External Malleolus Fracture

Meanings of External Malleolus Fracture

An external malleolus fracture can have various injury patterns. If a distal fibular fracture is treated early and appropriately, no consequential damage usually remains.

What is an external malleolus fracture?

The outer malleolus fracture is a bone fracture that occurs relatively frequently in humans. Above all, the distal fibular fracture often occurs as a sports injury.

According to bittranslators.com, a fracture of the outer ankle is one of the so-called ankle fractures. In medicine, a distal fibular fracture is classified according to, among other things, the severity of the fracture of the outer ankle and the extent of the damage it causes to adjacent body structures (such as tears in the ligaments).

A distal fibular fracture often manifests itself in immediate pain accompanied by a bruise and severe swelling. In most cases, it is not possible for an affected person to put weight on the affected foot immediately after a fracture of the outer ankle.


In the vast majority of cases, an external malleolus fracture is caused by an ankle twisting or a dislocation (in medicine also referred to as dislocation) of the ankle bone. The ankle bone protrudes from the so-called ankle fork, which forms the joint. A distal fibular fracture is only very rarely the result of direct violence.

As a sports injury, a distal fibular fracture occurs primarily during ball sports (such as tennis or soccer); here there are frequent shorter sprints with the following stop movements, which represent an increased risk for an athlete to twist an ankle and suffer a fracture of the outer ankle.

In addition, traffic accidents are among the situations in which a distal fibular fracture occurs relatively often in the injured. Other factors that limit the safety of walking and thus promote a distal fibular fracture are, for example, excessive consumption of alcohol or moving on smooth and / or uneven surfaces.

Symptoms, ailments & signs

An external malleolus fracture is primarily associated with very severe pain. The pain itself often spreads to the neighboring regions of the body, so that there too severe pain and, in general, restricted mobility. The patient’s quality of life is greatly reduced by this fracture.

In some cases, the affected person may lose consciousness for a short time when they break and may be injured if they fall. Furthermore, the affected region swells and is usually also affected by a [[bruise9]. The pain itself is stabbing and burning and can also lead to mental disabilities or irritability. Many patients also suffer from depression due to the fracture of the lateral ankle.

Due to the severe pain, running, walking or standing is no longer possible without further ado. The foot itself can no longer be put on either. In most cases, however, an external malleolus fracture can be treated well. Only in a few and especially in serious cases does damage to the joint occur, so that it has to be operated on. The pain itself usually goes away a few days after the fracture, if the area is cast in a cast and properly treated.

Diagnosis & course

An external malleolus fracture is usually diagnosed with the help of x-rays. This diagnostic method allows, among other things, to show the anatomical course of a distal fibular fracture; This is made possible by comparing two x-ray images that are made from different perspectives in the case of a fracture of the outer malleolus.

Often, performing such a standardized x-ray examination is sufficient to diagnose an external malleolus fracture; If structures such as joint capsules or ligaments that have been affected by a fracture of the outer malleolus are also to be considered as part of a diagnosis, this is possible, for example, with the help of magnetic resonance imaging (MRI) or computed tomography (CT).

The course that a distal fibular fracture takes depends, for example, on the severity of the injury; If there are no complications during the healing process, possible residual symptoms such as sensitivity to the weather or swelling usually recede completely after a few months. A complicated lateral malleolus fracture can result in long-term joint damage; permanent complaints, such as chronic pain, are very rare.


In most cases, there are no further complications with the external malleolus if the symptom is treated correctly and, above all, early on by a doctor. In the case of a fracture of the outer ankle, the patient suffers from extremely severe pain, which in the worst case can lead to fainting. The ankle is swollen and red.

It is usually not possible for the person affected to perform any physical activity on the affected area. In most cases, treatment is carried out with the help of a surgical procedure. This does not lead to any further complaints. The ankle is straightened and finally positioned in a cast so that it cannot move.

The pain can be treated with pain relievers, but these will subside a few days after the break. Slight complications can arise if the external malleolus fracture is the result of an accident in which surrounding body parts and the skin were also damaged. In this case, inflammations or infections can develop.

It usually takes six weeks to heal. During this time, the patient is severely restricted in his movement and may need the help of other people or carers.

Treatment & Therapy

Appropriate treatment steps after an external malleolus fracture depend on the type and severity of the fracture. As a first aid measure in the event of a fracture of the lateral ankle, doctors recommend in most cases first of all to relieve the corresponding leg, to position it high and to cool it.

If there is a slight fracture of the outer ankle, in which the bone is not or barely displaced, treatment can usually be conservative (i.e. without the use of surgical measures): For this purpose, the ankle is first straightened and then immobilized for a certain time. Surgical intervention may be necessary after a fracture of the outer malleolus if the ends of the fracture have shifted significantly.

Surgery may also be necessary if there is a distal fibular fracture in the form of an open hernia or if vessels and / or nerves are affected. An external malleolus fracture is straightened and fixed with screws or plates. This procedure in the case of a fractured outer ankle is usually followed by a plaster cast that remains on the leg for about 6 weeks. Physiotherapy procedures can ultimately have a positive effect on the healing process after a fractured outer ankle.

Outlook & forecast

In normal cases, the prognosis of a lateral ankle fracture is to be classified as good with fast and optimal medical care. Many complications can be avoided with an initial treatment followed by a comprehensive examination. The younger the patient and the less past damage they have had to the ankle or ankle, the faster they will recover.

In the healing process, the advice of the doctor must be taken into account so that the too early reloading does not cause a relapse. Recovery takes several months and is prolonged as soon as the bones are overexerted too early or the feet are not adequately protected. Surgical intervention takes place in the case of complicated or multiple fractures of the ankle.

Existing chippings are removed, corrections are initiated and the ankle is stabilized. In principle, healing also takes place in the event of a serious injury. However, this takes more time and it cannot be guaranteed that the patient will be symptom-free afterwards.

In some cases, everyday life has to be restructured and professional or leisure activities have to be adapted to the circumstances. When wearing unhealthy footwear, impairments are to be expected. The load capacity of the outer ankle changes after a fracture. Without medical care, the patient is at risk of painful adhesions of the ankle.


A fracture of the outer ankle can be prevented, for example, with appropriate footwear; For example, when hiking on uneven terrain, shoes with a high shaft can reduce the risk of suffering a distal fibular fracture. At the same time, training your reflexes and coordination can prevent a fracture of the outer ankle.


Follow-up care for a distal fibular fracture essentially consists of restoring all functions and monitoring tissue healing. After an operation due to a fracture of the outer ankle, the focus is on monitoring bone healing. This also checks whether any parts (screws, plates) that may be used lead to problems or not. Since swelling and infection can occasionally occur, this is necessary. If necessary, the operation must be tackled again using other means.

The healing is checked – depending on the selected therapy – according to defined protocols. The follow-up examinations of the foot and shin are only superfluous when the person concerned can load his foot normally again and the fracture has really healed. Usually there is a last check-up after a year.

Another typical check-up during follow-up is taking an X-ray after six weeks. Compression stockings are also prescribed at this point (if necessary) to contain the swelling. Part of the aftercare is a subsequent mixture of rest and exercise therapy.

For the time being, walking should be done with supports, jumps and sprints are to be avoided. At the same time, the mobility of the foot should be restored by means of exercises (to be carried out by a physiotherapist if necessary). You can restore your athletic abilities from around the third to sixth month after the operation. The exact schedule for such exercise therapies depends on the complexity of the fracture and its healing.

You can do that yourself

Anyone suffering from a painful lateral ankle fracture should follow the first aid measures and consult a doctor immediately. After or in addition to the medical treatment, there are some self-help options to relieve swelling on the foot and accelerate the recovery process.

To minimize the pain and swelling, ice is often used for pleasant cooling. The ice has a vasoconstricting effect on the injured tissue and thus a positive effect on the associated redness, inflammation, heat and swelling.

The cooling can take place in different forms, for example with an ice pack in an ice pack or an ice spray. A normal towel, which is placed in a moist plastic bag in the freezer compartment as preparation, is also a quick help. After about 15 minutes, the towel can be placed on the injured areas on the foot, thus relieving the symptoms.

It is also important to immobilize the joint and avoid overloading. In the time after an external ankle fracture, stress such as running, cycling or swimming should be avoided. Elevating the feet can counteract swelling and bruising. Even if these self-help options can help in everyday life and reduce pain, an external ankle fracture should always be under medical supervision.

External Malleolus Fracture

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