Broken Ankle Recovery Time

Broken Ankle Recovery Time: Severe dislocations may require surgery, but stable fractures require 6-8 weeks in a cast, then a walking boot or shoe brace.



Broken Ankle Overview:


  • The terms of ankle fracture and broken ankle are basically the same thing. This means that one of the bones of the ankle joint or broken, you can have multiple breaks with dislocations, or just one break in one area with no dislocation.
  • There is a range that can go from minimal breaking in only one spot of the ankle, versus a complete crushing and destruction of the ankle. Obviously the more severe complete crushing would take much longer to heal, if ever.
  • The more damage her ankle sustains, the more likely you are to need surgery. The tricky thing with ankle fractures, is that you may also have been damaged ankle joint ligaments. The ligaments of the ankle hold the bones together and in the correct position.
  • The problem with the broken ankle is, that you can develop long-term arthritis even if it does heal. The idea is to have the bones heal in a perfectly correct position, and reset the curtilage as much as possible, to prevent future rubbing and damage.



Ankle Joint Anatomy:

There are three bones that make up the ankle joint:

The talus: this is the top of the foot as it connects to the ankle joint. This is a bone that fits in between the tibia and fibula above it. This bone can move up and down for the most part, but not side to side within the ankle joint.


The fibula: this is the smaller bone that makes up the ankle joint. This bone only takes about 15% of the pressure of the fracture. If you simply have a small crack through here, you can get away without doing surgery. But if there is a severe fracture here, it may need to have to be replaced and fixed back into position.


The fibula makes up the lateral malleolus, this holds that outside of your ankle together. This holds the talus inside the lateral malleolus.


Lateral malleolus
Lateral malleolus anatomy. This bone holds the talus in the ankle joint.


Tibia: this is the shinbone, and much of the top half of the ankle joint. This takes about 85% of the pressure of the ankle joint. This bone is broken significantly, you may deftly need surgery, and have a long healing time.


Medial Malleolus
Medial Malleolus, this bone holds the inside of the talus.


The tibia has two major components that make up the ankle joint: these include the medial malleolus in the posterior malleolus. These are the prominences that wrap around the talus and hold it into position. The medial malleolus is towards the center line of your body, and the posterior malleolus is the back of your ankle.


Posterior malleolus
Posterior malleolus, this bone holds the back of the talus.



Classification of ankle joint fracture:


  • Doctors can classify the severity of the fracture, and the specific location of the fracture.
  • Specifically, if both the tibia and the fibula are broken, this is called a bi-malleolar fracture. Because both the medial and lateral malleolus are broken.
  • If the lateral, posterior and medial malleolus are all broken, this is then termed at tri-malleolar or fracture.


Foot Doctors can also classify the ankle fracture based on the severity:


  • If there is a fracture, which is not displaced. This is simply called the nondisplaced fracture.
  • If there is over 1 to 2 mm of motion, this is now called a displaced fracture.
  • If there is more than a few different cracks, the bone can almost crack into dust. This is referred to as a comminuted fracture. This is the most serious of fractures.
  • If the fracture is open to the skin, this is called an open fracture.
  • For example, the fracture can be called an open displaced fracture. This can also be a tri-malleolar fracture.


Causes of a broken ankle:


The most common causes of a broken ankle include:


  • Twisting or rotating your ankle.
  • Rolling your ankle down and inward.
  • Tripping or falling.
  • Severe fall injury.
  • A severe impact during a car accident or collision.
  • Bending or twisting during the sports game.


Broken ankle symptoms:


Sometimes it could be difficult to realize if you have a broken ankle, because it is just a much more severe sprained ankle. Like mentioned earlier, damaging the ligands movements can sometimes be more serious than a broken ankle.


The symptoms of a broken ankle that would lead you to believe it is broken rather than sprained include:


1)A history of  trauma:

  • A recently twisted or rolled ankle.
  • Tripping or falling.
  • Severe impact & falling may cause it.


2)Immediate pain directly after the trauma:

  • Severe pain.
  • Swelling of the affected area.
  • Bruising.
  • Tender to the touch.
  • Inability to bear weight on the ankle.
  • Obvious deformity on the ankle.



Broken Ankle Recovery Time
If the ankle is broken it will need to be immobilized or be repaired with surgery. Find out below whether casting or surgery is necessary.

Sprained Or Broken Ankle?


It is impossible to tell for sure if there is a broken bone. But some signs make a broken bone more likely:


  • Gross deformity.
  • Dislocation of the ankle.
  • Inability to move the ankle.
  • Cracking noise during the injury.


Broken Ankle Recovery Time
This is a definite broken ankle. No doubt about it!


Broken Ankle Swelling:


Swelling can occur with any ankle injury. It does not necessarily confirm that a bone is broken.


Swelling is common in:

  • Inversion ankle sprains.
  • High ankle sprains.
  • Deep vein thrombosis.
  • Lymphedema.
  • Venous insufficiency.


Broken Ankle Recovery Time
There is no way to know for sure whether this is a broken ankle or sprained ankle based on just the swelling pattern.


Broken Ankle X-ray:


  • An X-ray or CT scan is need to know the full extent of the break for sure.
  • It is impossible to be 100% certain whether an ankle injury is a fracture or not without it.
  • Even if it does not seem broken, an X-ray is usually still a good idea to make sure!


Broken Ankle Recovery Time
A break like this is usually obvious, but sometimes it is just a small chip fracture that may need to be confirmed!



Broken Ankle Cast vs.Broken Ankle Surgery:


1)Broken Ankle Cast:


  • The general rule is that if no bones are displaced or ligaments ruptured a broken ankle can be treated with a cast.
  • The downside is, if proper healing is not attained, arthritis may set in during the future.


Indications for a broken ankle cast include:


  • Non-displaced break.
  • Less that 1-2mm of displacement
  • Under 10 degrees of angulation deformity.
  • No ligament rupture.
  • No incongruity of the talar mortise.


2) Broken Ankle Surgery:


  • Surgery is usually needed if there is bone displacement or ruptured ligaments.
  • Without surgery there is a much greater risk of degenerative joint disease (ankle arthritis).
  • Mal-union & non-union of the fracture fragments are also very possible.


Indications for broken ankle surgery:


  • A displaced break.
  • More than 1-2mm of displacement.
  • Over 5-10 degrees of angulation.
  • Ligamentous rupture.
  • Incongruity of the talar mortise.
  • Widening of the medial  or lateral clear space of the ankle joint.



Broken Ankle Walking Boot Vs. A Cast:


1)Broken Ankle Cast:


This is usually needed in more severe situation where the podiatrist does not want to risk you walking on the fracture.


  • Impossible to take the cast off.
  • Better compliance.


2)Broken Ankle Walking Boot:


These are usually dispensed in less severe situation. Theoretically if the patient does not take the walking boot off, this should have the same offloading & healing capacity.


  • They do come off.
  • Can take it off to shower.
  • Can take it off during bed.
  • Otherwise should not walk on it.


Broken Ankle Recovery Time:


  • Broken ankle recovery time definitely depends on the severity.
  • A severely displaced ankle fracture will require surgery, possible plates and screws. This can require 2-3 weeks to heal the incision site, then a cast for 6-8 weeks.
  • If surgery is not necessary, then a cast may be required for 6-8 weeks, then a walking boot for a further 3-4 weeks.
  • X-rays are used in the mean time to check the progress of the fracture.
  • It is important not to start walking too early or you may develop arthritis or a deformity of the ankle.
Broken Ankle Physical Therapy:


  • Physical therapy is definitely needed to optimize recovery.
  • The dangers of not having physical therapy following an ankle fracture are the lack of joint flexibility.
  • It is very easy at the beginning to simply start walking differently to take pressure off your ankle, but the problem is that your keep walking that way even after the fracture heals.
  • In our opinion this is the number one reason for long term problems, the joint contractures that develop can lead to knee, hip and back issues that then last a very long time.
  • People may then need further surgery for those issues.
  • Physical therapy can usually last for 3-4 weeks depending on injury coverage and severity of the fracture.


Broken Ankle Rehab:


  • Broken ankle rehab is usually performed through physical therapy.
  • Broken ankle rehab can take up to 6-12 months to regain your flexibility and normal walking from the time of the fracture.
  • We find best results with orthotics, bracing and offloading following removal of the cast.
  • The key is to find where your joints and ligaments are staying tight and make sure they do not stay that way permanently.





About the author

The Modern Podiatrist (Foot and Ankle Specialist Doctor):Today's podiatrist is required to undergo rigorous medical training that licenses them as physicians with equivalent legal standing to the MD and DO degree (These are physician recognized licenses most common only in the USA). Although admittedly the training does differ between the three degrees. The differences are listed below.In Michigan Podiatrists are trained and authorized to perform surgery in the foot and ankle up to the tibial tubercle below the knee.All our podiatrists and foot doctors have undergone rigorous training including a 4 undergraduate college degree, writing the medical school entrance exam (MCAT), followed by a 4 year medical school degree (DPM - Doctor of Podiatric Medicine),Once podiatrists in the USA complete the rigorous 4 year medical school courses, they are required to complete a minimum of 3 years of a surgical and non-surgical residency program. Some podiatrists and foot doctors then choose to go on to further fellowship training specializing in various forms of specialty such as diabetic surgery or reconstructive foot and ankle surgery.The training is not over yet! Each podiatrist must be judged by a governing body where they submit their surgical cases and are reviewed regularly to ensure excellent results. This is a career long evaluation with board qualifications and certifications every few years.So have faith that today's podiatrist is your best choice for your foot and ankle problems! We are able to approach you foot and ankle problems from a non-surgery perspective, but that when necessary we can provide you with the treatment that you need!All articles written by this account are considered to be for educational purposes only. It is impossible for us to truly assess your condition and the advice we give here is meant to give you a basis to then follow up with your podiatrist and foot doctor later.If you have any questions at all, or there is anything that we can help you with, please feel free to contact our office or email us. Podiatrists provide medically necessary treatment which should be covered by valid insurance plans, we are not a cosmetic or elective medical specialty.