Ankle Fracture (Broken Ankle)

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Article by J. Miller, Z. Russell, M. Jack

What is an Ankle Fracture?

An ankle fracture is where the is a break (fracture) within one or more of the three bones that constitute your ankle. These are your tibia (shin bone), fibula (outside leg bone) and your talus (a smaller bone that sits above your heel and articulates with its concave upper surface under your tibia and fibula).

How Do You Treat a Fractured Ankle?


Each ankle fracture needs specific rehabilitation based on its injury type and fracture stability.

Unstable fractures will almost always require surgical stabilisation followed by physiotherapy to restore your range of motion, strength, proprioception, balance and function. The most common procedure is an Open Reduction with Internal Fixation (ORIF).  Essentially, your ankle surgeon with use metal pates and screws to stabilise your ankle to allow the bones to heal.

Stable fractures may be treated with a protective and supportive splint and monitored for appropriate fracture healing. If they show signs of instability, then your surgeon may consider operative stabilisation.

The anatomic reduction (restoring your bone alignment as close to pre-fracture as possible) is necessary to restore the normal anatomy of this important weight-bearing joint. Poor post-fracture alignment can have significant implications for the development of tibiotalar joint arthritis and reduced function.

It is important that you are compliant with your doctor’s prescribed instructions because frequently patients are placed in a removable cast boot.

Based on that, it is very important to only perform the exercises prescribed by your orthopaedic surgeon or physiotherapist. You should also wear your walking boot/cast and only apply as much weight-bearing as advised by your physiotherapist or surgeon.

Do your exercises on a frequent basis throughout the day. Multiple sessions of short duration are generally better than longer sessions done only once or twice.

Can You Still Walk on a Fractured Ankle?

It is best to avoid walking on any fracture limb until your fracture is assessed for stability. Until you seek medical opinion, crutches and non-weight-bearing (NWB) status is recommended.

How Long Does it Take to Heal a Fractured Ankle?

Everyone is different, but those who follow their doctor and physiotherapist instruction normally recover quicker!

All fractures normally take a minimum of 6-weeks for the bone to remould and become stable. Lower limb fractures that require full weight-bearing have extra load requirements, so 12-weeks is normally the minimum that an ankle fracture could be considered stable enough to jog for example. But, everyone's fracture is different and you really MUST follow your ankle surgeon specific advice.

The following are general guidelines that are subject to surgeon modification. Everyone is different so please only follow the guideline specifically recommended by your surgeon.

  • You can normally remove your boot and begin to move your ankle up and down immediately after surgery to prevent ankle stiffness.
  • A compression stocking should be worn to control swelling along with ice and elevation above your heart. Eg Lie down with your foot and leg elevated.
  • Physiotherapy usually starts at 2-3 weeks post-op. Your physiotherapist will then guide and progress you through your various rehabilitation phases to safely restore your joint range of motion, muscle flexibility, strength, proprioception, balance, endurance, power, day to day function (walking, stairs work etc), and then finally your resumption of impact and multi-directional sports or activites.
  • 4 weeks non-weight bearing in a boot, followed by 4 weeks of protected weight-bearing in a boot.
  • If syndesmotic fixation - remain NWB until hardware removal at 8-12 weeks
  • Patients with intra-operative evidence of osteoporosis or osteomalacia (esp Diabetics) will be non-weight bearing (NWB) for an extended period of time (generally 8-10 wks). Your surgeon will advise you.
  • At 8 weeks transition to regular shoe wear commonly commences
  • You may begin driving at 8 weeks if surgery on the right foot, automatic transmission only for left post-op.
  • At 12 weeks most patients may be allowed to commence gentle running / higher impact activities. Please don’t commence running until advised by your physiotherapist or surgeon!
  • Once you can easily perform and single leg calf rise and hop on the surgical foot (single leg hop), you can usually consider a return to light jogging or gentle sports training.
  • It is common for post-ankle fracture rehabilitation to take 6 months to a year. Everyone is different, but those who follow their doctor and physiotherapist instruction normally recover quicker! 

If in doubt, please check with your surgeon or physiotherapist.

Do You Need a Cast for a Fractured Ankle?

Whether you require a cast or not will be determined by your doctor on a case by case basis.

Can a Fractured Ankle Heal on its Own?

Ankle fractures are more likely to require surgical intervention and physiotherapy than not. Fracture stability is the primary issue.  Then due to disuse and protection, every ankle becomes stiff and weak post-immobilisation or surgery.  Your doctor and physiotherapist will commonly treat these injuries, so please seek their professional opinion to help you get back on your two feet as soon as possible.

Is a Broken Ankle an Emergency?

It is best to see a doctor as soon as possible. If you can see a deformity, foot blueness, numbness pins and needles or you are unable to walk on your ankle or move your toes, it is best to head top emergency as soon as possible for an assessment.

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Helpful Products for Fractured Ankles

Ankle Brace

Related Injuries

General Information

Heel Pain

Traumatic Ankle Ligament Injuries


Foot Injuries

Bone Injuries

Degenerative Conditions

Soft Tissue Inflammation

Biomechanical Conditions

Nerve-Related Sources

Fractured Ankle Treatment Options

  • Early Injury Treatment
  • Avoid the HARM Factors
  • Soft Tissue Injury? What are the Healing Phases?
  • What to do after a Muscle Strain or Ligament Sprain?
  • Acupuncture and Dry Needling
  • Sub-Acute Soft Tissue Injury Treatment
  • Active Foot Posture Correction Exercises
  • Gait Analysis
  • Biomechanical Analysis
  • Balance Enhancement Exercises
  • Proprioception & Balance Exercises
  • Agility & Sport-Specific Exercises
  • Medications?
  • Heel Cups
  • Orthotics
  • Soft Tissue Massage
  • Walking Boot
  • Ankle Strapping
  • Brace or Support
  • Dry Needling
  • Electrotherapy & Local Modalities
  • Heat Packs
  • Joint Mobilisation Techniques
  • Kinesiology Tape
  • Neurodynamics
  • Physiotherapy Instrument Mobilisation (PIM)
  • Prehabilitation
  • Running Analysis
  • Strength Exercises
  • Stretching Exercises
  • Supportive Taping & Strapping
  • TENS Machine
  • Video Analysis
  • FAQs about Fractured Ankles

  • Common Physiotherapy Treatment Techniques
  • What is Pain?
  • Physiotherapy & Exercise
  • When Should Diagnostic Tests Be Performed?
  • Can Kinesiology Taping Reduce Your Swelling and Bruising?
  • How Can You Prevent a Future Leg Injury?
  • How Do You Improve Your Balance?
  • How Much Treatment Will You Need?
  • How to Strap an Ankle
  • Sports Injury? What to do? When?
  • What are the Common Massage Therapy Techniques?
  • What are the Early Warning Signs of an Injury?
  • What is a TENS Machine?
  • What is Chronic Pain?
  • What is Nerve Pain?
  • What is Sports Physiotherapy?
  • What's the Benefit of Stretching Exercises?
  • When Can You Return to Sport?
  • Why Kinesiology Tape Helps Reduce Swelling and Bruising Quicker
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    Last updated 11-Oct-2019 03:42 PM

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