Malleolar fracture; Tri-malleolar; Bi-malleolar; Distal tibia fracture; Distal fibula fracture; Malleolus fracture; Pilon fracture
An ankle fracture is a break in 1 or more ankle bones. These fractures may:
Some ankle fractures may require surgery when:
When surgery is needed, it may require metal pins, screws, or plates to hold the bones in place as the fracture heals. The hardware may be temporary or permanent.
You may be referred to an orthopedic (bone) doctor. Until that visit:
Without surgery, your ankle will be placed in a cast or splint for 4 to 8 weeks. The length of time you must wear a cast or splint depends on the type of fracture you have.
Your cast or splint may be changed more than once, as your swelling goes down. In most cases, you will not be allowed to bear weight on your injured ankle at first.
At some point, you will use a special walking boot as the healing progresses.
You will need to learn:
To reduce pain and swelling:
For pain, you can use ibuprofen (Advil, Motrin, and others) or naproxen (Aleve, Naprosyn, and others). You can buy these medicines without a prescription.
Acetaminophen (Tylenol and others) is a pain medicine that is safe for most people. If you have liver disease, ask your provider if this medicine is safe for you.
You may need prescription pain medicines (opioids or narcotics) to keep your pain under control at first.
Your provider will tell you when it is OK to place any weight on your injured ankle. Most of the time, this will be at least 6 to 10 weeks. Putting weight on your ankle too soon may mean the bones do not heal properly.
You may need to have your duties at work changed if your job requires walking, standing, or climbing stairs.
At a certain point, you will be switched to a weight-bearing cast or splint. This will allow you to start walking. When you start walking again:
You will need to have full strength in your calf muscle and full range of motion back in your ankle before returning to sports or work activities.
Your provider may do x-rays periodically after your injury to see how your ankle is healing.
Your provider will let you know when you can return to regular activities and sports. Most people need at least 6 to 10 weeks to fully heal.
Call your provider if:
Also call your provider if you have questions about your injury or your recovery.
McGarvey WC, Greaser MC. Ankle and midfoot fractures and dislocations. In: Porter DA, Schon LC, eds. Baxter's The Foot and Ankle in Sport. 3rd ed. Philadelphia, PA: Elsevier; 2021:chap 6.
Rose NGW, Green TJ. Ankle and foot. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 51.
Rudloff MI. Fractures of the lower extremity. In: Azar FM, Beaty JH, Canale ST, eds. Campbell's Operative Orthopaedics. 13th ed. Philadelphia, PA: Elsevier; 2017:chap 54.BACK TO TOP
Review Date: 7/8/2020
Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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