Ankle Fracture

What is an ankle fracture?

An ankle fracture is a break or crack in one or more of the bones that make up the ankle joint. These bones are the tibia, fibula, and talus.

What is the cause?

Usually a broken ankle happens when the ankle is twisted.

What are the symptoms?

When the ankle is broken, you may hear a snapping or popping sound. Symptoms may include:

• pain, swelling, bruising, or tenderness
• trouble moving the ankle or not being able to walk
• a grating feeling when your child moves the ankle (caused by broken bones moving against each other)
• tightness or pain caused by muscle spasms
• a change in the shape of the ankle

How is it diagnosed?

Your healthcare provider will ask about your child’s symptoms and how the injury happened. Your provider will examine your child. Your child will have X-rays of the ankle.

A child's bones are different from an adult’s bones in a couple ways. A child’s bones are more flexible and may crack rather than break. Or they may just buckle slightly. Also, the bones are still growing from areas near the ends of the bones called growth plates. A fracture in a growth plate may affect the growth of the bone but it may be hard to see with X-rays. Sometimes special tests are needed to diagnose fractures in the growth plate.

How is it treated?

The treatment depends on the type of fracture. If the broken bone is crooked, your healthcare provider will straighten it. Your child will be given some medicine first so the straightening is not painful. Sometimes surgery is needed to put the bones back into the correct position.

Your healthcare provider may put the ankle in a cast, splint, removable boot, or Aircast to keep it from moving while it heals.

How can I help take care of my child?

Follow the full course of treatment your healthcare provider prescribes. Also:

• To keep swelling down and help relieve pain, your healthcare provider may tell you to:
  • Put an ice pack, gel pack, or package of frozen vegetables wrapped in a cloth on the injured area every 3 to 4 hours for up to 20 minutes at a time for the first day or two after the injury.
  • Keep the injured ankle up on pillows when your child is sitting or lying down.
  • Give your child pain medicine, such as ibuprofen, as directed by your provider. Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, your child should not take the medicine for more than 10 days. Check with your healthcare provider before you give any medicine that contains aspirin or salicylates to a child or teen. This includes medicines like baby aspirin, some cold medicines, and Pepto-Bismol. Children and teens who take aspirin are at risk for a serious illness called Reye's syndrome.
• If your child has a cast, make sure the cast does not get wet. Cover the cast with plastic when your child bathes. Avoid scratching the skin around the cast or poking things down the cast. This could cause an infection.
• Your child may need to use crutches or a cane. Your healthcare provider will tell you how much weight your child can put on the leg, if any.
• Depending on the type of injury and how it was treated, your child may need to do special exercises to help the ankle get stronger. Most of the time preteen children are so active that their legs get stronger and more flexible without physical therapy.

Keep all appointments for provider visits or tests. Call your healthcare provider right away if:

• Your child has more pain, redness, warmth, or swelling.
• Your child has a fever.
• Your child has a loss of feeling in the injured area.
• The injured ankle or foot looks pale or blue or feels cold.

How long will the effects last?

Children tend to heal faster than adults, but healing times are different from one person to the next. As a rule, most fractures heal in 4 to 6 weeks.

How can an ankle fracture be prevented?

Most broken ankles are caused by accidents that are not easy to prevent. However, shoes that fit well and give good support can help prevent injury.