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Ankle Fractures


Ankle fractures (broken ankles) are a common injury in children and adolescents.  The ankle bones include the tibia (the shin bone) and the fibula (the smaller bone on the outside of the ankle).  Both of these bones have growth plates at the end.  When children and adolescents break their ankle, the break can go through the growth plate.  Sometimes the break can also go to the joint surface. There are many different types of ankle fractures, and treatment may be as simple as a boot or may require surgery for more severe ankle breaks.

Nondisplaced Fractures:

A nondisplaced fracture is one where there is a crack in the bone, but the bone has not shifted out of place. This is similar to if there is a crack in a plate or bowl, but the plate or bowl has not fallen apart. Most of the time, nondisplaced fractures can be treated with a boot or a cast.
Broken Ankle
X-rays of a broken ankle

Displaced Fractures

A displaced fracture occurs when the bone breaks and shifts out of position. Many displaced fractures can be treated with manipulation and casting. Some displaced fractures will require surgery to keep the bone lined up correctly, especially if the joint surface is involved.


Broken ankles usually happen from a twist or fall.  Skateboard and scooter riding are also common ways to break an ankle.  When someone breaks their ankle, there is immediate pain and swelling.  Most people will not be able to walk or put their weight on a broken ankle.  Bruising happens a few hours later also. 


Your doctor will check the ankle for swelling, bruising, and area of tenderness. He or she will also examine the nerves and the blood supply to the foot.  He or she will make sure that there are no other injuries and that the skin is healthy enough for either a cast or surgery if needed.

X-rays and Tests:

X-rays are the most common way to confirm the diagnosis of an ankle fracture.  Sometimes a CT scan is used look more closely at the joint surface and/or growth plates. 
Ankle fracture before and after surgery
Ankle fracture before and after surgery with 2 metal screws


Depending on the way the bone is broken, walking boot or cast may be used for treatment.  Sometimes your doctor will want you to use crutches to keep the weight off of the ankle while the bones heal.  If the bones have moved or “displaced”, surgery may be recommended.   Sometimes the bones can be put back into place without surgery with a manipulation in the doctor’s office. 

Outcomes (Prognosis/Expectations):

Broken ankles usually heal within 6 to 12 weeks.    Return to sports may take longer.  Your doctor may follow the ankle for many months to be sure that the growth plates continue to grow properly.  Fractures that involve the joint do have a small risk of arthritis and stiffness even with proper treatment.

More Information:

Q:  What is an Ankle Fracture? 

An ankle fracture is a break of the bones in the ankle, either the tibia (shin bone) or fibula (the bone on the outside of the ankle).    

Q:  What causes ankle fractures? 

Ankles are most commonly broken by a twist or fall.  Ankle fractures happen in sports, scooter and skateboard riding, and sometimes just by falling on even ground or off of a stair.    

Q:  How do I know if I should go to the doctor? 

If your child has a swollen and painful ankle and refuses to walk after a fall or a twist, you should bring your child to your doctor.

Q:  Will my child return to sports?

Most ankle breaks heal within 6 to 12 weeks.  Return to sports should be careful. Your doctor will let you know when sports are safe. Even after the ankle bones heal, your child may need more time to work on ankle motion or strength.   

Q:  Is an MRI necessary?

X-rays give usually give enough information to treat an ankle fracture.  Sometimes a CAT scan will be used to give more information about the bone surfaces or growth plate. 

Q:  Will my child need surgery? 

If the bone is out of place, your doctor may manipulate the bone to push it back into place.  Sometimes surgery is needed to put the ankle back into the proper position. Sometimes, metal screws or plates must be put in the bone to hold the position.

Q. Will my child need physical therapy?

Most children do not need formal physical therapy and are able to regain all their motion and strength on their own. Sometimes your physician will recommend a home exercise program.

Q. Will there by any long term problems after my child’s ankle fracture heals?

Most children do not have any long term problems if their ankle fracture is treated properly.  However, some fractures that involve the growth plate need to be followed to make sure the growth plate continues to grow. This is usually the case if the growth plate fracture required a manipulation, needed surgery, or if the joint surface was involved. There is also a small risk of future arthritis in fractures that involve the joint, even if they are treated properly.

Q:  How do I know when my child can return to sports? 

After the bone is healed and your child can walk and run without a limp, your doctor will likely allow them to return to sports.