Ankle Pain, Injury and Surgery

The ankle is a complex joint which controls a range of movements. The joint consists of two leg bones which run alongside each other, the tibia and the fibula, and the talus, a bone in the foot slots between them. They are all held in place by ligaments which act like strong bands.

Possible causes of ankle pain

Historical injuries such as sprains and fractures are often the cause of ankle pain, but there are also a number of types of arthritis which can result in sometimes severe discomfort. These are:

  • Ankle arthritis
  • Rheumatoid arthritis
  • Psoriatic arthritis
  • Gout
  • Septic arthritis

Treatment – Treatments include ankle arthroscopy, ankle replacement and ankle fusion.

A straightforward fracture is normally treated by putting the ankle in a plaster cast for between six and eight weeks. After the initial four weeks the cast is sometimes changed for one which is removable or a special boot which allows the patient to put some weight through the injured ankle.

In the case of severe fractures, surgery to realign and fix the bone is necessary, normally under general anaesthetic – although there are sometimes other options. Plates, wires or screws are used in the procedure, which is known as an open reduction and internal fixation. It is unusual for the metalwork to be removed from the ankle.


Ligaments – The most common ankle injury involves the ligaments and normally happens when the foot twists. In most cases the resulting injury is a sprain, but small pieces of bone can sheer off or the cartilage lining can chip. The tendons around the ankle can also become damaged.

What to do – Most minor ankle injuries will get better if you rest, apply ice and a bandage. In some cases a visit to the hospital and further treatment is necessary.

If the ligaments are seriously damaged this can affect stability and physiotherapy or orthotics is normally beneficial. It is also possible to perform a ligament reconstruction, but only in the most severe cases.

Fractures – A break or crack is commonly referred to as a fracture. The symptoms are similar to a sprain, so it is important to look out for the characteristics of a fracture, which are:

  • Severe pain in the bones around the injured ankle
  • Lack of ability to put any weight on the injured ankle
  • The sound of cracking when the injury occurs
  • The ankle is deformed
  • Swelling which worsens over three or four days
  • Broken skin over the ankle joint

Recovery – It normally takes around 12 weeks to recover from a fractured ankle but it depends on the severity of the injury and can in fact take a lot longer. It is important to follow medical advice on rehabilitation.

This page is intended for information purposes only and should not replace advice that your relevant health professional would give you.

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