An ankle fracture occurs when a bone on one or both sides of the ankle is partially or completely broken. Most ankle fractures result from falls, jumps, sports, exercise, or trauma. In males, most ankle fractures occur between the ages of 10 and 19. Females experience more ankle fractures overall in all other age groups. Fracture types may vary from simple to complex. They may involve one, two, or three fracture areas. It is essential to seek evaluation after an ankle injury to determine if you have a fracture. Physical therapists play an important role in helping people recover from ankle fractures. They can help you return to regular activities in the safest and fastest way possible. Show
Physical therapists are movement experts. They improve quality of life through hands-on care, patient education, and prescribed movement. You can contact a physical therapist directly for an evaluation. To find a physical therapist in your area, visit Find a PT. Find a PT Near You! What Is an Ankle Fracture?An ankle fracture is when a bone on one or both sides of the ankle joint breaks, completely or partially. There are several ankle fracture types based on the number of bones broken. They are:
Fractures are measured in severity by whether they are:
When a fracture involves several broken bones, or the bones do not line up, the fracture is unstable and requires immediate treatment. There also is a higher risk for infection for individuals with a compound fracture. Signs and SymptomsPeople who fracture their ankles may experience:
How Is It Diagnosed?Ankle fractures are diagnosed using an X-ray and a physical exam. If you see a physical therapist first, they will perform a full evaluation. It will include questions about your medical history, how your injury occurred, and a physical exam. Your physical therapist will observe your ability to walk and bear weight on the injured ankle and examine the area for swelling, deformity, and tenderness. They also will assess your foot and lower leg to find out if other areas may be injured. If an ankle fracture is suspected, your physical therapist will refer you for an X-ray. If the X-ray reveals a fracture, you will be referred to an orthopedic doctor, podiatrist, or the emergency room for further treatment. It is important to have an ankle injury assessed by your physical therapist or doctor soon after your injury to determine whether you have a severe ankle sprain or a broken bone. If the bone pierces the skin, go immediately to a hospital emergency room. How Can a Physical Therapist Help?When ankle fractures require immobilization using casting or a protective boot, or the use of crutches to get around, your joints can become stiff. Also, sometimes surgery and casting are needed to repair a fracture. Whether or not you have surgery, a physical therapist can help restore proper joint movement and flexibility after your cast comes off. Physical therapy also can help you safely regain strength in the ankle you have not used during casting. Before SurgeryIf you have an ankle fracture, treatment will depend on the number of broken bones and whether you have a simple, complex, or compound fracture. Initial treatment involves realigning and stabilizing the bones by a doctor, often with a cast. This treatment will be done in the hospital emergency room or, if needed, with surgery. If you require surgery, you may see a physical therapist prior to surgery, who will:
After SurgeryIf your ankle fracture requires surgery, your doctor will cast it or provide you with a fracture boot to stabilize it post-surgery. A physical therapist will visit your hospital room once you are medically stable. They will help you sit on the bedside, get up and out of bed, and then balance to stand on your uninjured leg. The surgeon will give instructions as you may or may not be allowed to put any weight on the involved ankle for about six to 10 weeks. Your physical therapist will teach you how to walk using crutches or a walker and manage steps and curbs. When an X-ray confirms that the fracture has healed, your doctor will remove your cast. Your physical therapist will work with you to safely progress to putting weight on your ankle. They will begin treatment to help you gain back your strength, range of motion, balance, and sports skills so you can return to your regular activities. If You Do Not Need SurgeryA physical therapist can help treat a broken ankle after repair by a doctor, who will use casting to realign the bone, or apply a boot. Once the bone heals, a physical therapist can help you gain back your strength, range of motion, balance, and sports skills. While your ankle is in a cast and you cannot bear weight on it, your physical therapist can teach you how to walk using crutches or a walker. They will teach you how to get in and out of bed and your car, and use stairs. Your physical therapist will provide you with the equipment that best suits your needs. When an X-ray shows that your bone has healed enough, your doctor will remove your cast. You then will begin bearing weight on that leg and continue or begin your physical therapy treatment. Your treatment plan may include:
Return to full participation in sports and work activities generally occurs 12 to 16 weeks after an ankle fracture. Note: Physical therapy treatment and recovery times differ for each person. This will depend on your type of injury, how well you are healing, and whether you had surgery. Your age and physical health will also be factors. Can This Injury or Condition Be Prevented?Not all ankle fractures can be prevented. However, you can take the following precautions to reduce your risk of an ankle injury:
You also can do the following practical things to reduce your risk of falling:
What Kind of Physical Therapist Do I Need?All physical therapists are prepared through education and experience to treat ankle fractures. However, you may want to consider:
You can find physical therapists in your area with these credentials and clinical expertise on Find a PT, a tool built by the American Physical Therapy Association. General tips when you are looking for a physical therapist (or other health care provider):
Find a PT Near You! Is this content helpful?Thank you for the feedback. Thank you. Your feedback has been sent. The American Physical Therapy Association believes that consumers should have access to information to:
The following resources offer some of the best scientific evidence related to physical therapy treatment for incontinence. They report recent research and provide information on the standards of practice in the United States and internationally. They link to a PubMed* abstract (which may offer free access to the full text) or other resources. You can read them to learn more or bring a copy to your health care provider. Scheer RA, Newman JM, Zhou JJ, et al. Ankle fracture epidemiology in the United States: patient-related trends and mechanisms of injury. J Foot Ankle Surg. 2020;59(3):479−483. Article Summary on PubMed. Alshamrani HA, Alloub H, Burke D, Offiah AC. Vitamin D intake, calcium intake and physical activity among children with wrist and ankle injuries and the association with fracture risk. Nutr Health. 2019;25(2):113–118. Article Summary on PubMed. Jansen H, Jordan M, Frey S, Hömlscher-Doht S, Meffert R, Heintel T. Active controlled motion in early rehabilitation improves outcome after ankle fractures: a randomized controlled trial. Clin Rehabil. 2018;32(3):312–318. Article Summary on PubMed. Warner SJ, Garner MR, Nguyen JT, Lorich DG. Perioperative vitamin D levels correlate with clinical outcomes after ankle fracture fixation. Arch Orthop Trauma Surg. 2016;136(3):339–344. Article Summary on PubMed. *PubMed is a free online resource developed by the National Center for Biotechnology Information. PubMed contains millions of citations to biomedical literature, including citations in the National Library of Medicine's MEDLINE database. Details Expert Review: Apr 14, 2022 Symptoms & Conditions Ankle Fracture Author(s) Mary Kay Zane Expert Reviewer(s) Lisa Noceti-DeWit Stephen F. Reischl You Might Also Like...
Which of the following would be best to use to immobilize an ankle or foot injury?Depending on the severity of the sprain, your doctor may recommend an elastic bandage, sports tape or an ankle support brace to stabilize the ankle. In the case of a severe sprain, a cast or walking boot may be necessary to immobilize the ankle while it heals.
When splinting an injured body part should you?The basic rule of splinting is that movement above and below the injured, broken bone should be restricted. That helps to protect the fracture area. For example, if the injury occurred in the lower leg, the splint for the leg should limit both the knee and the ankle.
Why should you immobilize a musculoskeletal injury?Injuries that result in instability require immobilization, decreasing the likelihood of further damage, protecting soft tissues, alleviating pain, and accelerating healing.
For which type of injury in a child would a sling be most appropriate?Slings can be used for many different injuries. They are most often used when you have a broken (fractured) or dislocated arm, elbow, or shoulder.
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