Seeing as your ankle joint is comprised of 3 bones, there are numerous ankle fracture types. In the medical field your ankle is seen as having 3 sides and a “roof”. Fractures can occur in each of these areas or in combination, depending on how you injured your ankle. The lower portion of your shin bone forms the roof and inside of your ankle. While the lower portion of the Fibula forms the outside and back of your ankle joint.
The most common ankle fractures are:
Lateral malleolus fracture: This is the most common ankle fracture type. It is a break of your lateral malleolus, the knobby bump on the outside of your ankle and the lower portion of your fibula.
Bimalleolar ankle fracture: This is the second-most common ankle fracture. This type of fracture involves the break of both your lateral- and medial malleolus, the knobby bump on the inside of your ankle and lower portion of your tibia.
Trimalleolar ankle fracture: This type of ankle fracture involves breaks in all 3 sides of your ankle. Namely the medial- and lateral malleolus as well as the lower portion of your posterior malleolus of the tibia.
Pilon ankle fracture: Also known as a Plafond fracture, this is a fracture through the weight bearing “roof” of your ankle (the central portion of the lower tibia). This fracture is usually a result of a higher energy traumatic injury, for example falling from a height and landing on one foot.
As the number of fracture lines increase, so does the complexity of your injury and your risk of long-term joint damage. Trimalleolar ankle fractures and pilon fractures have the most cartilage injury and therefore, have a higher risk of developing arthritis and degenerative changes in the future. Within each of the above fracture types, the fracture will be further classified as a displaced or nondisplaced fracture.
Displaced: Broken portions of bones shifted and are not well aligned.
Nondisplaced: Bones are broken but didn’t shift and are still well aligned.
The treatment of your fractured ankle will be based on your fracture alignment and the stability of your ankle joint. Generally a nondisplaced ankle fracture doesn’t require any surgery or lead to many secondary complications. Whereas a displaced ankle fracture mostly requires surgery and has greater risk of developing postoperative infection, malalignment and quicker degeneration of your ankle joint.
Things to consider when determining how severe your ankle fracture is… If you feel you have many of the following symptoms your ankle fracture is more serious.
- Frequency – Constant pain that does not resolve with pain medication.
- Size – Very focused area of pain on the bone that radiates up the shin to the knee or down to the foot.
- Color – Severe discoloration and bruising of the area.
- Loading – Not able to take any weight on the injured leg due to too much pain or your ankle joint giving way.
- Amount of movement – Limited or no movement of your ankle, limited by pain and grinding of the broken bones.
- Intensity – Severe pain with a localized sharp stabbing pain, that radiates up and down your leg.
- Movement or static positions – Severe pain when moving your ankle and only slight decrease in pain when keeping ankle still.
- Symmetry – Drastic difference in shape and alignment of your ankle compared to the uninjured side.
- Open or closed fracture – If the displaced bone fragments pierce through the skin.
- Amount of bone involved – If all 3 bones of your ankle is fractured.
- Numbness – Complete sensation loss and severe pins and needles felt in your toes.