Treating Ankle Fractures

Treatment of an ankle fracture may be surgical or nonsurgical, depending on where and how badly your ankle has been broken. 

Some stable ankle fractures may be treated in a walking boot. These breaks are stable and will often heal without more treatment. You may be able to start walking on your ankle as soon as the pain lessens.

Some breaks may need a cast.

A cast may be used to hold the broken bone in its right position for healing. Sometimes the parts of broken bone must first be realigned. This is done by a process known as reduction. The type of reduction is based on how far the bone has moved from its normal position.

Image of ankle bones showing sites of common fractures

Closed reduction

If you have a clean break with little soft tissue damage, closed reduction may be used. Before the procedure, you may be given medicine to relax your muscles. Then your healthcare provider manually readjusts the position of the broken bone.

Open reduction

If you have an open fracture (bone sticking out through the skin), badly misaligned parts of bone, or severe tissue injury, open reduction may be needed. You may be given medicine during the procedure to let you sleep and relax your muscles. Your healthcare provider then makes one or more cuts (incisions) to realign the bone and fix soft tissue. Screws or plates may be used to hold the bone in place during healing.

Doctor and patient

Casting the fracture

To make sure the bone is lined up the right way, an X-ray is taken. Then the ankle is put in a cast to hold the bone in place during healing. You’ll likely have to wear the cast for several weeks. For less severe fractures, a walking boot, brace, or splint may be all that’s needed to hold the bone in place during healing.

The road to healing

Once your fracture has been treated, your healthcare provider will tell you how to help it heal. You may be told to limit ankle use or weight-bearing activities. You may have to take medicines and elevate the foot. If you have a cast, remember to keep it dry.