Ankle Fracture

An ankle fracture is a break in one or more bones that form and stabilise the ankle joint.

The break may involve the lower ends of the shin bones or the outer ankle bone. It can be stable or displaced, closed or open, and may occur with ligament damage. The pattern determines whether protection, manipulation or surgery is needed.

Common presentations include ankle pain, swelling, bruising, tenderness and difficulty moving the joint. An inability to bear weight is frequent after a significant fracture. A visibly changed ankle shape suggests displacement and needs urgent assessment. Read more about [Ankle Pain](/symptoms/ankle-pain/) and [Visible Deformity After Injury](/symptoms/visible-deformity-after-injury/).

A fracture can result from a twist, fall, sports impact, road injury or direct blow. The force may break one bone or travel through the ankle and injure several structures. A clinician also considers the direction of the force and whether the skin is damaged.

The first priorities are checking circulation and sensation, protecting the ankle and controlling swelling. Bone healing is followed by a gradual return of movement, strength and balance. Weight-bearing instructions change according to the fracture pattern and follow-up imaging, so do not advance them independently.

Falls, high-impact sport, uneven surfaces and previous ankle instability can increase injury exposure. Bone weakness, poor balance and reduced vision may make falls more likely. A history of an earlier fracture or surgery can affect the assessment and treatment plan.

Examination checks swelling, skin condition, circulation, sensation, tenderness and alignment. X-rays usually define the broken bones and their position. Computed tomography may clarify a complex joint fracture, while other imaging is chosen when soft-tissue injury remains a concern.

A stable fracture may be protected with [Fracture Casting](/treatments/trauma-and-fracture-care/fracture-casting/) or [Walking Boot Immobilisation](/treatments/non-surgical-orthopedics/walking-boot-immobilisation/). The device limits movement while the bones heal; crutches may be needed until weight-bearing is allowed.

If the bones are displaced or the joint is unstable, [Fracture Fixation Surgery](/treatments/trauma-and-fracture-care/fracture-fixation-surgery/) may realign and hold them. After immobilisation or surgery, [Post-Operative Rehabilitation](/treatments/physiotherapy-and-rehabilitation/post-operative-rehabilitation/) can restore ankle movement, calf strength and balance.

Keep the limb elevated when advised and protect the cast or boot from water and pressure. Use mobility aids as taught, inspect exposed toes for colour and sensation, and attend planned reviews. Increasing pain, numbness, cold toes or a tight cast should be reported promptly.

Problems can include stiffness, weakness, skin pressure, delayed healing, altered alignment or persistent swelling. Joint-surface injury may contribute to later discomfort or [Ankle Osteoarthritis](/conditions/ankle-osteoarthritis/). Severe pain with numbness or a pale, cold foot requires urgent care.

Improve balance and leg strength, use suitable footwear for the activity, clear trip hazards and take care on uneven ground. Protective equipment may help in higher-risk sports. After a previous injury, rehabilitation can address movement and confidence before full activity resumes.

An orthopaedic trauma clinician assesses alignment, stability and bone healing. A physiotherapist can guide movement and loading once protection is reduced. Bring details of how the injury occurred, any numbness, and the weight-bearing advice already given.