Ankle fractures are breaks of the distal tibia or fibula (near or in the so-called malleolus) affecting the tibiotalar (ankle) joint. Occasionally, they involve the shaft of the fibula as well. Ankle fractures range from simple injuries of a single bone to complex ones involving multiple bones and ligaments. Twisting with the foot planted on the ground and the body rotating around it is the most common mechanism of injury. Compression loading (ex. from a fall) is more apt to produce a fracture of the weight-bearing surface of the distal tibia (the plafond). These are designated as “pilon fractures," and are considered distinctly different injuries. Ankle fractures can be broadly divided into stable or unstable injuries. Stable fractures typically heal with immobilization and protected weight-bearing whereas operative management is usually required for displaced or unstable fractures. Ankle fractures directly or indirectly involve the ankle joint. Some residual ankle arthrosis is therefore not uncommon, even if the bone heals perfectly.
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