Broken ankle

A misstep or twisting injury can cause bones to break. Treatment depends on where the injury is and how bad it is.

Update Date: 05.06.2025

Overview
Symptoms
When to see a doctor
Causes
Risk factors
Complications
Prevention
Diagnosis
Treatment
Preparing for your appointment
Overview
Symptoms
When to see a doctor
Causes
Risk factors
Complications
Prevention
Diagnosis
Treatment
Preparing for your appointment

Overview

A broken ankle, also called a fractured ankle, is an injury of one or more of the bones that make up the ankle joint. An ankle might break from a twisting injury, a misstep or fall, a sports injury or a car crash.

Fractures in ankle bones can range from tiny cracks to breaks in more than one place and breaks that come through the skin.

Treatment for a broken ankle bone depends on where the bone breaks and how bad the break is. A badly broken ankle may need surgery. Surgery involves putting plates, rods or screws into the broken bone to hold it in place while it heals.

Foot and ankle bones

A fall or blow to the ankle can break one or more of the three bones in the ankle joint: the fibula, the tibia and the talus. Rolling the ankle can cause a break in the knobby bumps at the end of the tibia and fibula.

Symptoms

A broken ankle might cause some of these symptoms:

  • Instant throbbing pain.
  • Swelling.
  • Bruising or bleeding under the skin.
  • Tenderness.
  • Loss of the usual shape of the joint, called deformity.
  • Trouble or pain with walking or putting weight on the foot.
  • Bone sticking through the skin, called an open fracture.

When to see a doctor

See a healthcare professional if the ankle has lost its shape, if the pain and swelling don't get better with self-care, or if the pain and swelling get worse over time. It's possible to walk on some fractures, so don't assume you don't need medical care if you can bear weight on your ankle.

Causes

A broken ankle is most often from a turning, twisting or rolling injury. But a direct blow to the ankle also can break it.

The most common causes of a broken ankle include:

  • Car accidents. The crushing injuries that can happen in car accidents may cause breaks that need surgery to be fixed.
  • Falls. Tripping and falling can break bones in the ankles. So can landing on the feet after jumping down from a height.
  • Missteps. Sometimes putting a foot down wrong or stumbling can result in a twisting injury that can cause a broken bone.

Risk factors

You may be at higher risk of a broken ankle if you:

  • Play high-impact sports. The stresses, direct blows and twisting injuries that happen in sports such as basketball, football, gymnastics, tennis and soccer can cause ankle bone breaks.
  • Use poor technique or sports equipment. Poor training techniques, such as not warming up, can raise the risk of ankle injuries. Bad equipment, such as shoes that are too worn or don't fit right, also can increase the risk of stress fractures and falls.
  • Suddenly increase your activity level. Whether you're a trained athlete or someone who's just started exercising, suddenly boosting how long, hard or often you exercise can increase your risk of a stress fracture.
  • Keep your home cluttered or poorly lit. Walking around in a house with too much clutter or too little light may lead to falls and ankle injuries.
  • Have certain conditions. Having decreased bone density, called osteoporosis, can put you at risk of injuries to your ankle bones.
  • Smoking. Cigarette smoking can increase the risk of getting osteoporosis. Studies also show that healing after a break may take longer in people who smoke.

Complications

Complications of a broken ankle aren't common. But they may include:

  • Arthritis. Fractures that go into the joint can cause arthritis years later. If your ankle starts to hurt long after a break, see your healthcare professional.
  • Bone infection, called osteomyelitis. If you have an open fracture in which one end of the bone pokes through the skin, your bone may be exposed to bacteria that cause infection.
  • Compartment syndrome. This condition rarely occurs with ankle fractures. It causes pain, swelling, numbness and sometimes being unable to use the affected muscles of the ankle.
  • Nerve or blood vessel damage. Trauma to the ankle can injure or tear nerves and blood vessels. Seek medical help right away if you notice numbness or feel like your ankle isn't getting enough blood. Lack of blood flow can cause a bone to die, called avascular necrosis.

Prevention

These sports and safety tips may help prevent a broken ankle:

  • Wear proper shoes. Use hiking shoes on rough terrain. Choose the right athletic shoes for your sport.
  • Replace athletic shoes when needed. Get rid of shoes as soon as the tread or heel wears out or if the wear on the shoes isn't even. If you're a runner, replace your shoes every 300 to 400 miles.
  • Start slowly. That applies to a new fitness program and to every workout you do.
  • Have a balanced fitness program. A balanced fitness program includes aerobic fitness to work your heart, strength training to build muscles and movements that put your joints through their full range of motion, called flexibility.
  • Build bone strength. Get enough calcium and vitamin D. Calcium-rich foods include dairy products, leafy greens and tofu. Ask your healthcare professional if you need to take vitamin D supplements.
  • Get rid of clutter in your home. Keeping clutter off the floor can help you not trip and fall.
  • Strengthen your ankle muscles. If you're prone to twisting your ankle, ask a healthcare professional or personal trainer for exercises to help strengthen the muscles that support your ankle.

Diagnosis

Your healthcare professional will look at your ankle, foot and lower leg and check for tenderness. Moving your foot around can show your range of motion. Your health professional might want to watch how you walk.

Tests

To diagnose a broken ankle, your healthcare professional might order one or more of these imaging tests.

  • X-rays. Most ankle fractures can be seen on X-rays. Stress fractures often don't show up on X-rays until the breaks start healing.
  • Bone scan. A bone scan can show breaks that don't show up on X-rays. A technician injects a small amount of radioactive material into a vein. The radioactive material makes damaged bones, including stress fractures, show up as bright spots on the image.
  • CT scan. A CT scan uses X-ray techniques to create detailed images of the bones in the body from different angles. Compared with X-rays, CT scans can show more detail about the injured bone and the soft tissues that surround it.
  • MRI scan. MRI uses radio waves and a strong magnetic field to create detailed images of the soft tissues around the ankle joint. This imaging can show breaks not seen on X-rays.

Treatment

Treatments for a broken ankle bone vary depending on which bone is broken and how bad the injury is.

Medicines

Your healthcare professional may suggest a pain reliever available without a prescription, such as acetaminophen (Tylenol, others).

Therapy

After your bone heals, you need to restore the motion and strength of your ankle. A physical therapist can teach you exercises to help you restore full motion and build strength.

Surgical or other procedures

  • Reduction. If you have a displaced fracture, meaning the two ends of the break are not lined up, your healthcare professional may need to move the pieces back into place. This process is called reduction. You may need medicine to relax your muscles, calm you or numb the area before this procedure.
  • Immobilization. Most often, a broken bone must be kept from moving so that it can heal. This is called immobilization. Most often, a special boot or a cast holds the ankle bones in place. You wear the boot or cast until the break heals. This can take 2 to 3 months.
  • Surgery. Sometimes, a surgeon who specializes in bones and joints, called an orthopedic surgeon, may put in pins, plates or screws to keep a bone in place while it heals. These materials may be removed after the break has healed or if they stick out of the skin or cause pain.

Preparing for your appointment

You will likely seek treatment for a broken ankle bone in an emergency room or urgent care clinic. If the pieces of broken bone aren't lined up for healing, you may be referred to a doctor specializing in orthopedic surgery.

What you can do

You may want to write a list that includes:

  • Your symptoms and how they began.
  • Other medical conditions you have.
  • All the medicines, vitamins and supplements you take, including doses.
  • Questions to ask the healthcare professional.

For a broken ankle, basic questions to ask include:

  • What tests do I need?
  • What treatments are there? Which do you suggest?
  • If I need a cast, how long will I need to wear it?
  • Will I need surgery?
  • How much will I need to limit my activities?
  • Should I see a specialist?
  • What pain medicines do you suggest?

Be sure to ask all the questions you have.

What to expect from your doctor

Your healthcare professional may ask questions, including:

  • How did you injure yourself?
  • Did your symptoms come on suddenly?
  • Have you injured your ankles in the past?
  • Have you recently begun an exercise program or started exercising more or harder?

What you can do in the meantime

If your injury isn't bad enough for you to go to an emergency room, here are some things you can do at home until you can see your healthcare professional:

  • Apply ice for 15 to 20 minutes at a time, every 3 to 4 hours, to lessen the swelling.
  • Keep your ankle raised above the level of your heart to help prevent swelling.
  • Don't put weight on your injured ankle.
  • Lightly wrap the injury in a soft bandage that provides slight pressure.

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