FOOT AND ANKLE FRACTURES

A broken foot or ankle, or foot or ankle fracture, is a fracture or multiple fractures of one or more of bones in the ankle joint or foot.  David Larson, DPM, a fellowship-trained foot and ankle surgeon, specializes in Foot & Ankle Fractures. After an exam, Dr. Larson can determine your risk and make treatment recommendations. To make an appointment, call the office in Mesa or Phoenix, Arizona, or request an appointment today.

What is a Foot or Ankle Fracture?

A broken foot or ankle, or foot or ankle fracture, is a fracture or multiple fractures of one or more of bones in the ankle joint or foot. The primary bones where we most often see fractures are in the three ankle bones: 

• Tibia (shinbone)
• Fibula (outer ankle bone)
• Talus (which is the bone that connects your leg to your foot)

It is often hard to tell the difference between a break in the foot or ankle and a sprain, as symptoms can be similar. With an ankle sprain, the ligaments that connect bone to bone to provide stability of the ankle joints have been injured. Sprains can be in connection with ankle fractures.

What are the Symptoms of an Ankle Fracture?

The most common symptoms of a foot or ankle fracture are pain and swelling, which may be present only in the foot or ankle region itself. Swelling can also spread to other parts of the foot or up toward the knee. With a fracture, pain will often be intense when bearing weight. When pain persists, it’s a good idea to see a doctor who specializes in foot and ankle injuries, as a fracture left untreated can cause long-term problems, including ankle arthritis.

How Do You Diagnose a Foot or Ankle Fracture?

The first step in determining if it’s a fracture or sprain are X-rays. Other diagnostic tests your doctor may want to order a CT scan or MRI. These additional tests can help David Larson, DPM understand the full scope of the injury.

What Causes Foot and Ankle Fractures?

A common cause of foot and ankle fractures, notably ankle fractures are rotational injuries. These are injuries that involve twisting, turning or rolling while walking or running. Breaks can also be caused by high-force impact, called a traumatic fracture. Fractures can also be caused by repetitive stress – a stress fracture.

More About Stress Ankle Fractures

Ankle stress fractures are fairly common. They occur most often after a person has begun a new activity that involves significant impact of the foot, such as hiking, running or field sports. An active person who quickly increases their activity is also at risk for a stress fracture. Stress fractures can occur in any of the three ankle bones, especially the tibia or fibula. They are also common in the navicular bone. This bone is separate from the ankle but lies directly beneath the talus.

The Most Common Types of Ankle Fractures 

Lateral malleolus fracture 

A break of the lateral malleolus, the knobby bump on the outside of the ankle (in the lower portion of the fibula); this is the most common ankle fracture.

Bimalleolar ankle fracture 

The second-most common type of fracture where there is a break in both the lateral malleolus and of the medial malleolus, the knobby bump on the inside of the ankle (in the lower portion of the tibia).

Trimalleolar ankle fracture 

Here there is a break in three sides of the ankle: the medial malleolus of the tibia, as well as the lateral malleolus and posterior malleolus (in the lower portion of the fibula).

Pilon fracture (also called a plafond fracture) 

This is a fracture through the weight-bearing “roof” of the ankle (the central portion of the lower tibia). This fracture is usually due to trauma such as a fall.

Fractures will be either nondisplaced or displaced: 

• Nondisplaced Ankle Fracture 
• Bones are broken but still in correct position and alignment. 
• Displaced Ankle Fracture 
• Fractured portions of bone are separated or misaligned.

Fractures and Ankle Arthritis

It’s important to know that an ankle fracture can be linked to future ankle arthritis. When the number of fracture lines increase, so does the risk of long-term joint damage. Additionally, trimalleolar ankle fractures and pilon fractures have the most cartilage injury. Therefore, these fractures have a higher risk of arthritis in the future. This is why prompt attention to an ankle fracture is important. The quicker the fracture is treated effectively by a trained foot and ankle specialist, the better chance you will have of avoiding ankle arthritis in the future.

Contact David Larson, DPM to schedule an appointment for a consultation as soon as possible for full diagnosis.

What are the Most Common Types of Foot Fractures?

Fifth metatarsal fractures are the most common breaks of the foot. This is the long bone on the outside of the foot that connects to the little toe. Two types of fractures often occur here:   

• Avulsion fracture: A small piece of bone is pulled off the main portion of the bone by a tendon or ligament, typically caused when the ankle rolls. 
• Jones fracture: Occurs in a small area of the fifth metatarsal that receives less blood and is therefore more prone to difficulties in healing. These fractures can either be stress fractures due to overuse or an acute break. Jones fractures are less common and more challenging to treat than avulsion fractures. 
• Other types of fifth metatarsal fractures include midshaft fractures, which occur from trauma or twisting.

What are the Treatment Options for Foot and Ankle Fractures?

Certain mild breaks (stable and with no displacement) can be treated non-surgically with a splint, short leg cast, or other protective device such as a walking boot. Some patients may be able to walk immediately while wearing a support while others may have to use crutches to limit weight-bearing.

For more serious fractures in which bones or bone fragments are misaligned, surgical intervention is necessary to prevent improper healing (malunion) that would impede proper movement in the ankle and possibly lead to other complications.

Treatment is based on the alignment of the bones and the stability of the ankle joint. The goal is to have the bones heal as close to perfect as possible, preventing any residual instability or malalignment of the bone. A malalignment of as little as two millimeters in the ankle joint can lead to arthritis.

What Can I Expect for Recovery from Foot and Ankle Fracture Surgery?

For the average person, it takes about six weeks for bones to heal. If ligaments or other soft tissue are also damaged, healing can take longer. 

After surgery, patients are typically advised not to weight-bear for four to six weeks, allowing the bones to heal. Patients are placed on a pain management protocol. For the first couple of weeks, patients are in a splint and are elevating the limb 90% of the day. After 10 to 14 days, the sutures are removed, and patients are typically placed in a removable boot. Patients can start moving the ankle once the sutures are removed. X-rays are typically obtained around week six post-op. If the bone is healed, patients can then start weight-bearing and begin physical therapy. Six weeks of therapy or more is often required for a full recovery. 

If you suspect a foot or ankle fracture, it’s important to seek treatment with a qualified foot and ankle surgeon. Early intervention is key to maintaining the health of the ankle joint over the long term. To learn more about Foot and Ankle Fractures, make an appointment at the practice of David Larson, DPM, today. Call the nearest office to speak with a staff member or request an appointment online.