About the fracture

A ‘lateral ankle avulsion fracture’ is a small break (fracture) to the ankle bone.

It is caused by a fragment of bone breaking off (avulsion) from the side (lateral) of the ankle where it attaches to tendons or ligaments. It is treated like a sprain.

Recovering

Healing

Healing usually takes around 6 weeks.

Pain and swelling

Leg up on pillow with cold pack over ankle

Your ankle may be swollen and painful. This is normal for 3 to 6 months after your injury.

Swelling is often worse at the end of the day. Resting with your foot up, and using ice or cold packs, will help (see Caring for your injury, below). You can also take pain killers.

Blue arrow icon.pngSpeak to your GP or pharmacist for advice on what medicines to take for the pain.

Walking and your boot

Physio boot

The boot protects your ankle and will make you more comfortable. Wear the boot when you are standing and walking for the first 2 weeks. You can put weight through your foot. You may find it easier to use crutches in the early stages.

You can take the boot off at night or when resting.

Blue arrow icon.pngTell us if you have diabetes. You may need a special boot.

Exercises

Man walking with crutches wearing fracture boot

Start exercise as soon as possible. See below for details.

Stop smoking

Quit smoking icon

Reducing or stopping smoking will help recovery.

Blue arrow icon.pngFor help, talk to your GP or pharmacist, or go to www.smokefree.nhs.uk for more information.

Follow-up

Mobile phone icon

We do not usually book to see patients again. With this injury, most people recover well by following the instructions we give here.

Blue arrow icon.pngContact the Trauma Triage Clinic team (details at the bottom of this leaflet):

  • if you are still using the boot after 6 weeks
  • if you still have significant pain or swelling after 12 weeks
  • if you are concerned about your symptoms
  • if you are unable to follow the instructions given below
  • if you have pain other than in your ankle.

Caring for your injury

Rest your ankle, especially in the first 3 days. Raise your ankle on a stool or cushions so that it is above the level of your hip. This will help reduce the swelling.

Wear your boot whenever standing and walking for the first 2 weeks. You can take it off when resting and at night. Wear a long sock in your boot.

Use a cold pack to help with pain and swelling. You can use an ice pack or bag of frozen peas wrapped in a damp towel. Put this on your ankle for up to 15 minutes every few hours. Make sure the ice is not in direct contact with your skin.

Exercises

Early movement of the ankle and foot is important to promote blood flow and reduce the risk of a blood clot. You can find out more including symptoms of a clot on the NHS website.

  • Do these exercises 3 to 4 times a day.
  • Start straight away.
  • Take your boot off first.
  • Move gently and within comfort. You do not need to push into pain.

1.
  • Point your foot up and down.
  • Repeat this 10 times.

flexing and pointing foot


2.
  • With your heels together, move your toes apart to turn the foot outwards.
  • Repeat this 10 times.​​​​​​

turning ankle in and out


3.
  • Make gentle circles with your foot in one direction and then the other direction.
  • Repeat this 10 times.

circling feet

You can stop using the boot 3 weeks after your injury.

Start by walking without the boot at home. Build up to walking without it outside and for longer walks. You should not be using your boot 6 weeks after the injury.

It is normal to still have mild discomfort and swelling. This may continue for 3 to 6 months.

Activity and exercise

  • Gradually increase your activity.

  • Avoid anything that involves impact for 3 months. This includes running, jumping and dancing.

  • You can now also move on to the next exercises.

  • Do these exercises 3 times a day.

Blue arrow icon.pngContact the Trauma Triage Clinic if you are struggling to recover your movement or return to activity (contact details below).

 

 

Balance, level 1  
These exercises are for people who could not stand on one leg before their injury.  
1.
  • Hold onto a firm support in a safe space.
  • Stand with your feet as close together as possible.
  • Hold your balance for 30 seconds.
Standing with feet together

2.

  • Now try removing your hand.
  • Try to keep your balance for 30 seconds.
 
3.        
  • Hold onto a firm support.
  • Put one foot in front of the other, as close together as you can.
  • Hold this for 30 seconds.
  • If you can, try to let go of the support and keep your balance.
Standing with one foot behind the other

 

Stretches  
1.        
  • Sit with your leg straight out in front of you.
  • Put a towel or bandage around your foot and pull it towards you.
  • Feel a stretch in the back of the calf.
  • Hold for 30 seconds.
flexing foot up using band
2.
  • Point your toes down as far as they go.
  • Put your other foot on top and apply some pressure. This will stretch the top of your foot.
  • Hold for 30 seconds.

Pointing foot

 

Balance, level 2  
These exercises are for people who could stand on one leg before their injury.  
1.
  • Hold onto a firm surface in a safe space.
  • Try to stand on one leg (your injured leg).
  • Hold this for 30 seconds.
  • Stop if you experience pain.
  • When you can do this comfortably, try the next exercise.
Standing on one leg

2.

  • Try to stand on one leg (your injured leg) without holding on to a support.
  • Try to hold this for 30 seconds.
  • When you can do this comfortably, try the next exercise.
 

3.

  • Try these exercises with your eyes closed.
  • Make sure you are always in a safe environment with a support to hold if needed.
 

Frequently asked questions

The boot has a thicker sole which can make you feel uneven. Make sure you wear a supportive shoe or trainer on your uninjured foot. This will reduce stress on other joints.

If you need more advice, contact the Trauma Triage Clinic.

If you have diabetes, contact us to discuss your boot. This is particularly important if you have problems with your skin or sensation. We may provide you with a specialist diabetic boot.

You can return to driving when:

  • you are no longer using your boot
  • and you can walk comfortably
  • and you can perform an emergency stop without pain.

Before you start driving again, it is recommended that you speak to your insurance company and test your ability to drive in a safe environment.

You can get a fitness for work statement from your GP.

Please return both the boot and crutches to the Physiotherapy Department.

Contact information

Trauma Triage Clinic

 

For any urgent queries at other times call NHS 111

Telephone:

020 8934 6983 (Monday to Friday, 8am to 4pm)

Email: Khn-tr.orthopaedics@nhs.net