The ankle is made up of three bones:
- the tibia (shin bone), which forms the inside, front, and back of the ankle
- the fibula, which forms the outside of the ankle
- the talus, a small bone that sits between the tibia and fibula and the heel bone
The ends of these bones are called malleoli. The tibia has a medial (inside) malleoli and a posterior malleoli. The fibula forms the lateral (outside) malleoli.
A fracture is a partial or complete break in a bone. In the ankle, fractures involve the far (distal) ends of the tibia and/or the fibula. Some distal tibia fractures can involve the rear (posterior) part of the bone, which also are known as posterior malleolar fractures. Ankle fractures can range from less serious avulsion injuries (small pieces of bone that have been pulled off) to severe, shattering-type breaks. Some fractures also may involve injuries to important ankle ligaments that keep the ankle in its normal position. Ankle fractures are commonly caused by the ankle twisting inward or outward.
One or all of these signs and symptoms may accompany an ankle fracture:
- Pain at the site of the fracture, which can extend from the foot to the knee
- Swelling, which may occur along the length of the leg or be more localized at the ankle
- Blisters, which should be treated promptly
- Decreased ability to walk. It is possible to walk or bear weight upon the ankle with less severe fractures. Never rely on walking as a test of whether the ankle is fractured.
- Bones protruding through the skin. This condition is known as an open ankle fracture. These types of ankle fractures require immediate treatment to avoid problems like infection.
Most patients with ankle fractures are treated in an emergency room or a doctor’s office. An X-ray of the damaged ankle may be taken to determine what the fracture looks like, which bones are broken, how separated or displaced the bones are, and the condition of the bone itself. The X-ray will help determine the proper course of treatment.