Broken Ankle: Symptoms, Causes, Treatment & Complete Guide
Updated: 3 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer: What Is a Broken Ankle?
A broken ankle is an injury to one or more of the three ankle bones: the tibia, fibula and talus. It most often results from a turning, twisting or rolling injury. Treatment depends on the break, ranging from rest and a boot or cast for two to three months to surgery for severe breaks, followed by physical therapy. [1]
What the research says
After surgery, earlier weight-bearing probably helps a little — without more reoperations. A Cochrane review of 53 studies (4,489 adults) found early weight-bearing (within 3 weeks of surgery) probably leads to slightly better ankle function (mean difference 3.56, 95% CI 1.35–5.78), though not a clinically meaningful difference, and may make little or no difference to reoperation (risk ratio 0.50, 95% CI 0.09–2.68). This applies to fixed fractures under a surgeon's direction. (Lewis et al., Cochrane Database Syst Rev, 2024) [3]
Early weight-bearing did not raise complication rates. In a meta-analysis of 11 randomized trials (862 patients), early weight-bearing after ankle fracture surgery improved ankle function scores at 6 weeks (standardized mean difference 0.69, 95% CI 0.49–0.88), and patients returned to daily activity sooner, with no significant rise in complications (RR 1.49, 95% CI 0.85–2.61). (Chen et al., J Foot Ankle Res, 2024) [4]
Starting guided exercise early sped recovery after fixation. In a trial of 157 adults after surgery for Weber B ankle fractures, those in an early-motion exercise program scored 62.0 versus 48.8 on the Olerud-Molander Ankle Score at 12 weeks (mean difference 13.2, 95% CI 5.66–20.73); the gap faded by 52 weeks and no instability was reported. (Matthews et al., Bone Joint J, 2024) [5]
Broken Ankle at a Glance
What it is: An injury of one or more of the three bones of the ankle joint (tibia, fibula, talus)
Severity range: Tiny cracks to breaks in multiple places to breaks through the skin (open fracture)
Most common mechanism: Turning, twisting, or rolling injury
Warning signs: Instant throbbing pain, swelling, bruising, tenderness, deformity, trouble walking, open fracture
Key misconception: You can walk on some fractures — bearing weight does not rule out a break
Diagnosis: Physical exam plus X-rays, bone scan, CT, or MRI
Healing aid: Boot or cast worn 2–3 months; surgery with pins, plates, or screws for severe breaks
Recovery support: Physical therapy restores motion and strength after the bone heals
A broken ankle at a glance: causes, warning signs, diagnosis, treatment, home care, and prevention.
What Is a Broken Ankle?
A broken ankle, also called a fractured ankle, is an injury of one or more of the bones that make up the ankle joint. An ankle might break from a twisting injury, a misstep or fall, a sports injury, or a car crash. Fractures in ankle bones can range from tiny cracks to breaks in more than one place and breaks that come through the skin.
Three bones form the ankle joint, and a fall or blow can break any of them:
Tibia: The shin bone — the larger of the two leg bones
Fibula: The thinner bone on the outside of the leg
Talus: The ankle bone connecting the leg to the foot
Rolling the ankle can cause a break in the knobby bumps at the end of the tibia and fibula — the parts you can feel on each side of the ankle.
The tibia, fibula, and talus form the ankle joint; any of them can break.
What are the seven warning signs of a broken ankle?
A broken ankle can cause instant throbbing pain, swelling, bruising, tenderness, deformity, trouble walking and, in an open fracture, bone sticking through the skin.
Instant throbbing pain: Pain begins right away, often throbbing
Swelling: The ankle and foot may puff up quickly
Bruising or bleeding under the skin: Discoloration or internal bleeding around the injury
Tenderness: The area is painful to touch
Deformity: Loss of the usual shape of the joint
Trouble or pain walking: Pain with walking or putting weight on the foot
Open fracture: Bone sticking through the skin
When to See a Doctor — Including the Walking Myth
See a healthcare professional if the ankle has lost its shape, if the pain and swelling don't get better with self-care, or if the pain and swelling get worse over time. And here is the most important rule in this entire guide:
It's possible to walk on some fractures — so don't assume you don't need medical care if you can bear weight on your ankle. [1]
The ability to walk is a poor test for ruling out a break. If the mechanism was a fall, twist, or blow and any of the warning signs above are present, get the ankle checked rather than assuming it is "just a sprain."
What causes a broken ankle?
A broken ankle is most often from a turning, twisting, or rolling injury. But a direct blow to the ankle also can break it. The most common causes include:
Car accidents: The crushing injuries that can happen in car accidents may cause breaks that need surgery to be fixed
Falls: Tripping and falling can break ankle bones — so can landing on the feet after jumping down from a height
Missteps: Putting a foot down wrong or stumbling can result in a twisting injury that causes a broken bone
What are the risk factors for a broken ankle?
High-impact sports, poor technique or equipment, sudden increases in activity, a cluttered home, osteoporosis and smoking can all raise your risk of a broken ankle.
Play high-impact sports: The stresses, direct blows, and twisting injuries in basketball, football, gymnastics, tennis, and soccer can cause ankle bone breaks.
Use poor technique or sports equipment: Not warming up can raise the risk of ankle injuries; worn or ill-fitting shoes can increase the risk of stress fractures and falls.
Suddenly increase your activity level: Whether a trained athlete or a new exerciser, suddenly boosting how long, hard, or often you exercise can increase stress fracture risk.
Keep your home cluttered or poorly lit: Too much clutter or too little light may lead to falls and ankle injuries.
Have certain conditions: Osteoporosis — decreased bone density — can put you at risk of injuries to your ankle bones.
Smoke: Cigarette smoking can increase the risk of osteoporosis, and studies show that healing after a break may take longer in people who smoke.
What complications can a broken ankle cause?
Complications of a broken ankle, which can show up even years after the injury, aren't common. But they may include:
Arthritis: Fractures that go into the joint can cause arthritis years later — if your ankle starts to hurt long after a break, see your healthcare professional.
Bone infection (osteomyelitis): If you have an open fracture in which one end of the bone pokes through the skin, your bone may be exposed to bacteria that cause infection.
Compartment syndrome: Rarely occurs with ankle fractures; causes pain, swelling, numbness, and sometimes the inability to use the affected muscles of the ankle.
Nerve or blood vessel damage: Trauma can injure or tear nerves and blood vessels. Seek medical help right away if you notice numbness or feel like your ankle isn't getting enough blood — lack of blood flow can cause a bone to die, called avascular necrosis.
How Is a Broken Ankle Diagnosed?
Your healthcare professional will look at your ankle, foot, and lower leg and check for tenderness. Moving your foot around can show your range of motion, and your provider might watch how you walk. [2]
To diagnose a broken ankle, your provider might order one or more of these imaging tests:
X-rays: Most ankle fractures can be seen on X-rays; stress fractures often don't show up until the breaks start healing.
Bone scan: Can show breaks that don't show up on X-rays — a technician injects a small amount of radioactive material into a vein, and damaged bones, including stress fractures, show up as bright spots on the image.
CT scan: Uses X-ray techniques to create detailed images of the bones from different angles; shows more detail about the injured bone and the surrounding soft tissues than X-rays.
MRI scan: Uses radio waves and a strong magnetic field to create detailed images of the soft tissues around the ankle joint; can show breaks not seen on X-rays.
How is a broken ankle treated?
Treatments for a broken ankle vary depending on which bone is broken and how bad the injury is. [2]
Medicines
Your healthcare professional may suggest an over-the-counter pain reliever such as acetaminophen (Tylenol, others).
Reduction: Getting the Pieces Back in Line
If you have a displaced fracture — meaning the two ends of the break are not lined up — your healthcare professional may need to move the pieces back into place. This process is called reduction. You may need medicine to relax your muscles, calm you, or numb the area before this procedure.
Immobilization: The Boot or Cast
Most often, a broken bone must be kept from moving so that it can heal — this is called immobilization. Most often, a special boot or a cast holds the ankle bones in place. You wear the boot or cast until the break heals, and this can take two to three months.
Surgery
Sometimes, a surgeon who specializes in bones and joints — called an orthopedic surgeon — may put in pins, plates, or screws to keep a bone in place while it heals. These materials may be removed after the break has healed, or if they stick out of the skin or cause pain.
Therapy: Rebuilding Motion and Strength
After your bone heals, you need to restore the motion and strength of your ankle. A physical therapist can teach you exercises to help you restore full motion and build strength.
Treatment Summary
Medicines: Over-the-counter pain relievers such as acetaminophen
Reduction: Displaced bone pieces moved back into place, with numbing or muscle-relaxing medicine as needed
Immobilization: Boot or cast holds the ankle in place for 2–3 months until the break heals
Surgery: Orthopedic surgeon places pins, plates, or screws; removed after healing or if they protrude or cause pain
Therapy: Physical therapist teaches exercises to restore full motion and strength after the bone heals
What can you do at home for a broken ankle before seeing a provider?
Until you see a provider, care for a broken ankle at home by icing it, keeping it raised above heart level, avoiding weight on it and wrapping it lightly.
Apply ice for 15 to 20 minutes at a time, every 3 to 4 hours, to lessen the swelling.
Keep your ankle raised above the level of your heart to help prevent swelling.
Don't put weight on your injured ankle.
Lightly wrap the injury in a soft bandage that provides slight pressure.
How can you prevent a broken ankle?
Proper shoes, starting workouts slowly, a balanced fitness program, strong bones, a clutter-free home and stronger ankle muscles can help prevent a broken ankle.
Wear proper shoes: Use hiking shoes on rough terrain; choose the right athletic shoes for your sport.
Replace athletic shoes when needed: Get rid of shoes as soon as the tread or heel wears out or wear isn't even; runners should replace shoes every 300 to 400 miles.
Start slowly: Apply this to a new fitness program and to every workout you do.
Have a balanced fitness program: Aerobic fitness for your heart, strength training for muscles, and flexibility movements for your joints' full range of motion.
Build bone strength: Get enough calcium and vitamin D — calcium-rich foods include dairy products, leafy greens, and tofu; ask your provider about vitamin D supplements.
Get rid of clutter in your home: Keeping clutter off the floor helps you avoid tripping and falling.
Strengthen your ankle muscles: If you're prone to twisting your ankle, ask a healthcare professional or personal trainer for strengthening exercises.
How should you prepare for a broken ankle appointment?
You will likely seek treatment for a broken ankle in an emergency room or urgent care clinic. If the pieces of broken bone aren't lined up for healing, you may be referred to a doctor specializing in orthopedic surgery.
What You Can Do
Write a list that includes your symptoms and how they began, other medical conditions you have, all the medicines, vitamins, and supplements you take (including doses), and the questions you want to ask the healthcare professional.
Questions to Ask
What tests do I need?
What treatments are there? Which do you suggest?
If I need a cast, how long will I need to wear it?
Will I need surgery?
How much will I need to limit my activities?
Should I see a specialist?
What pain medicines do you suggest?
Be sure to ask all the questions you have.
What to Expect from Your Doctor
Your healthcare professional may ask:
How did you injure yourself?
Did your symptoms come on suddenly?
Have you injured your ankles in the past?
Have you recently begun an exercise program or started exercising more or harder?
Frequently Asked Questions
What is a broken ankle?
A broken ankle, also called a fractured ankle, is an injury of one or more of the three bones that make up the ankle joint — the tibia, the fibula, and the talus. Fractures range from tiny cracks to breaks in multiple places to breaks that come through the skin.
What does a broken ankle feel like?
A broken ankle might cause instant throbbing pain, swelling, bruising or bleeding under the skin, tenderness, loss of the joint's usual shape (deformity), and trouble or pain with walking or putting weight on the foot. A bone sticking through the skin signals an open fracture.
Can you walk on a broken ankle?
Yes — it's possible to walk on some fractures, so being able to bear weight on your ankle does not rule out a break. See a healthcare professional if the ankle has lost its shape or if pain and swelling don't improve with self-care. [1]
What causes a broken ankle?
A broken ankle is most often from a turning, twisting, or rolling injury, but a direct blow can also break it. Common causes include car accidents, falls — including landing on the feet after jumping from a height — and missteps that twist the ankle.
How long does a broken ankle take to heal?
Most broken ankles are immobilized with a special boot or a cast until the break heals, and this can take two to three months. After the bone heals, physical therapy helps restore full motion and strength. [2]
When is surgery needed?
A badly broken ankle may need surgery, in which an orthopedic surgeon puts pins, plates, or screws into the broken bone to hold it in place while it heals. Surgery is also common when a fracture is displaced — the two ends of the break are not lined up.
How can I prevent a broken ankle?
Wear proper shoes for your sport and terrain, replace worn athletic shoes (runners every 300–400 miles), start new activities slowly, keep a balanced fitness program, build bone strength with calcium and vitamin D, keep your home free of clutter, and strengthen your ankle muscles if you're prone to twisting your ankle.
Conclusion
The three lessons to carry away from this guide:
The walking myth: being able to stand or walk does not rule out a fracture — instant throbbing pain, swelling, bruising, tenderness, deformity, or pain bearing weight after a twist, fall, or blow all deserve a professional check.
Treatment follows the break: which bone broke and how badly determines whether you need only pain relief and a boot, a cast for two to three months, realignment of displaced pieces, or surgery with pins, plates, or screws — followed by physical therapy to rebuild motion and strength.
Prevention is practical: proper footwear, gradual activity increases, stronger ankle muscles, better bone health, and a clutter-free home cover most of the risk factors that lead to these injuries.
This guide has walked you through the three bones of the ankle joint, the seven warning signs, the causes and risk factors, the imaging tests that find fractures X-rays can miss, the full treatment path from reduction to therapy, the at-home first steps, and seven prevention habits. For more injury and recovery guides, see our guides to Achilles tendinitis and ACL injuries for related lower-body injury care.
This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
Related Reading
Foot X-Ray: What It Shows, Why It's Done, What to Expect and Results explains the imaging test commonly used to diagnose this condition in the foot and ankle.
References
Mayo Clinic Staff. Broken ankle — Symptoms and causes. Mayo Clinic. June 5, 2025. https://www.mayoclinic.org/diseases-conditions/broken-ankle/symptoms-causes/syc-20450025
Mayo Clinic Staff. Broken ankle — Diagnosis and treatment. Mayo Clinic. June 5, 2025. https://www.mayoclinic.org/diseases-conditions/broken-ankle/diagnosis-treatment/drc-20450038
Lewis SR, Pritchard MW, Parker R, et al. Rehabilitation for ankle fractures in adults. Cochrane Database Syst Rev. 2024;9(9):CD005595. PMID 39312389. https://doi.org/10.1002/14651858.CD005595.pub4
Chen B, Ye Z, Wu J, et al. The effect of early weight-bearing and later weight-bearing rehabilitation interventions on outcomes after ankle fracture surgery: a systematic review and meta-analysis of randomised controlled trials. J Foot Ankle Res. 2024;17(2):e12011. PMID 38635458. https://doi.org/10.1002/jfa2.12011
Matthews PA, Scammell BE, Coughlin TA, et al. Early Motion and Directed Exercise (EMADE) following ankle fracture fixation: a pragmatic randomized controlled trial. Bone Joint J. 2024;106-B(9):949-956. PMID 39216862. https://doi.org/10.1302/0301-620X.106B9.BJJ-2023-1433.R1
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