How to tell if ankle is broken or sprained

Fractured versus sprained ankle

A fractured ankle refers to a break or crack in one or more of the bones that make up the ankle joint. The ankle joint is composed of the tibial, the fibula, and the talus. Fractures can occur in any of the bones, and they can vary in type and severity from minor hairline cracks to complete breaks that cause displacement or fragmentation of the bone.

A sprained ankle is a common injury that occurs when one or more ligaments in the ankle are stretched or torn. Ligaments are tough bands of tissue that connect bones to each other and provide stability to the joints. An ankle sprain typically happens when the ankle is twisted, rolled, or turned in an awkward manner, causing the ligaments to overstretch or tear. The severity of ankle sprain can vary from mild (Grade 1) to moderate (Grade 2) to severe (Grade 3), depending on the extent of ligament damage.

Ankle sprain injury is categorized into three different types.

1. Inversion ankle sprain: This is the most common type of ankle sprain injury and occurs when the ankle rolls or is twisted inward. In inversion ankle sprain, the outer (lateral) ligaments of the ankle are typically affected (ATFL, CFL, and PTFL).
2. Eversion ankle sprain: Eversion sprain is less common and occurs when the ankle rolls or is twisted outward. The inner ligaments of the ankle are typically affected (Deltoid ligaments).
3. High ankle sprain: This type of ankle sprain is even less common than eversion sprain which involves the injury of the syndesmotic ligaments that connect the bones (tibia and fibula) above ankle joint and require longer recovery time.

Differentiate fractured ankle or sprained ankle

Determining whether an ankle is broken or sprained can be challenging because some of the symptoms overlap. Here’s some break down of the sign and symptoms that associate with each:

1. Pain Intensity: Both a broken ankle and a sprained ankle will cause pain, but the intensity may differ. A broken ankle usually results in more intense pain, especially when weight is put on it. A sprained ankle may be painful, but the pain is often less severe.
2. Swelling: Swelling is common with both injuries, but it might be more pronounced with a fracture. Look for significant swelling that occurs rapidly after the injury, as this could indicate a fracture.
3. Bruising: Bruising may develop with both a broken ankle and a sprained ankle, but it tends to be more extensive with a fracture.
4. Deformity: In some cases of a broken ankle, there may be a visible deformity or misalignment of the ankle joint. This could be a sign of a fracture rather than a sprain.
5. Inability to Bear Weight: If you’re unable to put any weight on the injured ankle without experiencing significant pain, it could be a sign of a fracture rather than a sprain.
6. Range of Motion: With a sprained ankle, you might still be able to move the joint to some extent, although it will likely be painful. A broken ankle may limit your range of motion significantly.
7. Sound: Sometimes, a broken bone may produce a snapping or popping sound at the time of injury. However, not everyone hears this sound, and its absence doesn’t rule out a fracture.

Conclusion

Distinguishing between a sprained ankle and a fractured ankle based solely on signs and symptoms can be challenging, as there is significant overlap between the two conditions. Therefore, obtaining an X-ray of the ankle is crucial to accurately diagnose whether a bone fracture is present. Moreover, it’s important to note that even after ligaments have fully recovered from injury, individuals may continue to experience ankle pain. This persistent discomfort can often be attributed to misalignment of the ankle bone, leading to impaired biomechanics of the ankle joint. Consulting a chiropractor specializing in spine and extremity injuries is advisable in such cases. Chiropractors can assess and address ankle misalignments to promote proper joint function and alleviate pain.