Table of ContentsView AllTable of ContentsFracture LocationsCommon TypesSymptomsTreatment
Table of ContentsView All
View All
Table of Contents
Fracture Locations
Common Types
Symptoms
Treatment
The stability of the joint after an ankle fracture and the necessary treatment hinge on exactly where the break occurs.
This article reviews the bones that may be involved in an ankle break, the most common types of these injuries, how they impact the joint, and related symptoms.
Jan-Otto / Getty Images
Ankle Bones and Break Locations
A broken ankle is not one specific injury. The ankle is a complex joint that forms where the following bones come together. If you fracture your ankle, there may be a break in one or more of these.
The bony prominences at the ankle are called themedial malleolus(the end of the tibia) and thelateral malleolus(the end of the fibula). The ends of these bones form a cup shape that the talus bone sits within.
When a broken ankle occurs, the injury may be to the end of the tibia (the medial malleolus) or to the fibula (the lateral malleolus), or both. Talus fractures can also happen, but they are less common.
Determining how to proceed with treatment depends, in part, on the location of the injury.
Most Common Types of Ankle Fractures
While there are many types of ankle fractures, some are more common than others.
It’s important not only to know what bones are affected with each type of ankle fracture, but whether the break renders the ankle stable or unstable, as this effects treatment.
The stability of an ankle fracture describes how the talus moves in relation to the ends of the tibia and fibula:Astable ankle fractureis one in which a bone is broken, but the movement of the talus is unchanged.With anunstable broken ankle,the talus does not move in a normal manner. This means that the joint is not held in a symmetric position.
The stability of an ankle fracture describes how the talus moves in relation to the ends of the tibia and fibula:
Lateral Malleolus Fractures
Bone(s) affected:Fibula
Fractures of the fibulaalone are the most common type of ankle fracture.
Many fibular fractures can be treated without surgery, but it is important to ensure the ankle joint remains stable. This means that even though there is a break in the bone, the ankle joint is still aligned normally.
If the ankle joint is unstable or the ligaments are damaged, then surgery is likely to be recommended.
Symptoms of Lateral Malleolus Fractures
Medial Malleolus Fractures
Bone(s) affected:Tibia
This fracture of the inner side of the ankle occurs to the bone on the end of the tibia (medial malleolus). An isolated medial malleolus fracture is much less common than an isolated lateral malleolus fracture.
In general, a displaced (out of position) medial malleolus fracture is treated with surgery.
Medial Malleolus Fracture and Broken Ankle Treatment
Bimalleolar Ankle Fractures
Bone(s) affected:Tibia and fibula
Bimalleolar ankle fracturesoccur when there is an injury to both the inner and outer side of the ankle.
These injuries always result in an unstable ankle joint, and in most patients, surgery will be recommended. If the fracture heals in anything less than a perfect position, the ankle joint alignment will be affected and could lead to accelerated arthritis of the ankle.
Even with surgical treatment, ankle cartilage can be damaged at the time of the fracture leading to a higher chance of arthritis. Still, you should aim to do as much as possible to repair these fractures properly to keep the chance of long-term problems as low as possible.
Bimalleolar Equivalent Fracture
This injury is only a fracture of the fibula, but there is also a tear of the ligaments on the inner side of the ankle.
This leads to instability of the ankle joint, just as if the inner side were fractured, and therefore can require surgery.
Trimalleolar Fracture
A trimalleolar ankle fracture is similar to a bimalleolar ankle fracture, but the bone in the back of the tibia is also fractured. The bone in the back of the tibia is called the posterior malleolus.
Posterior Malleolus Fracture
This is a rare injury in isolation.Fractures of the posterior malleolusare generally found in association with bimalleolar ankle fractures, in which case the injury is called a trimalleolar ankle fracture.
Maisonneuve Fracture
Bone(s) affected: Tibia and fibula
AMaisonneuve fractureis a less common injury, but needs to be considered as can easily be missed without a thorough examination.
In the Maisonneuve fracture, the bone is injured on the inner side of the ankle (the medial malleolus). While the lateral malleolus is intact, there is a fracture much higher up on the fibula bone, typically around the knee.
The force of this injury passes through the large ligament that connects the two leg bones, called the syndesmosis. Because of the damage to this supporting ligament, the ankle is unstable and surgery is most often necessary.
Talus Fracture
Bone(s) affected:Talus
Talus fractures usually occur on their own, without involvement of the tibia or fibula. Less than 1% of ankle fractures are talus fractures.
This injury typically occurs during a major traumatic event, such as a car accident.
Talus Fracture of the Ankle
Symptoms of a Broken Ankle
Commonsymptoms of an ankle fractureinclude:
There are clinical criteria used to differentiate ankle fractures from ankle sprains. These guidelines, called the Ottawa Rules, help determine if X-rays should be done in people who haveankle pain.
Treatment of a Broken Ankle
Once an ankle fracture is diagnosed, it is important to begin appropriate treatment. There are many treatments, both surgical and nonsurgical, and the right one depends on having the correct diagnosis.
Unstable ankle fractures are more likely to require invasive treatment.
Your surgeon can guide you on the best course of action in your case.
Summary
There are a number of different types of ankle breaks. These can occur in one or more of the three bones in your ankle: the tibia, the fibula, and the talus.
Ankle breaks can be stable or unstable. An unstable break affects the way the talus moves in relation to the tibia and fibula.
An ankle break may cause pain, swelling, bruising, and trouble walking. Treatment usually depends on the type of break.
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.Johns Hopkins Medicine.Tibia and fibula fractures.Elsoe R, Ostgaard SE, Larsen P.Population-based epidemiology of 9767 ankle fractures.Foot Ankle Surg. 2018;24(1):34-39. doi:10.1016/j.fas.2016.11.002American Academy of Orthopaedic Surgeons.Ankle fractures (broken ankle).Buyukkuscu MO, Kulduk A, Alpay Y, Pehlivanoğlu G.Simultaneous fracture of the tibia shaft and talar body - a case report.Trauma Case Rep. 2019;21:100204. doi:10.1016/j.tcr.2019.100204American Academy of Orthopaedic Surgeons.Talus fractures.National Library of Medicine.Ottawa ankle rules.
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.Johns Hopkins Medicine.Tibia and fibula fractures.Elsoe R, Ostgaard SE, Larsen P.Population-based epidemiology of 9767 ankle fractures.Foot Ankle Surg. 2018;24(1):34-39. doi:10.1016/j.fas.2016.11.002American Academy of Orthopaedic Surgeons.Ankle fractures (broken ankle).Buyukkuscu MO, Kulduk A, Alpay Y, Pehlivanoğlu G.Simultaneous fracture of the tibia shaft and talar body - a case report.Trauma Case Rep. 2019;21:100204. doi:10.1016/j.tcr.2019.100204American Academy of Orthopaedic Surgeons.Talus fractures.National Library of Medicine.Ottawa ankle rules.
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.
Johns Hopkins Medicine.Tibia and fibula fractures.Elsoe R, Ostgaard SE, Larsen P.Population-based epidemiology of 9767 ankle fractures.Foot Ankle Surg. 2018;24(1):34-39. doi:10.1016/j.fas.2016.11.002American Academy of Orthopaedic Surgeons.Ankle fractures (broken ankle).Buyukkuscu MO, Kulduk A, Alpay Y, Pehlivanoğlu G.Simultaneous fracture of the tibia shaft and talar body - a case report.Trauma Case Rep. 2019;21:100204. doi:10.1016/j.tcr.2019.100204American Academy of Orthopaedic Surgeons.Talus fractures.National Library of Medicine.Ottawa ankle rules.
Johns Hopkins Medicine.Tibia and fibula fractures.
Elsoe R, Ostgaard SE, Larsen P.Population-based epidemiology of 9767 ankle fractures.Foot Ankle Surg. 2018;24(1):34-39. doi:10.1016/j.fas.2016.11.002
American Academy of Orthopaedic Surgeons.Ankle fractures (broken ankle).
Buyukkuscu MO, Kulduk A, Alpay Y, Pehlivanoğlu G.Simultaneous fracture of the tibia shaft and talar body - a case report.Trauma Case Rep. 2019;21:100204. doi:10.1016/j.tcr.2019.100204
American Academy of Orthopaedic Surgeons.Talus fractures.
National Library of Medicine.Ottawa ankle rules.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
