An ankle fracture occurs when the tibia and/or fibula are broken. These two bones make up the roof (plafond) and sides (malleoli) of the ankle joint. What is usually referred to as the inside ankle bone (medial malleolus) is where the deltoid ligament is attached. The outside ankle bone (lateral malleolus) is site of attachment of the lateral collateral ligaments. Ankle fractures usually occur after an acute twisting injury where the body rotates over the foot planted firmly or by the foot itself rotates forcefully. The amount of force applied and the position of the foot and ankle at the moment the force is applied dictate the “personality” and severity of the fracture.
Ankle fractures can also occur as a result of a fall from height or head-on motor vehicle accidents. These fractures are referred to as “pilon” fractures and will be discussed separately.
Ankle fractures are classified based on the pattern or “personality” of the fracture. The position of the foot at the time the ankle twists determines the fracture pattern. Proper diagnosis requires a thorough physical examination and x-ray studies.
Depending on the personality of the fracture, recommended treatment may be conservative or surgical. Some fracture patterns, provided there is no displacement of the fracture, can be treated with immobilization in a boot or cast and non-thickened her and herweightbearing until the fracture becomes stable. However, other fractures because of the precise nature of the ankle joint or best treated surgically to accurately restore the anatomy. While this cannot guarantee arthritis will be avoided, the risk is significantly decreased her story and normal mechanics.