What is a broken ankle? An ankle fracture is when one or more of your ankle bones is partially or completely broken. A broken ankle can be a hairline ankle fracture, which is less severe, or a serious break that shattered the bone. Your ankle is a joint where three bones come together—the shinbone (the tibia), the small bone of your lower leg (the fibula), and the small bone that’s between the heel bone and the two leg bones (the talus). The name for an ankle fracture depends on which bones are broken. A broken ankle is different from a sprained ankle, although you could have both at the same time. While anyone can break an ankle, people who play high-impact sports are more at risk. People with decreased bone density are also at a higher risk of fracturing an ankle. The symptoms of a broken ankle depend on the type of fracture. Symptoms of broken ankle include pain, swelling, and difficulty bearing weight on the ankle. Your doctor will recommend treatment depending on how serious the ankle fracture is. Treatments can range from ice and rest to a cast for a hairline ankle fracture or surgery for a complex break or when bones are out of place. Left untreated, a broken ankle can lead to infection, deformity or arthritis. If you have ankle pain that won’t go away, you need to visit your doctor as soon as possible. If your ankle bone is protruding through the skin, seek immediate medical attention. What are the symptoms of a broken ankle? Broken ankle symptoms depend on which bones in the ankle are broken and how severe the break is. The most obvious and serious sign of a broken ankle is visible bone piercing the skin. If that has happened, you need emergency care. You might notice other symptoms of a less serious ankle hairline fracture. Common symptoms of a broken ankle The most common symptoms and signs of a broken ankle include: Immediate pain, which could be severe or throbbing, often increasing when putting weight on the ankle Swelling, which may be at the ankle or all the way up the leg Bruising and tenderness to the touch Difficulty or inability to walk Deformity, meaning the broken ankle looks different from the other ankle These symptoms can also be confused with an ankle sprain, so visit a doctor for an accurate diagnosis. It’s important to seek medical care from a foot and ankle surgeon if symptoms are severe or don’t go away with rest and other self-care. What causes a broken ankle? You can break any of the bones in your ankle by twisting, rotating or rolling your ankle. It can happen from tripping and falling, or simply putting your foot down the wrong way. You can seriously injury or shatter your ankle by dropping something heavy on your foot or ankle or from a vehicle accident. Overuse—such as running long distances or any activity with a bone weakened by osteoporosis—can cause a stress fracture. What are the risk factors for getting a broken ankle? You might be at a higher risk of breaking your ankle if you: Participate in certain high-impact sports, such as football, basketball, tennis, soccer or gymnastics Don’t use proper equipment, footwear or technique during sports or exercise Have osteoporosis, which causes decreased bone density Suddenly increase the frequency, intensity or duration of exercise Reducing your risk of breaking an ankle To reduce your risk of getting a broken ankle, you should: Wear appropriate footwear for your activities, and replace your shoes routinely as they begin to wear out Warm up before beginning each exercise session, and work your way up when starting a new exercise routine Alternate your high-impact exercise routine, such as running, with a lower-impact exercise, such as swimming Take care of your bones by getting enough calcium and vitamin D Talk to your doctor if you aren’t sure what type of exercise program is right for you. A doctor can also check your vitamin D levels and recommend a supplement if necessary. If you’re at higher risk of hurting your ankle, ask your doctor what types of exercise can help you strengthen your ankle muscles. How is a broken ankle treated? Your doctor will examine your ankle, ask you questions about how you injured your ankle, and possibly order diagnostic imaging (X-rays, CT scan or MRI) to see which bones are broken and if any are out of place. Treatment for a broken ankle depends on which bones are broken and severity of the fracture. A small, stable ankle fracture may only need self-care, such as ice and elevation, along with supportive, protective footwear, such as high-top athletic shoes. A more severe fracture, where you can’t put weight on your ankle, usually requires wearing a short leg cast or a removable brace for about six weeks until the break heals. A severe, unstable broken ankle including bones out of alignment, may require surgery. During surgery, your surgeon will reposition any bones that are out of place and may use wiring, metal rods, or screws to hold the bones in place while they heal. Rehabilitation, physical therapy, and home exercises are all very important for strengthening the ankle muscles after a broken ankle. It may take several months before you can walk normally and return to regular activities. What are the potential complications of a broken ankle? After suffering a broken ankle, you might be at risk for other conditions or complications. Ankle joint stiffness, weakness, loss of range of motion, and arthritis Infection, if the bone broke through your skin Damage to nearby nerves or blood vessels Bones not healing properly Possible complications for ankle fracture surgery include: Pain, from the surgery and from the metal rods and screws Bones not healing correctly Infection, bleeding or blood clots Reaction to anesthesia Damage to nearby nerves, blood vessels, or tendons In children, a broken ankle may affect bone growth. See prompt medical care for a child with a possible broken ankle. A child who breaks an ankle should be checked regularly to make sure the leg and ankle bones are growing properly and evenly with the other leg.