Table of ContentsView AllTable of ContentsCauses and SymptomsDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Causes and Symptoms
Diagnosis
Treatment
Alateral malleolus fractureis a break in the bone on the outside of your ankle joint. The lateral malleolus is part of thefibula, the smaller of two bones of the lower leg that carries around 10% of your body weight.
Lateral malleolus fractures are the most common type ofankle fractureand one that can occur when you take a wrong step and twist or roll your ankle. Most are stable ankle fractures, meaning that the ankle joint remains aligned and able to move normally. These types of fractures don’t require surgery.
This article describes the symptoms of a lateral malleolus fracture, including how it is diagnosed and treated.
Verywell / Cindy Chung
What Are the Symptoms of a Lateral Malleolus Fracture?
The pain and swelling can spread to other parts of the foot or up toward your knee.
In addition to the fracture itself, there may be pain and swelling on the inside of your ankle. This may be a sign of an injury called abimalleolar equivalent fracture.
Stable vs. Unstable FracturesMost lateral malleolus fractures are stable (non-displaced). However, impact injuries can sometimes cause unstable fractures. These includedisplaced fractures(where the broken bone fragments are separated) andopen fractures(when the broken bones break through the skin).
Stable vs. Unstable Fractures
Most lateral malleolus fractures are stable (non-displaced). However, impact injuries can sometimes cause unstable fractures. These includedisplaced fractures(where the broken bone fragments are separated) andopen fractures(when the broken bones break through the skin).
How Is a Lateral Malleolus Fracture Diagnosed?
A lateral malleolus fracture is usually not too serious, but your healthcare provider will likely want to order imaging tests to check for signs of an unstable fracture. Aplain film X-rayis usually all that is needed to confirm the diagnosis.
If the injury is severe and/or there is a risk of a soft tissue injury, acomputed tomography (CT)scan ormagnetic resonance imaging (MRI)scan may be ordered. They both offer different benefits:
The good news is that most isolated lateral malleolus fractures are stable. Even so, it is important to see a specialist (typically anorthopedistororthopedic surgeon) who can characterize the fracture and ensure that the right treatment is delivered.
How Is a Lateral Malleolus Fracture Treated?
A lateral malleolus fracture will not heal on its own and will require some form of treatment even if the fracture is stable.
For a stable lateral malleolus fracture, the treatment will mainly involve managing symptoms and giving your bones plenty of time to heal.
This typically includes:
How Long Do I Have to Keep Off My Foot?
When Is Surgery Needed?
You likely won’t need surgery for a stable lateral malleolus fracture. That’s because non-surgical treatments have proven just as effective with a far lower risk of complications.
This doesn’t mean that all lateral malleolus fractures are treated with rest. If an unstable fracture is left untreated and doesn’t heal correctly, it can lead to joint disfigurement, chronic pain, andankle arthritis.
In cases like this, surgery may be needed.
Ankle ORIF SurgeryOpen reduction internal fixation (ORIF)is a type of surgery used to reduce (align and reconnect) broken bone fragments with a metal plate and screws. The procedure may performed underregionalorgeneral anesthesia.External fixation(using metal appliances inserted through the skin) is rare unless the bone is shattered, which might occur after a car crash.
Ankle ORIF Surgery
Open reduction internal fixation (ORIF)is a type of surgery used to reduce (align and reconnect) broken bone fragments with a metal plate and screws. The procedure may performed underregionalorgeneral anesthesia.External fixation(using metal appliances inserted through the skin) is rare unless the bone is shattered, which might occur after a car crash.
Open reduction internal fixation (ORIF)is a type of surgery used to reduce (align and reconnect) broken bone fragments with a metal plate and screws. The procedure may performed underregionalorgeneral anesthesia.
External fixation(using metal appliances inserted through the skin) is rare unless the bone is shattered, which might occur after a car crash.
If ORIF is needed, the fracture will usually heal within four to six weeks. The first couple of weeks would involve an ankle splint and elevation of the foot for around 90% of the day. After that, you can replace the splint with a removable boot. When X-rays show ample healing, you can startweight-bearing exercisesunder medical supervision.
Even so, surgery is relatively uncommon with lateral malleolus fractures, and some experts question whether ORIF should be the standard of care for all displaced ankle fractures.
Summary
Lateral malleolus fractures involve the bump of bone on the outside of your ankle. They can happen when you take an awkward step and roll or twist your ankle. Most are stable fractures in which the broken bone fragments remain aligned.
Surgery usually isn’t required with an isolated lateral malleolus fracture. Instead, rest, ice application, elevation, anti-inflammatory drugs, and ankle support should be enough for the ankle to heal correctly. In severe cases, open reduction internal fixation (ORIF) surgery may be needed.
6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.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):377-88. doi:10.3238/arztebl.2014.0377Aiyer AA, Zachwieja EC, Lawrie CM, Kaplan JRM.Management of isolated lateral malleolus fractures.J Am Acad Orthop Surg. 2019;27(2):50-59. doi:10.5435/JAAOS-D-17-00417American Academy of Orthopedic Surgeons.Ankle fractures (broken ankle).Ewalefo SO, Dombrowski M, Hirase T, et al.Management of posttraumatic ankle arthritis: literature review.Curr Rev Musculoskelet Med. 2018;11(4):546-57. doi:10.1007/s12178-018-9525-9Frangie R.Ankle fracture: open reduction and internal fixation.Operative Dictation Orthop Surg. 2013:231-233. doi:10.1007/978-1-4614-7479-1_64Frederiksen JO, Malmberg C, Karimi D, et al.Surgical treatment of displaced isolated lateral malleolar fractures: incidence of adverse events requiring revision: a retrospective cohort study.J Orthop Surg Res.2022;17:252. doi:10.1186/s13018-022-03135-z
6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.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):377-88. doi:10.3238/arztebl.2014.0377Aiyer AA, Zachwieja EC, Lawrie CM, Kaplan JRM.Management of isolated lateral malleolus fractures.J Am Acad Orthop Surg. 2019;27(2):50-59. doi:10.5435/JAAOS-D-17-00417American Academy of Orthopedic Surgeons.Ankle fractures (broken ankle).Ewalefo SO, Dombrowski M, Hirase T, et al.Management of posttraumatic ankle arthritis: literature review.Curr Rev Musculoskelet Med. 2018;11(4):546-57. doi:10.1007/s12178-018-9525-9Frangie R.Ankle fracture: open reduction and internal fixation.Operative Dictation Orthop Surg. 2013:231-233. doi:10.1007/978-1-4614-7479-1_64Frederiksen JO, Malmberg C, Karimi D, et al.Surgical treatment of displaced isolated lateral malleolar fractures: incidence of adverse events requiring revision: a retrospective cohort study.J Orthop Surg Res.2022;17:252. doi:10.1186/s13018-022-03135-z
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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):377-88. doi:10.3238/arztebl.2014.0377Aiyer AA, Zachwieja EC, Lawrie CM, Kaplan JRM.Management of isolated lateral malleolus fractures.J Am Acad Orthop Surg. 2019;27(2):50-59. doi:10.5435/JAAOS-D-17-00417American Academy of Orthopedic Surgeons.Ankle fractures (broken ankle).Ewalefo SO, Dombrowski M, Hirase T, et al.Management of posttraumatic ankle arthritis: literature review.Curr Rev Musculoskelet Med. 2018;11(4):546-57. doi:10.1007/s12178-018-9525-9Frangie R.Ankle fracture: open reduction and internal fixation.Operative Dictation Orthop Surg. 2013:231-233. doi:10.1007/978-1-4614-7479-1_64Frederiksen JO, Malmberg C, Karimi D, et al.Surgical treatment of displaced isolated lateral malleolar fractures: incidence of adverse events requiring revision: a retrospective cohort study.J Orthop Surg Res.2022;17:252. doi:10.1186/s13018-022-03135-z
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):377-88. doi:10.3238/arztebl.2014.0377
Aiyer AA, Zachwieja EC, Lawrie CM, Kaplan JRM.Management of isolated lateral malleolus fractures.J Am Acad Orthop Surg. 2019;27(2):50-59. doi:10.5435/JAAOS-D-17-00417
American Academy of Orthopedic Surgeons.Ankle fractures (broken ankle).
Ewalefo SO, Dombrowski M, Hirase T, et al.Management of posttraumatic ankle arthritis: literature review.Curr Rev Musculoskelet Med. 2018;11(4):546-57. doi:10.1007/s12178-018-9525-9
Frangie R.Ankle fracture: open reduction and internal fixation.Operative Dictation Orthop Surg. 2013:231-233. doi:10.1007/978-1-4614-7479-1_64
Frederiksen JO, Malmberg C, Karimi D, et al.Surgical treatment of displaced isolated lateral malleolar fractures: incidence of adverse events requiring revision: a retrospective cohort study.J Orthop Surg Res.2022;17:252. doi:10.1186/s13018-022-03135-z
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