Ankle fractures involve a break in one or more bones forming the ankle joint, typically occurring due to trauma like a fall or accident. The severity of the fracture varies, ranging from simple cracks to complex breaks involving multiple bones. Symptoms may include pain, swelling, bruising, and an inability to bear weight. Understanding the available treatment options is important for proper recovery and regaining mobility.

Non-Surgical Treatment Approaches

Non-surgical treatment is often suitable for stable or less severe ankle fractures. These methods typically involve:


Immobilisation is achieved using a cast, brace, or walking boot to stabilise and align the fractured bones, preventing them from shifting out of place. This allows the bones to heal naturally over several weeks. Regular follow-up appointments ensure the bones remain properly aligned during recovery.

Weight-Bearing Restrictions

Patients are instructed to keep weight off the injured ankle to avoid disrupting healing. Crutches, walkers, or knee scooters are often used for mobility. Gradual weight-bearing may be introduced under medical guidance as the fracture heals.

Pain Management

Over-the-counter medications like ibuprofen or acetaminophen are recommended to control pain. Elevating the ankle above heart level and applying ice packs can help reduce swelling and inflammation, providing additional relief.


After the immobilisation period ends, physiotherapy can restore strength, flexibility, and range of motion to the ankle. Exercises progressively improve mobility, while targeted strengthening exercises help regain stability in the joint, enabling a return to daily activities.

Surgical Treatment Methods

Surgical treatment is often required for unstable, complex, or displaced ankle fractures that cannot heal adequately through non-surgical means. The following are common surgical approaches used to stabilise the fracture and promote proper healing:

Open Reduction and Internal Fixation (ORIF)

ORIF involves repositioning fractured bones to their normal alignment, followed by securing them with internal devices like plates, screws, or pins. This method is often chosen for displaced or unstable fractures, providing stability and allowing early mobilisation.

External Fixation

An external fixator frame may be used in severe or complex fractures where immediate internal fixation isn’t possible. Pins are inserted into the bones and attached to an external frame to maintain proper alignment while the soft tissue heals, often as a temporary measure before further surgery.

Bone Grafting

Bone grafting may be necessary in cases where significant bone loss has occurred. Grafts, sourced from either the patient (autograft) or a donor (allograft), help promote bone healing and provide additional support.


A minimally invasive technique using a small camera (arthroscope) inserted into the joint. Cartilage damage can be repaired, bone fragments can be removed, and fracture alignment can be confirmed, making it useful alongside other surgical treatments.

Rehabilitation and Recovery Process

Rehabilitation ensures a successful return to normal activities following an ankle fracture. The gradual process demands steady effort to regain joint function, strength, and mobility. Key components of rehabilitation include:

Initial Immobilisation

After surgery or non-surgical treatment, the ankle is often immobilised in a cast or brace to protect the healing bones and prevent displacement. Depending on the injury’s severity, this stage may last several weeks.

Gradual Weight-Bearing

Under medical guidance, weight-bearing is gradually reintroduced once healing progress is confirmed via imaging. Assistive devices like crutches or walkers are used to transition to full weight-bearing without risking further injury.

Physical Therapy

Physical therapy focuses on restoring the ankle’s strength, flexibility, and range of motion. A customised exercise regimen will progressively increase in intensity, starting with gentle stretching and strengthening exercises before advancing to functional training.

Balance and Proprioception Training

Balance and proprioception exercises retrain the body’s sense of joint positioning and prevent future injuries. These exercises help patients regain stability and coordination, allowing a safe return to daily activities.

Long-Term Management

Patients may need to continue exercises beyond the supervised rehabilitation phase to maintain ankle function. Regular follow-ups ensure that complications like stiffness, arthritis, or re-injury are identified early and managed effectively.


Ankle fractures require proper diagnosis and treatment to ensure a successful recovery. Depending on the severity and type of fracture, treatment options range from non-surgical methods like immobilisation to surgical procedures such as ORIF or external fixation. Rehabilitation through physical therapy is recommended to regain full functionality. Always consult with a doctor to determine the best treatment plan for your specific injury.