Overview
Ankle fractures, or broken ankles, are a frequent injury in children and adolescents.
The ankle has two main bones: the tibia (shin bone) and the fibula (the smaller bone on the outer side of the ankle). Both bones have growth plates at their ends, which can be affected when a fracture occurs. Ankle fractures can range from simple breaks to more complex ones that involve the joint surface.
Treatment varies depending on the severity and type of fracture, ranging from a supportive boot to surgical intervention for more severe cases.
Anatomy
Types
- Nondisplaced Fractures: A nondisplaced fracture is characterized by a crack in the bone without any displacement or shifting of the bone fragments. It’s similar to a crack in a plate or bowl that remains intact. Nondisplaced fractures are typically managed with a boot or cast, which helps in stabilizing the bone while it heals.
- Displaced Fractures: A displaced fracture occurs when the bone breaks and the fragments shift out of their normal alignment. Treatment for displaced fractures often involves manipulating the bone back into place and casting it. In some cases, surgery may be necessary to realign the bones properly, especially if the joint surface is affected.
Symptoms
Ankle fractures often result from twists or falls, and are common in activities like skateboarding or scooter riding. Symptoms typically include immediate pain and swelling, difficulty walking or bearing weight, and bruising that appears a few hours after the injury.
Diagnosis & Treatment
Examination
Your doctor will assess the ankle for signs of swelling, bruising, and tenderness. They will also evaluate the nerves and blood supply to the foot to ensure there are no additional injuries and that the skin is suitable for a cast or surgical procedure if needed.
X-rays and Tests
X-rays are the primary method for diagnosing an ankle fracture. In some cases, a CT scan may be used to get a detailed view of the joint surface and growth plates.
Treatment
Treatment depends on the fracture's nature. A walking boot or cast is commonly used, and crutches may be recommended to avoid putting weight on the injured ankle. Displaced fractures may require surgical intervention to realign the bones. In some cases, the bones can be repositioned without surgery through manipulation in the doctor’s office.
Outcomes
Ankle fractures generally heal within 6 to 12 weeks. However, returning to sports might take longer. Your doctor will monitor the ankle to ensure the growth plates are healing properly. Although proper treatment usually leads to good recovery, fractures involving the joint carry a small risk of developing arthritis and stiffness later on.