Ankle injuries usually occur when the foot suddenly and forcefully twists outwards or inwards (rolled or twisted ankle). Often this results in a sprained or torn ankle ligament. Very severe twisted ankles or extreme trauma may also cause the ankle bone to fracture. If the syndesmosis also tears, the ankle joint will become unstable. The syndesmosis is the ligament that connects the outer and inner ankle bones. Ankle injuries that involve a torn syndesmosis must be surgically treated.

The ankle is a complex joint formed by the ends of the fibula (outer ankle bone), tibia (inner ankle bone) and the talus bone. The inner and outer ankle bones are each known as a malleolus and if one of them breaks it is referred to as a malleolar fracture.

A broken ankle may involve the fracture of one of the ankle bones (malleolar fracture) or both ankle bones (bimalleolarfracture). The ligament between the outer and inner ankle bones, known as the syndesmosis, plays an important role in relation to ankle injuries. Ankle fractures are classified according to whether or not the syndesmosis is damaged. This also helps to determine the most appropriate treatment.

Ankle injuries cause immediate and often very intense pain. Standing on the affected foot will either be impossible or only possible with severe pain.  In most cases the ankle swells up rapidly and a bruise forms if the ligaments or bones have been damaged.

Fractured ankles are diagnosed by making an x-ray image of the ankle. Depending on the situation, computed tomography or magnetic resonance imaging examinations may also be carried out.

Ankle injuries and fractured ankles are treated according to the type of injury. If there is ligament damage but no broken bones, the ankle can usually be treated conservatively. Special braces (Aircasts) are used to stabilise the joint after the swelling has subsided. If a bone has been fractured, conservative treatment is only suitable in certain cases. A distinction is made between ankle fractures with a damaged syndesmosis and those without. If the syndesmosis is injured, the ankle will definitely require surgery. Find out more about the surgical treatment options for broken ankles in the ankle surgery section.

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