Injured ankle wrapped in gauze

Do All Ankle Fractures Need Surgery?

Your body has 206 bones. They can all break.

But based on the location and severity of the fracture, your symptoms, treatment, and recovery can vary widely.

Even something as simple-sounding as “a broken ankle” can mean many things, because the ankle joint actually consists of three bones:

  • Your shinbone, known as the tibia
  • A smaller bone of the lower leg called the fibula
  • The talus, a small bone that sits between the calcaneus (your heel bone) and the other two bones

Any of these bones can break, and treatment options depend on which bone — and where on each bone (the inside, the back, the end) — the fracture occurs.

Not all ankle fractures require surgery. This article will explain different kinds of ankle fractures and whether they can be treated without surgery. 

Causes, Symptoms, and Diagnosis of Ankle Fractures

The most obvious cause of any fractured bone is trauma from something hitting it or when it hits something hard enough to break. A broken ankle can occur from twisting, rotating, or rolling your ankle, especially if your ligaments (tissues that connect bone to bone) are weak. An ankle fracture could also be accompanied by ligament damage.

Fractures almost always cause pain, and often cause bruising in the area. You’ll likely find it difficult to walk and bear weight, the area will hurt to the touch, and your foot might look different due to swelling or the bone being out of place.

Diagnosing whether you have a fracture (instead of a sprain or strain) and its severity will require one or more tests, including an X-ray, CT or MRI scan. 

The Different Kinds of Ankle Fractures

The diagnosis will determine what kind of ankle fracture you have, which could include:

  • Lateral malleolus fracture: The most common type of ankle fracture is a break of the lateral malleolus, the knobby bump in the lower area of the fibula, on the outside of the ankle.
  • Pilon fracture: This occurs in the shinbone, near the ankle. Though it affects only one bone (unlike the two kinds of fractures listed below), it is a serious fracture.
  • Bimalleolar ankle fracture: This is when there’s a break of the fibula and at the base of the tibia (“bi” meaning “two”).
  • Trimalleolar ankle fracture: As “tri” means “three,” this is when you have fractures in three areas: the medial malleolus (the inner part of the lower tibia), the lateral malleolus (as described above) the posterior malleolus (the back part of the tibia). This is a severe kind of fracture, but rare.

Nonsurgical Treatment of an Ankle Fracture

If the fractured ankle is not out of place, and if it occurs in just one or two places. you may not require surgery. This treatment could include wearing a brace or a short cast, with instructions not to put any weight on the ankle for several (four to six) weeks.

Surgical Treatment of an Ankle Fracture

If the fractured ankle is out of place, if the bone or bones are fractured in multiple locations, or if it’s an open fracture (meaning bone pokes through the skin) surgery may be required. The procedure will be based on the location(s) of the fracture(s), and may require a bone graft (adding transplanted bone or bone-like material) as well as a combination of screws, plates, and wiring to help keep the ankle stable.

Contact Our NJ Orthopedic Foot Surgeon About Treating an Ankle Fracture 

Schedule an appointment with our NJ orthopedic foot surgeon today about diagnosing foot conditions including ankle fractures, in addition to exploring both surgical and nonsurgical treatment options.