How do ankle fractures happen?

Ankle fractures occur generally due to a twisting injury.  Most of the time it requires some “energy “.  This means usually the injury occurs when someone is running, falling from a height  or in some cases just falling or tripping over a rock, or stepping off a stair, or in an accident of some kind involving a motor vehicle.

How common are ankle fractures?

According to many studies ankle fractures occur at a rate of 100-160 fractures /100,000 people.  They are more common in people who participate in sports.

How can I tell if I have a fracture or a sprain?

The  short answer is that  you probably can’t.   Unless the ankle is displaced, a sever  ankle sprain and an ankle fracture look almost exactly the same.  They also feel very similar.  Many people believe that if you can walk on it it is not broken .  That is definitely not true.  Is this picture of fracture or sprain?  The only way to tell is with an x-ray.

Do ankle fractures have a good diagnosis?

 A quick review of the medical literature reveals that most patients that have an ankle fracture if it is properly treated do reasonably well.  80% of athletes  function at near normal levels once the ankle fracture has healed.  Older patients are more likely to have problems even if the ankle is repaired correctly.

How long does it take a ankle fracture to heal?

This could take several months.   It appears that a lot of the long-term prognosis for ankle fractures depends a lot on how much  “energy” was involved in the injury.  Tripping on a rock is a lot different than being in a motor vehicle accident.  Sports injuries are in the middle.   The more energy that went into the fracture the worse the prognosis.  Some ankle fractures never feel great afterwards and there is always the possibility of arthritis.  Bones take 2-3 months to heal and the joint can be sore for up to a year.  Some joints never feel “normal” after ankle fractures.

What are some of the associated injuries that can occur with an ankle fracture?

Ankle fractures are violent injuries and associated trauma to other structures is quite common. Up to three bones can be fractured in the ankle. Several bones in the foot can also be fractured. All these need to be checked and cared for to optimize outcomes.

Some of the things that can happen are: 

  • Ligament ruptures, tears or sprains
  • Tendon ruptures
  • Bone bruises
  • Cartilage damage
  • Nerve injury
  • Foot fractures
  • Back, knee or hip injuries

Who is more likely to fracture their ankle?

Ankle fracture can happen to anyone!

Most ankle fractures occur in two groups:

  1. The older patient with osteoporosis that has a fall.
  2. Younger patients who are involved in sports that get a twisting injury.

Are there different types of ankle fractures?

There are many classification systems for ankle fractures but the only when you really need to worry about, as the patient, is whether or not the ankle fracture is displaced.

The main questions are:

  1. Are the bones where they should be, or are they in a different location?
  2. Is the fracture stable?

If they are  not lined up correctly, or they are unstable then the fracture is likely to cause problems later and surgery should be performed as soon as possible .  Of course other factors come into play.  The general health of the patient and whether not they are a good candidate for surgery plays a role in that decision.   Also another thing to worry about is how many bones are fractured.  The more bones that are injured the more likely it is you need surgery. 

Do need to have surgery if I broke my ankle?

Long term clinical studies after ankle fractures show there is a risk of arthritis.  The main cause of the ankle arthritis is a joint that is not congruent.


This means if the joint is not put back together exactly there is an increased incidence of arthritis because the joint is not congruent.   It is much more likely that quick intervention can get the bones back to their normal position.  Delay of even a week can result in greatly increased difficulty in getting the bones lined up because the body has already started to heal the area and fibrosis and scar is forming.

What are the long-term affects after an ankle fracture?

Ankle fractures can have long-term life consequences!

Such as:

  1. Physical: Inability to participate in sports or strenuous activities
  2. Psychological: Depression, fatigue, anxiety and problems with sleep
  3. Social:  Employment issues, family problems, alcohol use, and decreased quality of life

Most patients do very well.  Clinical studies indicate that 70-80%  the patient has returned to normal preoperative activity.  Factors that affect the outcome include the severity of the fracture, the age of the patient, associated comorbidities of the patient such as diabetes, obesity, physical state of the patient prior to the surgery, AND THE ABILITY OF THE SURGEON TO GET THE ANKLE FRACTURE BACK IN GOOD ALIGNMENT.


Why consider Next Step Foot & Ankle Clinic for an Ankle Fracture?


QUICK ACCESS TO CARE:  As with any injury time is a factor.  The sooner it is addressed and treated, whether surgically or conservatively , the better.  We make a commitment to our trauma patient is to try  and get them in on the same day as the call.  In reviewing our patient list patients who require surgery generally have that surgery within the 1st week.  This makes for easy reduction of fractures, less pain and swelling and more rapid return to activities.

DYNAMIC TESTING:  The only way to truly evaluate whether not a fracture is stable is to place this fracture under stress.  We are very skilled and using local anesthetic to make the ankle numb and we have access to fluoroscopy to do dynamic stress testing.

LASER THERAPY:  Postoperatively laser therapy can cut healing time by about 40%.  We have made the significant investment to have the MLS laser therapy available in our office.

YOU SEE A DOCTOR, NOT A PHYSICIAN ASSISTANT OR NURSE PRACTITIONER.  On your 1st visit you will see the doctor.  He will follow you through the entire procedure both before and after.  You are not “handed off” to someone else.   Out without

EXPERTS AT THE REST OF THE PROBLEMS:  Ankle fractures are associated with a lot of other injuries including nerve entrapment, nerve injury, tendon injury, ankle instability, bone bruises inside the ankle.  We see and care for these  every day in our practice.  

HOLISTIC APPROACH:  We are firm believers  in taking care of the whole patient.  Routinely with fractures and bone surgery we offer our patients a nutritional supplement that has been shown to dramatically increase bone healing.  


 Let Dr. Silvester, Bills, Larsen  and the Next Step Foot & Ankle Clinic staff help you recover properly.
Call 210.375.3318 to make an appointment.