(Fibula Fracture; Tibia Fracture)
Ankle fractures can involve the bump of bone on the outside of the ankle (lateral malleolus), which is the end of the smaller leg bone in the lower leg (fibula). Or they can involve the bump on the inside of the ankle (medial malleolus), which is the end of the larger leg bone (shinbone, or tibia), or the back lower end of the shinbone (posterior malleolus) or, more often, both.
Ankle fractures are common. The ankle may fracture when the foot is forced up or down or rolls in or out. The ankle may fracture in more than one place. Sometimes the top of the fibula (near the knee) is also fractured.
The ankle joint consists of three bones:
These three bones are connected by several ligaments, which form a ring and make the ankle stable. Fractures often disrupt the ring in more than one place. For example, if one of the bones is fractured, a ligament is often severely torn at the same time. If a fracture disrupts two or more structures in the ring, the ankle is unstable.
Sometimes when force is applied to a ligament in the ankle, the ligament breaks off a small chip of bone at the point where the ligament attaches to the bone. This type of fracture, called an avulsion fracture, may feel more like a severe sprain rather than a broken bone.
To check for fractures, doctors examine and gently feel (palpate) the ankle. If they suspect a fracture, they take several x-rays to confirm (or rule out) the fracture.
Based on results of the examination and x-rays, doctors determine whether the ankle is stable or not. Then they can determine the best treatment.
For most stable ankle fractures (including avulsion fractures), a cast is required for about 6 weeks. These fractures usually heal well.
For unstable fractures, surgery may be required. Usually, open reduction with internal fixation (ORIF—see Surgery) is done. After such injuries, the ankle may not be as strong as before.