Ankle injuries: sprains and fractures

Back to Patient education: foot & ankle

What is an ankle sprain or fracture?

Sprains and fractures are two of the most common ankle injuries.

Ankle sprains stretch and tear the ligaments that support your ankle. The injury ranges from many microscopic tears in the ligament fibers to a complete tear or rupture. Ankle sprains are often mistreated or not treated at all, which can lead to prolonged discomfort, re-injury, chronic disability and early arthritis.

An ankle fracture is a break in one or more of the bones that make up the ankle joint. Broken ankles vary from a simple break in one bone to multiple fractures that prevent you from walking.

How does an ankle injury occur?

Ankle injuries occur when the ankle joint is twisted too far out of its normal position. Some common causes include:

  • Rotating or rolling the ankle
  • Tripping or falling
  • Landing awkwardly after a jump
  • Walking or running on an uneven surface
  • Trauma from a fall, car accident or sports injury
  • Faulty footwear, such as very high-heeled shoes or loose-fitting sandals

What are the symptoms of an ankle injury?

Symptoms vary depending on the severity of the injury. Mild ankle sprains cause tenderness, swelling and stiffness. If the sprain is more acute, or the ankle is broken, symptoms typically include extreme pain, instability, limited range of motion and the inability to bear weight. In some cases, you’ll hear a crack or snap as the injury occurs. If the break is bad enough, the bone will protrude from the skin. This is known as a compound, or open, fracture.

How is an ankle injury diagnosed?

In addition to a physical exam and health history, your doctor may take an X-ray of your foot to identify If you have an ankle injury, your doctor will check for swelling, point tenderness, discoloration, deformity and range of motion – the foot’s ability to move in all its normal positions. In addition to a physical exam, your doctor can use specific tests, including X-rays, MRIs and CT scans to diagnose the severity and exact location of a broken ankle.

What is the treatment?

It is important to have an ankle injury evaluated by a qualified surgeon for proper diagnosis and treatment.

If you think you have sprained your ankle, the recommended first aid is RICE (rest, ice, compression and elevation), which should begin as soon as possible after the injury occurs. Additional treatment could include an ankle brace or air cast, non-steroidal anti-inflammatory medications and, for more severe sprains, physical therapy.

There are many types of ankle fractures, and treatments vary significantly depending on the location and severity of the injury. If your ankle is badly broken or unstable, surgery may be necessary. In this procedure, the bone fragments are first repositioned into their normal alignment. This is called a reduction. The surgeon then inserts special screws and metal plates to hold the bones together as they heal. Healing usually takes about six weeks. Rehabilitation is necessary to restore strength, flexibility and range of motion.