Ankle Fractures

Ankle Fractures

Rachel Miller is a highly experienced HCPC-registered podiatrist who helps many people with their rehabilitation after an ankle fracture.

An ankle fracture can vary between small cracks in your bones to sever breaks that pierce the skin.  A minor hairline crack can heal on its own, a sever break may need surgery. A crack or break can occur in one or more of the 3 bones in your ankle, the tibia, fibula, and talus and this can be a side effect of a sprain.

If you are in severe pain, your ankle is at an odd angle, if your foot feels numb or your toes have gone blue or white, seek immediate urgent medical help.

Please see below if you want more detailed explanation of ankle fractures.

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Ankle Fractures

Symptoms of ankle fractures

Symptoms can include:

• pain, throbbing, especially when putting weight on your ankle
• swelling
• bruising
• stiffness
• a fever
• redness
• tenderness

See a medical practitioner if you suspect you have an ankle fracture. You may need to have an X-ray, CT scan or MRI to diagnose your ankle fracture.

Causes of ankles fractures

A fractured ankle may occur from twisting your ankle from a simple misstep or fall, or from direct trauma during a sports injury, for example.  Some foot structures and conditions are more prone to twisting an ankle which can result in a fracture.

Treatment of ankle fractures

Every ankle fracture is different and requires an appropriate treatment and rehabilitation plan based on the type and severity of the fracture.

Management typically begins with medical assessment and diagnostic imaging. Depending on the fracture, treatment may involve immobilisation in a cast or walking boot and in some cases surgery. Your treating medical team will advise when it is safe to begin weight-bearing and how your fracture should be protected while it heals.

Once the fracture is appropriately managed and your treating clinician confirms that rehabilitation can begin, a gradual and guided programme may help restore movement, strength, balance and function.

Some principles from the PEACE & LOVE framework, which was developed primarily for soft-tissue injuries, may also be relevant during rehabilitation. However, the appropriate timing and progression of rehabilitation exercises following an ankle fracture should always be guided by your treating medical professional.

P – Protect: Protect the healing fracture and follow advice about weight-bearing and activity.

E – Elevate: Elevate the affected leg if swelling is present.

L – Load: Gradually reintroduce weight-bearing and activity when advised by your treating clinician.

V – Vascularisation: Appropriate low-impact activity may help maintain general fitness when it is safe to do so.

E – Exercise: Rehabilitation exercises can help restore mobility, strength, balance and function as the fracture heals.

Your recovery time will depend on the type and severity of the fracture and your individual circumstances. Some fractures may heal sufficiently for weight-bearing within several weeks, while more complex fractures can take considerably longer. Swelling, stiffness and discomfort may persist for several months after an ankle fracture, particularly following a severe injury or surgery.

It is important to follow the advice of your orthopaedic team, physiotherapist, podiatrist or other medical professional and to progress your rehabilitation gradually. Do not rush your recovery or return to sport or strenuous activity until you have been advised that it is safe to do so.

Further treatments can include:

• Maintain your fitness with guided movement, balance and strength exercises.
• Improve bone health with a balanced diet and possibly supplements.
• Lifestyle advice such as stop smoking, reduce caffeine intake.
• Footwear advice.
• An orthotic insole.

If you have suffered from an ankle injury, an experienced podiatrist may be able to help you with your rehabilitation. You may benefit from specialist biomechanical assessment.  You can be prescribed an orthotic insole as part of your treatment plan. A bespoke orthotic insole supports and cushions the foot and may reduce pain on impact on walking and running. An orthotic insole can to help correct overpronation, where a foot rolls in during gate or supination, where a foot rolls out during gate, which may stress and strain the ankle, cause instability, sprained ankles and ankle fractures.

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