Overview Of Ankle Fractures In Adults

Ankle fractures are increasingly common injuries that necessitate a careful approach for proper management. Over five million ankle injuries occur each year in the United States alone [1].

This topic review will provide an overview of ankle fractures that result from minor trauma (ie, indirect or low energy fractures), including a basic approach to their evaluation and management. Fibular fractures above the lateral malleolus, tibial fractures, and ankle injuries other than fractures are discussed elsewhere. (See "Fibula fractures" and "Overview of tibial fractures in adults"and "Ankle sprain" and "Non-Achilles ankle tendinopathy".)


The incidence of ankle fractures is approximately 187 fractures per 100,000 people each year [1]. Since the mid-1900s, this rate has increased significantly in many industrialized countries, most likely due to growth in the number of people involved in athletics and in the size of the elderly population [1-3].

The vast majority of ankle fractures are malleolar fractures: 60 to 70 percent occur as unimalleolar fractures, 15 to 20 percent as bimalleolar fractures, and 7 to 12 percent as trimalleolar fractures [1,4]. There are similar fracture rates overall between women and men, but men have a higher rate as young adults, while women have higher rates in the 50 to 70-year age group [1,4].

Cigarette smoking and a high body mass index have been associated with ankle fractures [5,6]. In contrast to fractures of the radius and other fractures common among perimenopausal and postmenopausal women, bone density has not been clearly demonstrated to be a major risk factor [7].


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