Patients are often confused by the words break and fracture. These words are synonymous and mean the exact same thing. A fracture of the ankle can involve any of the three bones associated with the ankle joint: the talus, tibia or fibula. The tibia and/or fibula are the most commonly affected when ankle fractures occur. These injuries can vary in severity from a small simple avulsion fracture to an open (or compound) fracture where bone actually breaks the overlying skin. Open ankle fractures subject the bones and soft tissue to a greater chance of infection.
Immediate evaluation by a foot and ankle surgeon is imperative. If one is not available then the fracture should be evaluated by an emergency room physician. At your appointment the physician will likely take X-rays and may even ask for more advanced imaging studies such as a CT scan or an MRI. Your doctor will examine your foot and ankle for pain and deformity. Neurovascular status will also be evaluated to ensure that your blood vessels and nerves have not been compromised following your injury. Once your evaluation is complete, the initial treatment will consist of R.I.C.E:
- Rest: Staying off of the injured ankle to reduce the risk of further injury
- Ice: Applying ice to the area for 10-15 minutes per hour while awake will help reduce pain and swelling
- Compression: An elastic bandage like an ACE wrap may be used to help control swelling
- Elevation: Keeping the injured limb elevated at or above the level of your heart will help lessen swelling and the throbbing that may occur after the injury
After your physician has thoroughly assessed the extent of the ankle injury, they may recommend one of several definitive treatment plans. Simple fractures may be amenable to walking in a protective cast boot (cam walker) for several weeks, while a badly displaced fracture may require surgical care. Your physician will likely immobilize your ankle in a splint/cast or cast boot at your initial visit.