Broken ankle

A broken or fractured ankle is an injury to the bone. You may experience a broken ankle from a twisting injury from a simple misstep or fall, or from direct trauma during a car crash, for example.

The seriousness of a broken ankle varies. Fractures can range from tiny cracks in your bones to breaks that pierce your skin.

Treatment for a broken ankle depends on the exact site and severity of the bone fracture. A severely broken ankle may require surgery to implant plates, rods or screws into the broken bone to maintain proper position during healing.

If you have a broken ankle, you may experience some of the following signs and symptoms:

• Immediate, throbbing pain
• Swelling
• Bruising
• Tenderness
• Deformity
• Difficulty or pain with walking or bearing weight

See a doctor if there is obvious deformity, if the pain and swelling don't get better with self-care, or if the pain and swelling get worse over time. Also, see a doctor if the injury interferes with walking.

A broken ankle is usually a result of a twisting injury, but can also be caused by a direct blow to the ankle.

The most common causes of a broken ankle include:

• Car accidents. The crushing injuries common in car accidents may cause breaks that require surgical repair.
• Falls. Tripping and falling can break bones in your ankles, as can landing on your feet after jumping down from just a slight height.
• Missteps. Sometimes just putting your foot down wrong can result in a twisting injury that can cause a broken bone.

You may be at higher risk of a broken ankle if you:

• Participate in high-impact sports. The stresses, direct blows and twisting injuries that occur in sports such as basketball, football, gymnastics, tennis and soccer can cause ankle fractures.
• Use improper technique or sports equipment. Faulty equipment, such as shoes that are too worn or not properly fitted, can contribute to stress fractures and falls. Improper training techniques, such as not warming up and stretching, also can cause ankle injuries.
• Suddenly increase your activity level. Whether you're a trained athlete or someone who's just started exercising, suddenly boosting the frequency or duration of your exercise sessions can increase your risk of a stress fracture.
• Keep your home cluttered or poorly lit. Walking around in a house with too much clutter or too little light may lead to falls and ankle injuries.
• Have certain conditions. Having decreased bone density (osteoporosis) can put you at risk of injuries to your ankle bones.
• Smoking. Cigarette smoking can increase your risk of developing osteoporosis. Studies also show that healing after a fracture may take longer in people who smoke.

Complications of a broken ankle are uncommon but may include:

• Arthritis. Fractures that extend into the joint can cause arthritis years later. If your ankle starts to hurt long after a break, see your doctor for an evaluation.
• Bone infection (osteomyelitis). If you have an open fracture, meaning one end of the bone protrudes through the skin, your bone may be exposed to bacteria that cause infection.
• Compartment syndrome. This condition can rarely occur with ankle fractures. It causes pain, swelling and sometimes disability in affected muscles of the legs.
• Nerve or blood vessel damage. Trauma to the ankle can injure nerves and blood vessels, sometimes actually tearing them. Seek immediate attention if you notice any numbness or circulation problems. Lack of blood flow can cause a bone to die and collapse.

These basic sports and safety tips may help prevent a broken ankle:

• Wear proper shoes. Use hiking shoes on rough terrain. Choose appropriate athletic shoes for your sport.
• Replace athletic shoes regularly. Discard sneakers as soon as the tread or heel wears out or if the shoes are wearing unevenly. If you're a runner, replace your sneakers every 300 to 400 miles.
• Start slowly. That applies to a new fitness program and each individual workout.
• Cross-train. Alternating activities can prevent stress fractures. Rotate running with swimming or biking.
• Build bone strength. Get enough calcium and vitamin D. Calcium-rich foods include milk, yogurt and cheese. Ask your doctor if you need to take vitamin D supplements.
• Declutter your house. Keeping clutter off the floor can help you to avoid trips and falls.
• Strengthen your ankle muscles. If you are prone to twisting your ankle, ask your doctor for exercises to help strengthen the supporting muscles of your ankle.