What is an ankle fracture?

Ankle fractures occur when one of the bones that make up the ankle joint are broken. These bones are the tibia, the fibula, and the talus. These injuries usually occur when the ankle is twisted. Occasionally the injured bones are out of alignment with the other bones of the ankle joint. This is called a dislocation.

Your child's bones are different than those of an adult. First, they are more flexible. Sometimes the bones crack like green branches from a live tree instead of snapping like a dry stick. Other times the bones just buckle slightly. The second major difference is that a child's bones are still growing from areas near the end of the bones called growth plates. Fractures in the growth plate can be difficult to see on the x-ray and they may affect the growth of the bone. Sometimes special tests are needed to diagnose fractures in this area.

What are the symptoms?

Symptoms of a broken ankle include:

• severe pain
• inability to walk
• swelling
• trouble bending the ankle
• a grating feeling when the ankle is moved caused by the broken bones moving against each other
• muscle spasms
• an obvious deformity of the ankle.
   

How is it diagnosed?

Your child's health care provider will talk to you and your child about how the ankle was injured, examine the ankle, and any other injured areas and take an x-ray of the ankle.

How is it treated?

The treatment will depend on what type of fracture your child has. Sometimes when the fracture is mild it can be treated with a splint. More severe fractures may need to be put in a cast. Sometimes surgery is needed.

Your child may need to use crutches for several weeks after the injury.

How can I help take care of my child?

To reduce swelling keep the injured ankle elevated on pillows when your child is resting. For the first day or two, ice packs can be placed on the injured ankle. Put the ice pack on for 10 minutes. Leave it off for 20 minutes before putting on more ice.

Most cast material is not made to get wet. If your child needs a cast that can get wet talk to your provider about a water friendly cast.

Don't let your child scratch around or poke things down the cast as this may lead to an infection.

How long will the effects last?

Children tend to heal faster than adults, but healing times vary from one person to the next. As a rule, most fractures heal in 4 to 6 weeks. Your child's provider may repeat x-rays to check on the pace of healing 2 or 3 weeks after the injury. If the bones are healing well your child may be able to put weight on the ankle after a few weeks.

Depending on the type of injury and how it was treated your child may need to do rehabilitation exercises. Most of the time children are so active that they regain strength and flexibility without physical therapy.

When should I call my child's health care provider?

Call immediately (or go to the emergency room) if:

• Your child has increased pain, redness, warmth, or swelling.
• Your child has a loss of feeling.
• The injured ankle or foot looks pale, blue, or feels cold.