Ankle Fracture

The ankle joint is comprised of the tibia (shinbone), fibular and the talus. The tibia and fibula form the ‘mortice’ for the ankle joint and can be felt as the bony prominence on the inside and outside of the ankle. The distal tibia and fibula are held together by the tibiofibular syndesmosis.

An ankle fracture is usually caused by trauma such as a fall, a twisting injury (such as rolling your ankle) and sports related injuries. Therefore ankle injuries can reported both in the younger athletic population as well as the older adult.

Symptoms

Following an acute ankle fracture, there are usually reports of:

• Pain

• Swelling

• Bruising that appears soon after the injury

• Potential evident deformity 

• Difficulty or inability to weight bear 

Diagnosis

A mechanism of injury that could potentially lead to an ankle fracture, such as rolling your ankle, could also affect the ligaments that reside on the inside and outside of your ankle. It is therefore important to perform a thorough assessment to decide whether your symptoms are a result of a severe ankle sprain or an ankle fracture. The Ottowa ankle rules provides high sensitivity and specificity as to whether the ankle may be fractured and should this be the case, an x-ray would be required to rule out any fracture.

How Can Physiotherapy Help?

If an ankle fracture is identified, a period of immobilisation with progressive weight bearing will be suggested if the fracture is undisplaced, or may require surgery with a period of non-weight bearing and immobilisation if the fracture is displaced. Typically this would be a period of 6 weeks approximately, after which time the ankle can start to be mobilised.

During your recovery physiotherapy can help with:

• Mobility and functional adaptations while you recover

• Advice and exercise 

• Pain management, including scar desensitisation

• Home exercise programme – both once out of a boot however focussing on other parts of the lower limb during the immobilisation phase

• Massage and mobilisation

• Graded return to sport