Lateral Malleolus Fracture Symptoms and Treatment

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Lateral malleolus fractures are breaks in the bone on the outside of the ankle joint. The lateral malleolus is part of the fibula, one of two bones of the lower leg, which carries about about 10% of your weight.

These breaks are the most common type of ankle fracture. They can happen when you take an awkward or uneven step that causes you to twist or roll your ankle.

Most lateral malleolus fractures are stable ankle fractures, where the ankle joint remains aligned and able to move normally. These type of fractures usually don't require surgery.

This article reviews symptoms of a lateral malleolus fracture and ways to treat it.

How to Treat a Lateral Malleolus Fracture
Verywell / Cindy Chung 

Lateral Malleolus Fracture Symptoms

Lateral malleolus fractures cause pain, swelling, and bruising around the ankle.

If you have pain in other areas of the foot and ankle, you may have a more serious ankle injury.

You can have pain and swelling on the inner side of the ankle in addition to the lateral malleolus fracture. This may be a sign of an injury called a bimalleolar equivalent fracture.

Your doctor might recommend surgery for this, as it is an unstable fracture. In other words, the fracture compromises the integrity of the ankle. If left alone, the bone may heal in a position where the ankle doesn't function properly. That makes it more likely for you to develop early ankle arthritis.

Diagnosis

A lateral malleolus fracture is usually not too serious. But your healthcare provider might test you for signs of a more serious, unstable ankle fracture.

The good news is that isolated lateral malleolus fractures don't usually have this problem and tend to be stable ankle fractures. However, it's important to see a specialist to know the difference between the two.

Treatment

There are two parts involved in the treatment of a stable lateral malleolus fracture. First, you need to focus on resting and getting the swelling to go down. Then, you can gradually progress to putting weight on the ankle again.

  • Ice application: Apply ice to help reduce pain and swelling.
  • Elevation: Lie down and keep your ankle elevated above your heart to limit how much it swells.
  • Anti-inflammatory medications: Nonsteroidal anti-inflammatory medications (NSAIDs) can help control swelling and pain. This includes drugs like Motrin (ibuprofen) and Aleve (naproxen).
  • Rest/immobilization: A stable ankle fracture can support your weight. But you can control pain and swelling if you limit weight-bearing. Usually, a week or two with crutches will manage these symptoms.

When it comes to weight-bearing, studies show no difference between the various types of ankle supports. Some recommended options are:

  • Walking casts
  • Walking boots
  • Air casts
  • Ankle braces
  • High-top shoes (hiking boots)

Talk to your healthcare provider about the best option to support your ankle and provide you comfort during recovery.

Recap

Most lateral malleolus fractures don't require surgery. However, you will want to take steps to reduce pain and swelling in the ankle. Treatment usually involves rest, ice, and elevation. Ankle supports can also help.

Is Surgery Preferable?

You likely won't need surgery for stable lateral malleolus fractures. That's because non-surgical treatment is just as effective.

Also, surgery can put you at risk of an infection or problems while you heal that can lead to long-term problems. People who have surgery for fibula fractures might have swollen ankles for a long time.

Lastly, some people have metal implants put in around the ankle. They may choose to have the metal removed later, which means they'll need a second surgery.

So if your doctor doesn't recommend surgery, it's probably for the best.

Summary

Ankle fractures tend to be stable (less serious) or unstable (more serious). Lateral malleolus fractures are stable ankle fractures, and you usually don't need surgery. They can happen when you take an awkward step and roll your ankle.

To treat these ankle fractures, aim to reduce pain and swelling. Use ice, keep your ankle elevated, and take anti-inflammatory medication if you need it. Rest and limit movement at first, and then progress to putting weight on your ankle.

Take things one day at a time and follow your doctor's instructions.

Frequently Asked Questions

  • What is a lateral malleolus fracture?

    It's a fracture of the lateral malleolus bone (the large bump on the outer side of the ankle).

  • What are the symptoms of a lateral malleolus fracture?

    The most common symptoms are ankle pain and swelling but can spread to other parts of the foot or up toward the knee. The pain is usually more intense when you put weight on the ankle.

  • What causes a lateral malleolus fracture?

    Most often, it happens because of a high-impact injury from a fall, a blow to the ankle, or a twist to the ankle.

  • How is a lateral malleolus fracture diagnosed?

    A plain film X-ray is all a doctor needs to diagnose a lateral malleolus fracture. They may order a magnetic resonance imaging (MRI) or computed tomography (CT) scan if it's an unstable ankle fracture or related to trauma to the joint or connective tissues.

  • How is a lateral malleolus fracture treated?

    It depends on the severity of the fracture. You can treat some mild fractures without surgery. In this case, an ankle splint or short leg cast along with supportive care and pain management can be enough. For severe fractures, you may need surgery with internal or external fixation to keep the bone stable as it heals.

  • How long does it take for a lateral malleolus fracture to heal?

    If you need surgery, the fracture can usually heal within four to six weeks. The first couple of weeks usually involve an ankle splint and elevation of the foot for abound 90% of the day. After that, you can replace the splint with a removable boot. When X-rays show ample healing, you can start weight-bearing exercises with medical supervision.

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5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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