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Ankle fracture

Last updated: April 19, 2021

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Ankle fractures are the most common fractures of the lower extremity. They are most often caused by twisting the ankle, the circumstances of which the patient will typically recall. The major symptoms are pain in the affected area and decreased range of motion. If physical examination and the patient history suggest a fracture (e.g., patient is unable to bear weight on the affected leg), an x-ray is performed. The most important diagnostic consideration is whether the fracture is stable (as is the case in isolated malleolar fractures) or unstable (e.g., bimalleolar fracture). Unstable fractures require surgery, whereas stable fractures can be treated conservatively with a short leg cast.


Fracture Stability
  • Usually stable
  • Usually unstable, as often associated with other malleolar fractures
  • Mostly unstable
  • Always unstable

Weber classification of ankle fractures

The Weber classification categorizes ankle fractures according to the level of the fibular fracture in relation to the ankle syndesmosis (tibiofibular syndesmosis).[2]

Special forms

  • Avulsion of a bony fragment from the posterior tibial margin (Volkmann triangle) [4]
  • Pilon fracture: fracture of the distal tibia that involves the tibial part of the talocrural joint and is frequently associated with fibular fractures

We list the most important complications. The selection is not exhaustive.

  1. Dähnert W. Radiology Review Manual. Lippincott Williams & Wilkins ; 2011
  2. Weber classification of ankle fractures. Updated: January 1, 2016. Accessed: December 8, 2016.
  3. Maisonneuve fracture. Updated: January 1, 2016. Accessed: December 8, 2016.
  4. Neumaier Probst E, Maas R, Meenen NM. Isolated Fracture of the posterolateral tibial lip (Volkmanns's triangle). Acta Radiologica. 1997; 38 (3): p.359-362. doi: 10.1080/02841859709172083 . | Open in Read by QxMD
  5. Ankle radiograph (an approach). Updated: January 1, 2016. Accessed: December 8, 2016.