How serious can a broken foot be

Ankle fracture

Mostly a sports accident is the reason: If you twist your foot too much, you can break your upper ankle. One or more bones can be affected. An ankle fracture is a serious injury.

At a glance

  • An ankle fracture usually occurs during exercise.
  • If the foot bends too much, the upper ankle can break.
  • An ankle fracture is a serious injury that can affect one or more bones.
  • A fracture usually heals without problems after a while.

Note: The information in this article cannot and should not be used as a substitute for a doctor's visit and should not be used for self-diagnosis or self-treatment.

What is an ankle fracture?

If you bend your foot sharply, the ankle can be sprained. This injures the muscles and soft tissue around the ankle. In some cases, the foot kinks so badly that not only is the ankle sprained, but the ankle is broken as well. Doctors then speak of an ankle fracture. This is a serious injury. One or more bones of the ankle joint may be affected. If the ankle breaks, the ligaments are also often torn and the cartilage damaged. As a rule, an ankle fracture heals without any problems after a while.

What are the symptoms of an ankle fracture?

If the ankle breaks, the foot swells, hurts and bruises (hematomas) form. Those affected can no longer step and hardly move their feet. In some cases, the fracture also displaces the bones. This can lead to a misalignment.

What are the causes of an ankle fracture?

The most common ankle fracture occurs during exercise. For example, if you fall unhappy or sit down badly after a jump, you can twist your foot so badly that the joint breaks. Running on uneven ground or missteps can also lead to ankle fractures.

How does an ankle fracture work?

If the ankle fractures, it will take several days or weeks for the swelling to subside. It can take months for the ankle to heal completely. In the meantime, the foot is only limited in its resilience and mobility.

If the foot is loaded again too soon, the healing process can be disturbed. Therefore, if the fracture does not heal properly, further treatment may be necessary. However, the foot can also lose strength and mobility if it is immobilized for too long.

An ankle fracture usually heals well. One possible long-term consequence is osteoarthritis. The ankle joint can also remain unstable after a fracture. This increases the risk of injuring yourself again if you twist your ankle.

How is an ankle fracture diagnosed?

For the diagnosis, the doctor asks how the injury came about. Then the foot and ankle will be examined to determine how severe the injury is. If the ankle is suspected of being broken, it will be x-rayed. In some cases, an x-ray does not provide a clear diagnosis. Other methods are then used to take other images of the inside of the ankle - for example, with so-called computed tomography (CT) or magnetic resonance tomography (magnetic resonance imaging, MRI). Injuries to the articular cartilage and ligaments can often be better identified with magnetic resonance imaging.

How is an ankle fracture treated?

In the event of an ankle fracture, the foot and ankle are first immobilized, elevated and, if necessary, also cooled. Immobilization using plaster casts, bandages, splints or orthotics is important so that the joint is protected and can heal undisturbed. Usually they need to be worn for around 6 weeks. If bones have shifted due to the fracture or if bones have slipped out of the joint, the doctor can adjust them again. In some cases, surgery is also necessary.

Anyone who has broken their ankle can, after a while, start putting weight on and strengthening the joint in small steps. When the time is right to begin light exercise or physical therapy (physiotherapy) depends on how severe the injury is. In some cases, light exercises can be started just a few days after the fracture or surgery. Sometimes this only works after the splint or plaster cast has been removed. Since the foot is initially immobilized for a longer period in the event of an ankle fracture, it can be useful to prevent a possible thrombosis with injections.

Anyone who breaks an ankle fracture does not necessarily have to undergo an operation. Whether a surgical procedure is necessary depends, among other things, on:

  • how pronounced the break is.
  • where the ankle is broken.
  • whether it is an open break.
  • whether vessels or nerves are injured.
  • whether the bone parts have shifted.

If the joint is operated on, screws and plates can be used. They hold the broken bones together and make them grow back together.

Even after an operation, the ankle is immobilized with the help of a splint, bandage or a plaster cast. Some bandages and splints can be removed. Depending on the case, the screws and plates can be removed again when the break has healed and the bones have grown back together.

You can find more detailed information, such as what helps to get back on your feet after an ankle fracture, at

  • Working Group of the Scientific Medical Societies in Germany (AWMF). Venous thromboembolism (VTE) prophylaxis. S3 guideline. AWMF registration number 003-001. 10.2015. Accessed on June 15, 2020.
  • German Society for Trauma Surgery (DGU). Revised guideline S2-e: Ankle fracture. Trauma surgery guidelines. AWMF registration number 012-003. Accessed on June 15, 2020.
  • Goost H, Wimmer MD, Barg A, Kabir K, Valderrabano V, Burger C. Fractures of the ankle joint: investigation and treatment options. Dtsch Arztebl Int 2014; 111 (21): 377-388. Accessed on June 15, 2020.
  • Lin CW, Donkers NA, Refshauge KM, Beckenkamp PR, Khera K, Moseley AM. Rehabilitation for ankle fractures in adults. Cochrane Database Syst Rev 2012; (11): CD005595. Accessed on June 15, 2020.

In cooperation with the Institute for Quality and Efficiency in Health Care (IQWIG). Was standing: