Since the mid 80’s, a greater number of emergency room visits are by people with ankle injuries. Many of those injuries involve broken ankles, and many of those fractures are increasingly more severe. You may think that these ankle fractures belong to athletes but a large number of patients with broken ankles are ‘baby boomers’, those people born in the fifteen years after the end of World War II. Three bones come together at the ankle joint: the tibia or shinbone, the fibula (the other lower leg bone), and the talus or anklebone. When an individual breaks their ankle, any one or a combination of these bones may break. How can you tell if a fall has resulted in a broken ankle? After all, a severe sprain or tendon injury can result in similar symptoms.
One obvious symptom of a broken ankle is if the foot or ankle looks deformed after the injury. When I broke my ankle after slipping on a patch of mud, I knew immediately it was broken. My foot was no longer aligned with my leg, forming instead a 165 degree angle.
In some cases, the broken ankle bone will break through the skin, another obvious symptom. In the region called the medial malleolus, the inner ankle ‘bump’ formed by the end of the tibia, I could see a hard ridge where the skin seemed to be stretched tightly across bone. The bone did not break the skin.
A snapping or popping sound, the kind I heard when my foot shot out from under me, does not automatically indicate a broken ankle. A sound may also accompany a severe sprain.
Another symptom of a broken ankle is the inability to stand, walk, or put any amount of weight on the affected leg. With my ankle bent in such an unnatural angle, I did not even try to stand.
If the broken ankle involves a hairline fracture but not dislocation, a person may be able to move the ankle but will find activity increases the pain level while rest decreases it.
A broken ankle is often accompanied by instantaneous, severe, and pounding pain. Bruising soon follows. In my case, I felt a degree of pain comparable to a rating of 4 on a scale of one to ten, ten being unbearable pain. Bruising in that area was not apparent until the partial surgical cast was removed from my leg about four weeks later.
My ankle was extremely sensitive to touch. By the time we got to the emergency room, it had swollen, yet another symptom of a broken ankle.
The attending emergency room physician asked me to wiggle my toes. He also asked if I could feel anything when he touched my toes and parts of my foot. Numbness or tingling in the foot or toes is a sign of more serious damage. If I could not wiggle my toes or feel his touch, it would indicate that nerves or blood vessels leading to my foot were severed by the broken bones. My foot would have become abnormally cold to the touch and the skin would be pale or blue-tinged. The nerves and blood vessels in my ankle and foot were still intact.
With some injuries, the only sure way to know if you have broken or sprained your ankle is if you visit the emergency room for X-rays. Most ankle injuries that involve prolonged or severe pain should at the very least be examined by a physician.
