How to Tell If Your Ankle Is Broken

Medically reviewed by
Medically reviewed by Michael Menna, DO on November 01, 2019
Dr. Michael Menna is a board-certified, active attending emergency medicine physician at White Plains Hospital in White Plains, New York.
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Michael Menna, DO
on November 01, 2019
Written by
Written by Rod Brouhard, EMT-P
Rod Brouhard is an emergency medical technician paramedic (EMT-P), journalist, educator, and advocate for emergency medical service providers and patients.
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Rod Brouhard, EMT-P

There are two types of clues as to whether a bone is broken or not. They're called signs and symptoms. Symptoms are things only the patient can feel while signs are things anyone (patient or not) can see or touch. Basically, to stick with the sign terminology, these are things you can read.

The Only Symptom of a Broken Ankle

To get symptoms out of the way, you should know that a broken ankle only has one, pain.

A broken ankle hurts. It hurts worse when you move it. It hurts ridiculously fricking bad if you try to stand or put weight on it. My recommendation: don't do that.

Signs

The only sure-fire way to know if any bone is broken is by seeing the actual broken bone. That's the sign, the one that clears up any doubt.

You definitely can see if a bone is broken by looking at it directly with the naked eye, but there's usually a bunch of pesky flesh and blood in the way. Usually, you need to use an x-ray to see a broken bone. Of course, when the broken ends of a femur are sticking out of your thigh, it's pretty much a dead giveaway. Barring either a really nasty compound fracture—or a creepy zombie style cutaway just to get a look—you'll need that x-ray.

At the end, I'll show you what a broken ankle can look like on an x-ray (albeit, in this case, with a really tiny fracture). For now, let's concentrate on the signs of a broken ankle we usually can see, and we'll start with deformity.

1

Deformity

swollen ankle
Leslie Antonis

Deformity is a medical term for, well, being deformed. It's when a part of the anatomy isn't formed the way it's supposed to be. It can be a bone that's bent in the wrong place or a foot that's twisted at an odd angle. It can also be as simple as a grossly swollen ankle.

Swelling is a really common form of deformity and it is from blood or other fluid accumulating at the site of the injury. Swelling isn't a great indicator of a fracture because it comes from the soft tissues—that pesky flesh and blood—that can't be "broken."

2

Discoloration

bruised and swollen ankle
Leslie Antonis

Bruising is another common sign of a broken ankle.

Bruising or discoloration is from blood. Usually, blood is contained in the blood vessels (arteries and veins). After an injury, blood leaks out of the blood vessels and pools in the flesh and muscle, where you can see it.

There's one more sign commonly associated with broken bones: crepitus. This one is harder to imagine. It can't be seen, but it can be felt. It's the broken bits of bone grinding on each other with movement or manipulation of the injury. To the person feeling for it, it can be described as a bag of gravel. Not fun.

3

The X-ray

ankle xray
Leslie Antonis

The definitive test for a broken bone is an x-ray. There's a fine line between a fracture and a sprain, so an x-ray is often the only way to tell the difference. Treatment of a broken ankle starts with an x-ray.

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