What Is a Broken Ankle (Fractured Ankle)?

Written by Rachel Reiff Ellis
Medically Reviewed by Shruthi N, MD on July 15, 2025
11 min read

A broken ankle, also called an ankle fracture, is when you break one or more of the three bones that make up your ankle. These breaks can be tiny cracks in the bone or may break the bone all the way through. You can have breaks in one place or many. 

Some ankle breaks need surgery to correct them, while others heal with a device to keep your joint in place for many weeks.

What does a broken ankle look like​?

Broken ankles can look different depending on where the break happens and how serious the break is. But you might notice your ankle looks:

  • Bent
  • Distorted
  • Rotated
  • Out of place
  • Swollen
  • Bruised

In some serious breaks, you can have bone that comes out of the skin. This is called an open fracture.

There are many ways people get broken ankles, but the most common include:

  • Twisting or rotating your ankle; for example, when your foot doesn’t land flat when you’re stepping off a curb
  • Tripping or falling
  • A motor vehicle (such as car) accident
  • Injury while playing sports

“Orthopedic surgeons have multiple ways to classify ankle fractures, which are valuable for understanding treatment and outcome, but a good broad way to consider fractures is ‘high-energy’ versus ‘low-energy,’” says Alexandra Page, MD, an orthopedic surgeon in San Diego and spokesperson for the American Academy of Orthopedic Surgeons. 

“High-energy fractures would be those resulting from a motor vehicle accident or a fall from a great height, and low-energy fractures would occur after a twist or stumble, similar to a sprain,” she says.

Symptoms of ankle fractures can vary depending on how complex your break is and how you broke your ankle. Usually, you feel:

  • Sudden pain
  • Pain when you touch your ankle
  • Swelling
  • Bruising
  • Trouble putting weight on your ankle

“A mild fracture can feel very much like an ankle sprain, and it is quite possible to not realize a bone is actually broken,” says Page.

Your ankle isn’t a bone itself, it’s a joint made up of three bones and four ligaments. The three bones include your:

  • Tibia, or shinbone
  • Fibula, the smaller bone of the lower leg
  • Talus, the bone that sits between your heel bone and your tibia and fibula; this bone connects your foot to your leg and is the one sometimes called your “ankle bone.”

You can break these bones in different ways, including: 

  • A partial break, where the bone isn’t broken all the way through
  • A complete break, where the bone is broken into two separate parts

Doctors give different names to ankle fractures depending on where the breaks happen. Some of these include:

Lateral malleolus fracture. Your lateral malleolus is the bony knob outside your ankle. This type of fracture is the most common ankle fracture.

Medial malleolus fracture. The medial malleolus is the bony knob on the inside of your ankle.

Bimalleolar fracture. This is what doctors call it when you break the knobs on both sides of your ankle at the same time.

Posterior malleolus fracture. Your posterior malleolus is the bony part at the back of your tibia.

Trimalleolar fracture. This is what doctors call it when you break all three of your ankle bones at the same time.

Pilon fracture. At the end of your tibia is part of the bone called the roof of your ankle. When you break this part of the bone, it’s called a pilon fracture.

If you have an ankle injury and your ankle is in severe pain, you may need medical care. Some signs that you could have a broken ankle include:

  • Your ankle is at an odd angle.
  • Your ankle is swollen and bruised.
  • You can’t put weight on your ankle.
  • It’s hard to move your ankle, or it’s very stiff.
  • You have a severe injury you can see on your ankle.
  • Your toes are blue or numb.
  • You see bone sticking out of your skin at your ankle.

If you get a fever, shivers, or feel hot, this may mean you have an infection as a result of your ankle fracture. This needs medical care. 

When checking for a fracture, your doctor will first do a physical exam of your ankle by looking at it and feeling it. This may involve:

  • Looking at the blood vessels near your ankle
  • Checking the pulse at the top of your foot
  • Testing the sensation in your foot to see if your nerves are damaged
  • Gently moving the ankle to test for pain
  • Looking at the joints near the injury

They’ll also take your medical history, including a description of how you injured it. 

They may ask you:

  • Where does it hurt now?
  • How long ago did your injury happen?
  • Does your knee, shin, or foot hurt also?
  • How did the injury happen?
  • Did your ankle turn in or out?
  • Did you hear a crack or a pop?
  • Were you able to walk immediately after the injury?
  • Can you walk now?
  • Do you have any new numbness or tingling in your leg, ankle, or foot?
  • Have you had previous ankle fractures, sprains, or surgeries?

To formally diagnose a broken ankle, doctors use X-ray and, sometimes, other forms of imaging.

The first kind of test your doctor will use to see if you have a broken ankle is an X-ray. X-rays send radiation through your body. Dense parts of your body, such as bones, absorb more of the radiation than lighter structures, such as muscle. Fractures show up as a dark line or opening in the light bright area of the bones on X-rays.

In some cases, you might need more detailed images, either for very small fractures or to help an orthopedic surgeon understand how best to treat your fracture. Options include:

CT scan. CT scans use X-rays combined with a computer to get a more detailed images of bones and soft tissue. The results are better than what X-rays alone can get.

MRI. This machine uses a powerful magnet, radio waves, and a computer to create images of your ankle. “An MRI does not demonstrate bone detail as well as a CT scan, but has a role in certain types of ankle injuries as well,” says Page.

Bone scan. Bone scans can pick up hairline fractures before other types of imaging show them well. They can also help your doctor know how long you’ve had the break.

The treatment your doctor uses for your broken ankle depends on which bone or bones you broke and how complex your break is. You may need:

Pain relief medications. Pain is a common symptom of broken ankles. Your doctor will either suggest over-the-counter pain relief medications such as nonsteroidal anti-inflammation drugs (NSAIDs) like acetaminophen (Tylenol) or ibuprofen. They may also prescribe stronger pain relief medications for severe pain or swelling.

Immobilization. Your bone needs to be held in place while it heals. Depending on the type of break you have, you may need a boot, brace, or a cast that you wear for many weeks.

Reduction. This is a procedure doctors do in cases where the broken bone is not lined up and it’s possible for them to move it back into place without surgery. Your doctor will give you numbing medication or pain relief medication before doing a reduction.

Surgery. When your bone doesn’t line up correctly for healing or you have many breaks, you may need surgery. In some surgeries, surgeons use pins, plates, or screws to keep your bone in place while it heals. After surgery, you’ll wear a cast to keep everything in place while it heals.

After your doctor has treated your broken ankle, you’ll spend many weeks in a cast, boot, or brace at home. Your doctor will give you instructions on how to lower pain, help healing, and take care of your ankle.

One of the most important things you can do is to raise your ankle so that you slow blood flow to the area. 

“The body uses blood flow to deliver supplies to healing bone, and increased blood flow means increased swelling,” Page says. “Even six months later, when the bone is healed, the body continues to do ongoing work called ‘remodeling.’ By the end of the day, the foot and ankle may still swell and even turn purplish from the venous blood. Just putting the foot on a stool or overturned trash can or wearing a knee-high compression stocking can work wonders.”

You can also:

  • Gently move the parts of your leg or foot you can (such as toes and knee) to prevent stiffness
  • Continue to take anti-inflammatory pain relief medication
  • Avoid putting weight on your ankle until your doctor tells you it’s safe to do so

The type of follow-up appointments you need and how many you need will depend on your specific break, treatment, and healing process.

“Whether you have surgery or get a cast, bone healing takes about six weeks, regardless of surgery or casting with some variation based on individual health issues or age,” says Page.

If you have surgery, your doctor will tell you the schedule for follow-up appointments to check your healing. 

  • One week after your surgery, your doctor will take X-rays of your ankle to look at how the area is healing. 
  • Typically, six weeks after your surgery, your surgeon removes your cast. 
  • If you need further surgery to remove metal pieces in your ankle, your doctor will schedule those.

You may also need physical therapy to help your ankle get back to its former health and strengthen your ankle ligaments.

It’s not always possible to keep an ankle fracture from happening. Many of them are true accidents, says Page. 

“Certainly, awareness of one’s surroundings, particularly on irregular, wet or icy surfaces and appropriate shoe wear can lower fall risks,” she says. “For people involved in sports or hobbies that put the ankle at risk, working on flexibility and strength can protect from fractures and other ankle injuries.”

Other steps you can take to lower your risk for ankle fracture include:

  • Paying close attention when you’re walking on uneven ground
  • Keeping walkways in your house clear of clutter 
  • Wearing protective equipment that will help prevent injury during sports or other activities
  • Boosting bone strength with a healthy diet that includes plenty of calcium and vitamin D

As you’re healing, there are ways to work around your injury and adapt. Page recommends these tips:

  • Knee scooters are widely available, and they make getting around much easier than crutches for many people.
  • Meal preparation, including getting a meal from the counter to the table is a challenge with a broken ankle; so, those who live alone, plan ahead for meals.
  • Sponge baths are often the easiest and safest for the first few weeks after surgery or casting, both to avoid slipping in the shower and to avoid the risks of getting an incision (cut) wet before it is fully healed.

Plan to ask for help doing certain daily tasks until you’re fully healed.

If your ankle fracture is small and stable, meaning it doesn’t involve ligaments or tendons in the area, you may be able to walk on it soon after getting a boot. But in other cases, you may have to be off your feet and use crutches or even a wheelchair to get around. 

“For most people, the important question is ‘When can I get back to normal life?’” says Page. “But this varies greatly based on the type of fracture.”

For a simple fracture, she says, you may only need four weeks in a walking boot. Six months later, you may not even be able to remember which ankle you broke. But for other “high-energy” fractures that need huge surgery to reconstruct many pieces in your ankle, it could take months. And your ankle may have some limitations on it for many years afterward. 

“Most ankle fractures, even those requiring surgery, will heal uneventfully,” says Page. “However, I consider any fracture like a broken plate. If it has just a surface crack but the pieces never moved, it will be pretty much the same as always. Drop it from the counter, and pick up the pieces: a couple of large pieces you can glue back together should be just fine. But lots of small pieces, perhaps a few missing? These are the tough ankle fractures at risk for stiffness and arthritis.”

A broken ankle, or ankle fracture, happens when one or more of the bones in your ankle joint break. It can be caused by things such as twisting your ankle, falling, or being in a car accident. The symptoms often include pain, swelling, bruising, and trouble walking. Some breaks are minor and can heal with a boot or cast, while others are more serious and may need surgery. Treatment depends on how bad the break is and may include pain relievers, rest, and physical therapy. With proper care, most ankle fractures heal well. But more serious breaks may take you months to get well and can lead to long-term stiffness or arthritis.

Can you walk on a broken ankle​?

You should only walk on a broken ankle if your doctor gives you the go ahead. Even if you feel like it doesn’t hurt, don’t walk with an ankle fracture until you get the green light. Walking on a broken ankle before it’s stable can raise your risk for further surgeries.

How long does a broken ankle take to heal?

The timeframe for healing completely can vary depending on your specifics, but bone typically takes six weeks to heal. If you also have ligament or tendon injury, it may take longer. 

What are the long term effects of a broken ankle?

For some people, a broken ankle heals completely and goes back to normal. In some cases, you may have complications such as arthritis, bone infection, or nerve or blood vessel damage.

Can you wiggle toes with a broken ankle?

It’s possible for some people to wiggle their toes with a broken ankle. Whether you can depends on the location and how bad the break is. If your broken ankle damages or compresses your nerves or tendons that control your toe movement, you may not be able to move your toes.