we will treat you in a walking cast or removable boot for 6 weeks.

Unstable ankle fractures are usually treated with surgery as they are prone to slipping into a poor position. If we do not operate on an unstable injury you will require multiple repeat X-rays over several weeks to ensure this doesn’t happen. We will discuss the advantages and disadvantages of both methods with you when we decide which option to choose. Timing of surgery will depend on how swollen your ankle has become from the injury and you may be asked to elevate and rest the ankle for up to a week before our surgeons can safely operate.

Surgery for ankle fractures usually requires you to stay overnight in hospital. We usually use a combination of screws and plates to hold your bones in position but on occasion we may use a strong suture passed between the two bones in your ankle (a “TightRope”). Typically you will be asked to elevate your leg and not walk on the leg for the first fortnight. We aim to then get you into a boot or cast that you can walk on for the following four weeks. Unfortunately some injury types do require you to not walk on the leg for six weeks.

After an ankle fracture, whether we treat it with surgery or not, swelling and stiffness can continue for a significant period. We will refer you to one of the excellent physiotherapists in our Local Team of Experts to help with this.