Ankle Fractures

Description:

Ankle fractures (broken ankles) are a common injury in children and adolescents.  The ankle bones include the tibia (the shin bone) and the fibula (the smaller bone on the outside of the ankle).  Both of these bones have growth plates at the end.  When children and adolescents break their ankle, the break can go through the growth plate.  Sometimes the break can also go to the joint surface. There are many different types of ankle fractures, and treatment may be as simple as a boot or may require surgery for more severe ankle breaks.
 

Nondisplaced Fractures:

A nondisplaced fracture is one where there is a crack in the bone, but the bone has not shifted out of place. This is similar to if there is a crack in a plate or bowl, but the plate or bowl has not fallen apart. Most of the time, nondisplaced fractures can be treated with a boot or a cast.

Displaced Fractures

A displaced fracture occurs when the bone breaks and shifts out of position. Many displaced fractures can be treated with manipulation and casting. Some displaced fractures will require surgery to keep the bone lined up correctly, especially if the joint surface is involved.

Symptoms:

Broken ankles usually happen from a twist or fall.  Skateboard and scooter riding are also common ways to break an ankle.  When someone breaks their ankle, there is immediate pain and swelling.  Most people will not be able to walk or put their weight on a broken ankle.  Bruising happens a few hours later also. 
 

Examination:

Your doctor will check the ankle for swelling, bruising, and area of tenderness. He or she will also examine the nerves and the blood supply to the foot.  He or she will make sure that there are no other injuries and that the skin is healthy enough for either a cast or surgery if needed.
 

X-rays and Tests:

X-rays are the most common way to confirm the diagnosis of an ankle fracture.  Sometimes a CT scan is used look more closely at the joint surface and/or growth plates. 

Treatment

Depending on the way the bone is broken, walking boot or cast may be used for treatment.  Sometimes your doctor will want you to use crutches to keep the weight off of the ankle while the bones heal.  If the bones have moved or “displaced”, surgery may be recommended.   Sometimes the bones can be put back into place without surgery with a manipulation in the doctor’s office. 

Outcomes (Prognosis/Expectations):

Broken ankles usually heal within 6 to 12 weeks.    Return to sports may take longer.  Your doctor may follow the ankle for many months to be sure that the growth plates continue to grow properly.  Fractures that involve the joint do have a small risk of arthritis and stiffness even with proper treatment.
 

More Information:

• OrthoInfo - Ankle Fractures in Children