A broken (fractured) ankle needs to be treated as soon as possible. It typically takes between six and 12 weeks to heal.
How to tell if your ankle is broken
Symptoms of a broken ankle include:
- severe pain and tenderness
- bruising and swelling
- difficulty moving your foot or putting weight on it
- the ankle being an odd shape (dislocated)
- a snap or grinding noise at the time of the injury
- bleeding (if the bone has damaged the skin) – sometimes the bone may poke through the skin
Because of the shock and pain of breaking your ankle, you may also feel faint, dizzy or sick.
It can be hard to tell the difference between a minor break and a sprain. It's best to assume it's a fracture until it has been checked by a doctor or nurse.
What to do if your ankle is broken
If you think you or someone else has a broken ankle:
avoid moving or putting weight on the affected leg – try to keep it raised and supported (for example, on a cushion)
stop any bleeding by applying pressure to the wound with a clean pad or dressing if possible
apply an ice pack (such as a bag of frozen peas wrapped in a tea towel) to the ankle if one is easily available
don't eat or drink anything in case you need surgery to fix the ankle when you get to hospital
Ask a friend or relative to drive you to hospital and support your weight as you walk on your other foot.
Treatment for a broken ankle
When you arrive at the hospital, you'll be given painkillers and an ankle support (splint) may be fixed to your ankle to secure it in position.
An X-ray will usually be carried out to check whether your ankle is broken and how severe the break is.
For a minor fracture:
- a supportive boot, splint or plaster cast will usually be fitted – sometimes this may be done a few days later, to allow any swelling to go down first (a splint may be left on until a boot or cast is fitted)
- you may be given crutches or a walking frame if your doctor advises you not to put weight on your ankle to begin with
- you'll be given painkillers to take home and told how to look after your boot or cast
- you'll probably be invited to follow-up appointments to check how your ankle is healing
For more serious fractures:
- a doctor may try to realign the broken bones with their hands – this will usually be done while you're awake, but your leg will be numbed and you may be given medicine to relax you
- you may need surgery to realign the bones – this will often involve putting wires, plates, screws or rods inside your leg, but sometimes a temporary external frame is used
- a supportive boot or cast will usually be fitted before you go home
- you'll be invited to follow-up appointments to check how your ankle is healing
Recovering from a broken ankle
The boot or cast will usually need to stay on for around six weeks, but it may be needed for longer if the break was severe and the bone is taking longer to heal.
While your ankle is in a boot or cast:
- follow your doctor's advice about putting weight on your ankle – you may need to use crutches for a few weeks, but if the break is minor you may be able to walk on it straight away
- avoid activities such as carrying anything heavy, driving and sports – ask friends or family for help with things like shopping
- keep the boot or cast dry and keep your leg raised (for example, on pillows) whenever possible
- wiggle your toes and bend your knee regularly to reduce stiffness – your doctor or a physiotherapist will advise you about this
- get medical advice if you notice changes in your skin colour, unusual sensations in your leg or foot, signs of infection (redness, swelling or smelly discharge), severe or persistent pain, problems with your cast (it's too loose, too tight or cracked), or lower leg pain
Speak to your doctor about when you can return to work and normal activities. They will probably suggest gradually increasing how much you use your ankle over a few weeks or months.
Your ankle may be uncomfortable, swollen, stiff and weak after the boot or cast is removed. A physiotherapist can help with these problems, although sometimes they can last several months or more.