Ankle fracture | |
---|---|
Other names | Broken ankle[1] |
Fracture of both sides of the ankle with dislocation as seen on anteroposterior X-ray. (1) fibula, (2) tibia, (arrow) medial malleolus, (arrowhead) lateral malleolus | |
Specialty | Orthopedics |
Symptoms | Pain, swelling, bruising, inability to walk[1] |
Complications | High ankle sprain, compartment syndrome, decreased range of motion, malunion[1][2] |
Usual onset | Young males, older females[2] |
Types | Lateral malleolus, medial malleolus, posterior malleolus, bimalleolar, trimalleolar[1] |
Causes | Rolling the ankle, blunt trauma[2] |
Diagnostic method | X-rays based on the Ottawa ankle rule[2] |
Differential diagnosis | Rheumatoid arthritis, gout, septic arthritis, Achilles tendon rupture[2] |
Treatment | Splinting, casting, surgery[1] |
Frequency | ~1 per 1000/year[2] |
An ankle fracture is a break of one or more of the bones that make up the ankle joint.[1] Symptoms may include pain, swelling, bruising, and an inability to walk on the injured leg.[1] Complications may include an associated high ankle sprain, compartment syndrome, stiffness, malunion, and post-traumatic arthritis.[1][2]
Ankle fractures may result from excessive stress on the joint such as from rolling an ankle or from blunt trauma.[1][2] Types of ankle fractures include lateral malleolus, medial malleolus, posterior malleolus, bimalleolar, and trimalleolar fractures.[1] The Ottawa ankle rule can help determine the need for X-rays.[2] Special X-ray views called stress views help determine whether an ankle fracture is unstable.
Treatment depends on the fracture type. Ankle stability largely dictates non-operative vs. operative treatment. Non-operative treatment includes splinting or casting while operative treatment includes fixing the fracture with metal implants through an open reduction internal fixation (ORIF).[1] Significant recovery generally occurs within four months while completely recovery usually takes up to one year.[1]
Ankle fractures are common, occurring in over 1.8 per 1000 adults and 1 per 1000 children per year.[2][3] In North America this figure increases to more than 14 in ever 10,000 patients admitted to the Emergency Room.[4] They occur most commonly in young males and older females.[2]