Ankle Fracture

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KEY POINTS

• An ankle fracture is a break or crack in one or more of the bones in the ankle.
• Treatment may include surgery, a splint, cast, brace or special boot, and special exercises to help your child’s ankle get stronger and more flexible.
• Follow the full course of treatment your child’s healthcare provider prescribes.

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What is an ankle fracture?

An ankle fracture is a break or crack in one or more of the bones in the ankle. It may be just a bend or small crack in the bone, or the bone may break into pieces or shatter. Some fractures may stick out through the skin.

The bones in the ankle are the tibia, fibula, and talus.

What is the cause?

A broken ankle is usually caused by a twisting of the ankle. It may also be caused by a fall, a direct hit to the leg, or a medical condition that causes weak or brittle bones.

What are the symptoms?

Symptoms may include:

• A snapping or popping sound at the time of the injury
• Pain, swelling, bruising, or tenderness that happens right after the injury
• Pain when the injured area is touched or that keeps your child from putting weight on the foot
• An area of the ankle or foot that is cold, pale, or numb
• A change in the shape of the ankle

How is it diagnosed?

Your child’s healthcare provider will ask about your child’s symptoms and how the injury happened. Your provider will examine your child. Tests may include:

• X-rays of the ankle
• CT scan, which uses X-rays and a computer to show detailed pictures of the bones
• MRI, which uses a strong magnetic field and radio waves to show detailed pictures of the bones

How is it treated?

The treatment depends on the type of fracture.

• If your child has an open wound with the fracture, your child will need treatment to control bleeding or prevent infection.
• If the broken bone is crooked, your healthcare provider will straighten it. Your child will be given medicine first so the straightening is less painful.
• Sometimes surgery is needed to put the bones back into the right position.
• Your child’s provider may put the ankle in a cast, splint, brace, or removable boot to keep it from moving while it heals.
  • If your child has a cast, make sure the cast does not get wet. Cover the cast with plastic when your child bathes. Teach your child not to scratch the skin around the cast or poke things down between the cast and the skin. This could cause an infection.
  • Your provider will tell you how much weight your child can put on the leg, if any. Your child may need to use crutches, a knee walker, or a cane as directed by your healthcare provider.

With treatment, the fracture may take 4 to 8 weeks to heal. Your child may need to do special exercises to help the ankle get stronger and more flexible. Ask your child’s healthcare provider about this.

How can I take care of my child?

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

• To keep swelling down and help relieve pain, your child’s 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 ankle up on pillows so that it is above the level of the heart when your child is sitting or lying down.
  • Give your child pain medicine, such as ibuprofen, as directed by your child’s provider. Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, may cause stomach bleeding and other problems. Read the label and give as directed. 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.

Ask your child’s healthcare provider:

• How and when you will get your child’s test results
• How long it will take for your child to recover
• If there are activities your child should avoid and when your child can return to normal activities
• How to take care of your child at home
• What symptoms or problems you should watch for and what to do if your child has them

Make sure you know when your child should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent an ankle fracture?

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.