Understanding your injury

An ankle fracture may affect the inner, outer or back part of the ankle. The ligaments between the tibia and fibula, called the syndesmosis, can also be injured. Assessment includes the skin, circulation, sensation and X-rays; further imaging may be needed to understand the fracture and joint alignment. Stability matters as much as the number of broken bones.

Treatment and the procedure

A stable fracture with satisfactory alignment may be managed in a cast or boot, with review to check that alignment is maintained. An unstable, displaced or dislocated ankle may need manipulation and surgery. Fixation usually uses plates and screws; an injured syndesmosis may need additional fixation. Significant swelling can affect the timing of surgery. The aim is a stable, well-aligned ankle that can heal and recover function.

Benefits, risks and expectations

If surgery is planned, discuss bleeding, anaesthetic risks and complex regional pain syndrome as well as the risks specific to your injury. Your general health and the extent of surgery affect your personal risk.

Discuss wound problems, infection, nerve symptoms, blood clots, loss of alignment, delayed healing, nonunion, metalwork irritation and possible further surgery.
Stiffness, swelling and discomfort may persist after bone healing. Damage to the joint surface can lead to arthritis despite satisfactory fixation.
The likely benefit of surgery must be balanced against your health, skin condition, activity goals and the consequences of accepting the fracture position.

Rehabilitation and aftercare

Your written plan governs weight bearing, boot or cast use, movement and wound care. Elevate as advised and protect the dressing and cast. Once authorised, physiotherapy progresses from movement to strength, balance and walking. Full-weight-bearing exercises begin only after your treating team has confirmed that loading is safe; they are not an immediate postoperative programme. Return to work, driving and sport needs individual advice.

When to get urgent help

Attend A&E urgently for sudden severe pain, a cold or discoloured foot, or rapidly worsening numbness. Contact your team promptly about fever, discharge or a tight cast.
Seek urgent assessment for new calf pain or swelling. Call 999 for chest pain or breathlessness.

Your consultation

Ask which structures are injured, why surgery is recommended, whether metalwork removal is expected and what restrictions apply. This guide supports discussion; personalised consent records your own options and risks.

Your consent discussion

Use the patient pack to record your priorities, the proposed procedure, its alternatives, the benefits you hope for and risks that matter to you. A clinician will discuss your individual circumstances and complete the appropriate hospital consent process with you.

Reading or downloading a guide does not give consent. You can ask further questions, decline treatment or change your mind before the procedure.

Ankle fractures