Malleolus Fracture

The malleoli are the two protuberances’ on the inside and outside of the ankle.  These are commonly referred to as the ankle “knuckles”.  The knuckle on the outside of the ankle is called the lateral malleolus.  The knuckle on the inside of the ankle is called the medial malleolus. 

What causes Malleolus fractures?

Fractures of these occur when a significant force occurs across the ankle joint.  This ranges from a basic slip on ice to an automobile accident. 

What are the symptoms of a Malleolus fracture?

Patients will present with an ankle that is often extremely swollen and bruised.  The ankle may appear to be out of place; and most patients will have difficulty bearing weight on the extremity. 

How are Malleolus fractures evaluated?

Your ankle fracture will be diagnosed using a physical exam and x-rays.  In most cases, your physican will be able to use your x-ray to judge the severity of the injury.  In cases where the fracture may be subtle, a MRI or CAT scan may be used to help determine the exact location of the break.  

What are the treatment options for Malleolus fractures?

Fractures of the ankle are treated by assessing their severity.   An islolated malleolar fracture of the outside (lateral malleolus) or inside (medial malleolus) is judged by the amount of displacement of the bone.  If the malleolus has not shifted away from the joint, conservative care such as casting and crutches can be used for 6-8 weeks or until healed.  When these bones have shifted, the ankle joint can become unstable and it is necessary for surgical treatment.   This is done by placing plates, screws, and sometimes pins across the fractured bones.   This procedure requires 6-8 weeks of casting and crutches and often a course of physical therapy after the bones are healed to regain flexibility.  More severe ankle fractures include a bi-malleolar fracture that includes the breaking of both the lateral and medial malleolus.  A tri-malleolar ankle fracture includes breaking both the medial and lateral malleolus, as well as the back of the ankle called the posterior malleolus of the tibia.  Both a bi-malleolar and tri-malleolar are surgical injuries that can take up to 6 months to heal.  These are the most severe types of ankle fractures. 

What can I expect after undergoing successful treatment for Malleloar fracture?