Broken Ankle and Fractured Ankle

Brad Nakase, Attorney

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Ankle Ligaments

There are bones in the leg called tibia, fibula, and talus. The talus is connected to the tibia and fibula. They are all held together by ligaments. A ligament is a strong tissue in a joint that allows limbs to move in specific motions. The tibia-fibula ligament is located just above the ankle. The ligament itself is composed of a protein, collagen.

The deltoid ligament is located on the inside of the ankle and has two layers. Severe ankle bone fractures may damage this ligament.

The lateral ligament is on the outside of the ankle. This ligament is made up of three layers from front to back: the anterior talo-fibular ligament, calcaneo-fibular ligament, and posterior talo-fibular ligament. An ankle sprain affects the front and middle ligaments.

About 15 percent of ankle sprains involve the front ligament; the healing time for this injury may be lengthy. Generally, injury generally does not require surgery.

Ligament Damage

When a foot twists inward, damage to an ankle ligament will likely happen. The anterior and middle fibers of the ankle stretch, tear, or sprain under the body’s weight.

Additionally, the strain may displace pieces of bone along, damage cartilage lining, tear other ligaments, or cause pain to nearby tendons.

Ankle Sprain

Most ankle sprains heal with time and simple methods. Follow the RICE rules:

  • Rest – do not place weight onto the injured joint for a whole day
  • Ice – Reduce swelling by applying an ice pack or frozen bag of peas for 10-15 minutes, 3-4 times a day
  • Compression – Reduce swelling by using a bandage or strap
  • Elevation – Reduce swelling by elevating the ankle above the height of the body

After 2-3 days of the injury, placing a bit of weight on the injured joint and practicing stretches can be healthy.

Usually, a sprained ankle will recover within 6-8 weeks, although it may tend to swell for a few months longer.

Medical Attention

Seek professional advice for a severe ankle injury immediately. Physical therapy may be required. Here are some ways to know that an injury is severe:

  • The ankle is in so much pain that the ability to walk is lost
  • There are visible and obvious physical changes
  • The skin has been broken or damaged over the ankle
  • The injury occurred after a severe fall or blow
  • Pain and swelling does not improve after the first 3-4 days

Long-Term Effects

Uncommonly, there is a possibility that damage will permanently affect the ankle. Ligaments may not recover or heal properly and lose strength. Ankles may continue to be unstable, and pain may not go away completely.

Ankle Instability

A doctor or physical therapist will examine the injury and surrounding areas to identify abnormalities.

If a doctor suspects bone damage, an X-ray may be helpful. Specific X-Ray or MRI procedures may be taken to study possible ligament damage.

Ligament damage can lead to ankle instability. Physical therapy and rehabilitation will minimize long-term effects. There will be two areas of concentration: strength and balance. Through various exercises, a physical therapist will work to rebuild these areas. Other considerations, such as a stiff Achilles tendon, will also be monitored.

A foot’s shape can affect the amount of stress on ankle ligaments, and a customized shoe insole may be required to reduce strain.

An orthopedic foot and ankle surgeon may help if physical therapy has not improved strength and balance. The surgeon may perform an arthroscopy to examine the joint. An operation might be required if there are signs of weakness of the ankle ligaments.


An operation helps to tighten and re-attach ligaments to the bone. Additionally, a surrounding tendon can be used to replace ligaments.

The patient wears a cast for six weeks after surgery; following surgery the patient must support the ankle with a brace up to two months. The patient will attend physical therapy sessions soon after to rebuild strength and mobility. After three months, the patient can perform light exercise that does not involve any twisting of the body. Typically, regular exercise is allowed after six months.

Complications After Surgery

  • The ankle may be tighter than before the injury
  • Numbness or tingling of the foot
  • Excessive swelling continues
  • Ankle is stiff
  • Ankle is still unstable

Persistent Swelling

There may be additional injury to area around the talus, tibia and fibula when there is swelling several months after injury. Contact a general practitioner or physical therapist.

Risk Reduction

Be mindful of surroundings and avoid heeled shoes that increase stress on ankles. Many exercises can help to strengthen this area of the body. Practice stretches and remain active to support a healthy body.

Warm-up and cool down properly when playing sports. You may reduce the risk of injury by supporting the ankles with straps.

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