A broken ankle is also called a fractured ankle. It happens when one or more bones in the ankle joint break.

The ankle joint is made up of the following bones:

  • The tibia is the larger bone in your lower leg. It’s also called the shinbone.
  • Also called the calf bone, the fibula is the smaller bone in your lower leg.
  • The talus is the small bone between the heel bone (the calcaneus), and the tibia and fibula.

A broken ankle is very painful.

You might hear the bone break at the time of injury. It may sound like a snapping or grinding noise. Other symptoms include:

  • severe pain
  • swelling
  • tenderness
  • bruising
  • difficultly walking or moving foot
  • difficulty bearing weight
  • foot appears to be crooked (dislocated)
  • dizziness (from pain)
  • bone sticking out of the skin
  • bleeding (if bone pierces the skin)

A broken ankle isn’t the same as a sprained ankle. A sprained ankle happens when ligaments tear or stretch. Ligaments are tough tissue that hold bones in place.

If your ankle is sprained, you’ll have pain and swelling. The degree of pain and swelling will be determined by the type of sprain: a Grade I sprain will have little swelling, but a Grade III may have significant swelling. You may or may not be able to put weight on your ankle just after the injury.

A broken ankle may be more painful. Right after the injury, you may or may not be able to walk or place weight on the ankle. It depends on the type and cause of the fracture (motor vehicle accident versus a fall, for example). You may or may not have severe bruising and swelling.

The only way to make a determination if there is a fracture or sprain is to see a doctor.

To diagnose your injury, your doctor will do different tests. This might include:

  • Physical exam. The doctor will examine your ankle for swelling and tenderness. If there is tenderness over a ligament, the injury is most likely a sprain. If tenderness is over the bone, it’s most likely a fracture. They might also move your foot around to determine your range of motion.
  • X-ray. An X-ray lets a doctor see the location, type, and severity of the break.
  • Stress test. A stress test determines if a sprained ankle needs surgery. A doctor will place pressure on the ankle and take an X-ray. If the joint opens up, this indicates a Grade III tear that would need to be repaired.
  • CT scan. A CT scan provides more detailed images by taking multiple cross-sectional pictures of the ankle.
  • MRI scan. An MRI scan uses a magnetic field and radio waves to show the bones and surrounding tissue. It can help the doctor find fractures that don’t show up on X-rays. It can also see tears in the ligaments.

A broken ankle occurs when too much force is placed on the ankle. The most common causes include:

Trips and falls

Losing your balance may lead to trips and falls, which can place excessive weight on your ankle.

This might happen if you walk on an uneven surface, wear ill-fitting shoes, or walk around without proper lighting.

Heavy impact

The force of a jump or fall can result in a broken ankle. It can happen even if you jump from a low height.

Missteps

You can break your ankle if you put your foot down awkwardly. Your ankle might twist or roll to the side as you put weight on it.

Sports

High-impact sports involve intense movements that place stress on the joints, including the ankle. Examples of high-impact sports include soccer, football, and basketball.

Car collisions

The sudden, heavy impact of a car accident can cause broken ankles. Often, these injuries need surgical repair.

The type and severity of an ankle break depends on the amount of force that caused it. Types of ankle break injuries include:

Lateral malleolus fracture

This break occurs at the bottom of the fibula. It involves the bony “knob” outside of your ankle called the lateral malleolus.

Lateral malleolus fractures are the most common type of ankle breaks.

Medial malleolus fracture

A medial malleolus fracture happens at the end of the tibia. Specifically, it affects the medial malleolus, which is the knob inside your ankle.

These usually require surgery because the lining of the bone, the periosteum, folds into the fracture site at the time of the injury and prevents the bone from healing.

Bimalleolar ankle fracture

A bimalleolar ankle fracture involves both knobs in the ankle, which includes the fibula (lateral malleolus) and tibia (medial malleolus). These almost always require surgery to repair.

It’s the second most common type of ankle break.

Bimalleolar equivalent fracture

A bimalleolar equivalent fracture involves both knobs and the ligaments inside the ankle.

Posterior malleolus fracture

A posterior malleolus fracture occurs on the back of the tibia.

Usually, this break happens with lateral malleolus fractures. That’s because the posterior malleolus and lateral malleolus share ligament attachments.

Trimalleolar fracture

A trimalleolar fracture involves all three parts of the ankle, which include the medial (inside), lateral (outside), and posterior (back) malleoli. Like a bimalleolar fracture, this usually requires surgery.

Pilon fracture

A pilon fracture occurs in the “roof” of the ankle, which is at the end of the tibia. It’s also called a plafond fracture.

Typically, this injury also involves a fibula fracture. The underlying talus is frequently damaged to a degree. The cartilage covering the talus is often damaged as well, so arthritis will likely result.

A pilon fracture is usually caused by high-impact injuries like falls or car accidents.

Maisonneuve fracture

A Maisonneuve fracture includes two injuries: an ankle sprain and a break in the upper part of the fibula. The break is located near the knee.

This injury happens when you fall while rotating, causing the foot to awkwardly hit the ground. It’s most common in gymnasts, dancers, and skiers.

Syndesmotic injury

This injury affects the syndesmosis joint, which is located between the fibula and tibia. It’s held in place by ligaments.

If only the ligament is injured, it’s also called a high ankle sprain.

However, most syndesmotic injuries include a ligament sprain and at least one fracture.

If you think you have a broken ankle, visit a doctor as soon as possible.

Meanwhile, here’s what you can do to take care of yourself:

  • Keep weight off your foot. Elevate your ankle and prop it up on cushions.
  • Apply ice. This will minimize pain and swelling.
  • Apply pressure. If you’re bleeding, wrap the wound with a clean dressing.

If your broken ankle was caused by an auto collision or injury, or if the bone is sticking out of the skin, get medical help immediately.

X-rays can show the location, type, and severity of your ankle break.

This will help your doctor determine the appropriate way to treat your injury.

Every injury is different. The best treatment depends on the type and seriousness of your ankle break.

Ice

You can apply ice to reduce pain and swelling right after the injury. Wrap it in a towel before placing it on the skin.

Walking boot, cast, or splint

Mild ankle breaks can be treated with a walking boot, cast, or splint. These treatments keep the bone in place as it heals.

For more serious injuries, you’ll need to get surgery before using a boot, cast, or splint.

Crutches

Crutches help you walk around without bearing weight on the injured ankle. They’re used while wearing a boot, cast, or splint.

Reduction

If your broken bone has moved out of place, your doctor might need to physically move it back into position. This nonsurgical treatment is called closed reduction.

Before the procedure, you might receive a muscle relaxant, sedative, or general anesthesia to control the pain.

Surgery

Surgery is recommended for severe ankle breaks that can’t heal with a boot, cast, or splint.

A surgeon may use metal rods, screws, or plates to realign the bone. This will keep the bone in place as it heals. The procedure is called open reduction and internal fixation.

Generally, broken ankles heal within 6 to 12 weeks. Injuries that don’t need surgery may heal in 6 weeks. During this time, your doctor may take regular X-rays to check on the bone.

Injuries that need surgery can take 12 weeks or longer to heal. Your total recovery time depends on your injury, age, and overall health.

During recovery, it’s important to follow your doctor’s recommendations. This will help your broken ankle heal properly. Here’s what you can do to ensure a smooth recovery:

Avoid pressure

Try not to use your injured foot. When you walk or move, don’t apply weight on your ankle until allowed to do so by your doctor.

Rest

Don’t carry heavy items or play sports. If you need to go somewhere, ask family or friends. Your doctor will tell you when it’s safe to use your ankle.

Physical therapy

When your bones start to heal, your doctor might have you do physical or occupational therapy.

A physical or occupational therapist can show you how to exercise your ankle. These moves will strengthen the ankle bones.

Eat healthy

Like all injuries, a broken ankle needs enough nutrients to heal. Eating a healthy, well-rounded diet will support recovery.

Avoid smoking

Smoking slows down bone healing. Cigarette smoke has ingredients that disrupt your body’s ability to make new bone tissue.

Quitting smoking can be difficult, but a doctor can help you create a smoking cessation plan right for you.

Attend follow-up appointments

During recovery, you should visit the doctor regularly. They’ll need to check that your bone is healing correctly.

Broken ankle — can you still walk?

Typically, a minor ankle fracture won’t prevent you from walking. You might even be able to walk right after the injury.

If you have a serious break, you’ll need to avoid walking for a few months. As your ankle gets better, you can slowly return to normal activities.

A broken or fractured ankle occurs when one or more bones in your ankle break. These bones include the tibia, fibula, and talus.

Usually, ankle breaks are caused by falls, high-impact sports, car accidents, or injuries that place excessive force on the ankle.

Treatment depends on the severity of the break. If you have a minor ankle break, you might get a walking boot, cast, or splint. If it’s serious, you might need surgery to realign the bone.

Recovery can take 6 to 12 weeks. Severe ankle breaks that need surgery may take longer.