Stephen J. Schueler, M.D.

Overview Incidence Symptoms Evaluation Treatment questions for doctor specialist Home Care pain in adults pain in children toe ring removal using a walker using crutches warning signs Outlook Underlying Cause Types Anatomy

Broken Ankle Home Care

Home care for ankle fracture includes:

  • Apply a cold compress:
    • Wrap ice in a moist hand towel. Do not apply ice directly to the skin.
    • Apply for 20-30 minutes, every 1-2 hours, for the first few days.
  • Do not bear weight on your ankle until your doctor directs you to do so:
    • Use a walker.
    • Use crutches.
  • Follow cast care instructions.
  • Follow splint care instructions.
  • Elevate your ankle:
    • Above your heart if possible.
  • Acetaminophen for pain
  • Nonsteroidal anti-inflammatory medications for pain:
  • Take prescribed medications as directed:
    • Don't skip doses of your medication. This makes them less effective.
    • Be aware of the common side effects that may be caused by your medication.

Broken Ankle Pain in Adults

Medications commonly used to control pain and inflammation in adults with an ankle fracture include:


Acetaminophen
  • Acetaminophen decreases fever and pain, but does not help inflammation.
  • Adult dosing is 2 regular strength (325 mg) every 4 hours or 2 extra-strength (500 mg) every 6 hours.
  • Maximum dose is 4,000 mg per day.
  • Avoid this drug if you have alcoholism, liver disease or an allergy to the drug. See the package instructions.
  • Common brand names include Tylenol, Panadol, and many others.

Aspirin

Ibuprofen

Naproxen

Ketoprofen

NSAID Precautions

Broken Ankle Pain in Children

Common medications used at home for pain and fever in children with an ankle fracture include:


Aspirin and most of the other nonsteroidal anti-inflammatory drugs (NSAIDS) are not used in children except under a doctor's care.

Acetaminophen
  • Acetaminophen decreases fever and pain, but does not help inflammation.
  • Dosing is 10-15 mg per kilogram (5-7 mg per pound) of body weight every 4-6 hours, up to the adult dose.
  • Do not exceed the maximum daily dose.
  • Acetaminophen products come in various strengths. Always follow the package instructions.
  • Avoid this drug in children with liver disease or an allergy to acetaminophen.
  • Common acetaminophen products include Tylenol, Panadol and many others.

Ibuprofen

Naproxen

Broken Ankle Toe Ring Removal

Remove toe rings immediately after an ankle fracture, because it is difficult to remove the ring if the toe becomes swollen. Sometimes, the toe becomes so swollen that the ring must be removed with a ring cutter. The following will help you remove a toe ring from a swollen toe.

Ring Removal

  • Elevate the toe above the heart and apply a cold compress for 15-20 minutes.
  • Lubricate the ring:
    • Apply soapy water to the ring.
  • Ask another person to pull the skin tightly away from the ring, and then try to twist the ring off gently.
    • Stop if this causes pain or skin damage.
  • If this does not work, loop a piece of thin string or ribbon under the ring on both sides of the toe. Ask another person to grab the ends of both strings. Have the person pull equally on the ends of each string, while you gently twist the ring.

Reducing Toe Swelling
In order to reduce toe swelling, you may wrap a wide rubber band around the toe. Start at the tip of the toe and wrap towards the ring. Overlap the edges of the rubber band as you wrap the toe. After 5 minutes, remove the rubber band and try to remove the ring.

Do not wrap the toe with a rubber band if:

Seek medical care immediately for:

Broken Ankle Using a Walker

Elderly patients with an ankle fracture may require more support than a cane or crutches can offer.

A walker is much more stable than crutches or a cane. Adjust the walker so that the handles reach the crease in your wrist while you stand upright.

Using a Walker

  • Place your walker one stride ahead of you. Make sure that all 4 legs of your walker are on the ground.
  • Grasp the handles on the walker with both hands. Lean forward and support your weight on your arms.
  • Step forward with your good leg. Place your foot in the center of the square that is made by the walker feet.
  • Step forward with the other leg.

Walker Rules
  • Take small steps when you turn.
  • In order to sit in a chair, back up until your legs touch the chair. Reach behind you in order to feel the seat and then sit down.
  • In order to get up from a chair, push yourself up with your arms and then grasp the handles on the walker.
  • Make sure that the rubber tips on the legs of the walker are tightly fastened. Replace the rubber tips if they become worn.
  • Do not use your walker to climb stairs.
  • Do not use your walker on an escalator.

General Safety Tips
  • Remove small area rugs, electrical cords, spilled liquids or other items that may cause you to slip.
  • In the bathroom, install non-slip bath mats, toilet grab bars, a raised toilet seat, shower grab bars and a shower tub seat.
  • Keep household items in close reach.
  • Use a backpack, fanny pack, apron or shoulder bag to carry items.

Broken Ankle Using Crutches

Some patients with an ankle fracture will require crutches.

You must be able to support your entire weight on one leg, in order to use crutches. Crutches allow you to walk without placing any weight on an injured or painful leg.

Proper Adjustment for Crutches

  • The top of your crutch should be 1-1.5 inches below your armpit as you stand upright with the crutch resting on the floor.
  • The hand grips should be even with your hip joint.
  • Your elbows should bend as you use the hand grips.

Non Weight Bearing Technique
  • Stand on the good leg while using the crutches for balance.
  • Hold the bad leg off the floor.
  • Begin your step as if you are going to step on the bad leg, but do not place any weight on this leg. Instead, place both crutches in front of you and place your weight on your arms.
  • Your arms are supported by the crutches as you grip the crutch handles.
  • The crutches should be placed on the floor at an angle away from the side of your body, in a shape like the upright arms of the capital letter, "A."
  • Your elbows should bend as you support your weight.
  • Gently push off with your good leg after the crutches are firmly planted on the floor. Swing your body forward between the crutches.
  • Rest the top of the crutches tightly against each side of your chest and continue to support your weight with your arms.
  • Do not rest your armpits on the tops of the crutches. This can cause nerve damage.
  • Place your good leg on the floor and allow it to completely support your weight. Swing your crutches slightly away from your body and forward. Place the crutches on the floor to prepare for the next step.
  • Focus on where you are walking -- do not look at your feet.

Partial Weight Bearing Technique
  • Stand on the good leg while using the crutches for balance.
  • Begin to step on the bad leg, but do not place your entire weight on this leg. Instead, place most of your weight on your arms.
  • Your arms are supported by the crutches as you grip the crutch handles.
  • The crutches should be placed on the floor at an angle away from the side of your body, in a shape like the upright arms of the capital letter, "A."
  • Your elbows should bend as you support your weight.
  • Gently push off with your good leg after the crutches are firmly planted on the floor. Swing your bad leg forward between the crutches.
  • Rest the top of the crutches tightly against each side of your chest. Continue to support your weight with your arms and the bad leg.
  • Do not rest your armpits on the tops of the crutches.
  • Place your good leg on the floor and allow it to completely support your weight. Swing your crutches slightly away from your body and forward. Place the crutches on the floor to prepare for the next step.
  • Focus on where you are walking -- do not look at your feet.

Climbing Stairs with Crutches
When climbing stairs, you should climb one stair at a time, completely resting for a moment on one step before moving to the next step.

Follow these steps:
  • Start by supporting your weight with your good leg and both crutches.
  • Place your weight on both of the crutches and move your good leg up to the next step.
  • Transfer your weight to the good leg.
  • Lift the bad leg and the crutches onto the same step where you placed the good leg.
  • Support and stabilize yourself with both crutches and the good leg before moving to the next step.

Going down Stairs on Crutches
When going down stairs, you should go down one stair at a time. Stop and rest for a moment on one step before moving to the next step.

Follow these steps:
  • Start by supporting your weight with your good leg and both crutches.
  • Place your weight on the good leg and place both of the crutches onto the next lower step.
  • Transfer your weight to both crutches.
  • Place the good leg onto the same step where you placed the crutches.
  • Support and stabilize yourself with both crutches and the good leg before moving to the next step.

Broken Ankle Warning Signs

Notify your doctor for an ankle fracture and any of the following:

Continue to Broken Ankle Outlook

Last Updated: Nov 29, 2010 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Broken Ankle References
  1. DiGiovanni BF, Partal G, Baumhauer JF. Acute ankle injury and chronic lateral instability in the athlete. Clin Sports Med. 2004 Jan;23(1):1-19, v. [15062581]
  2. Kunkel M, Miller SD. Return to work after foot and ankle injury. Foot Ankle Clin. 2002 Jun;7(2):421-8, viii. [12462119]
  3. McKay GD, Goldie PA, Payne WR, Oakes BW. Ankle injuries in basketball: injury rate and risk factors. Br J Sports Med. 2001 Apr;35(2):103-8.[11273971]
  4. Pugia ML, Middel CJ, Seward SW, Pollock JL, Hall RC, Lowe L, Mahony L, Henderson NE. Comparison of acute swelling and function in subjects with lateral ankle injury. J Orthop Sports Phys Ther. 2001 Jul;31(7):384-8.[11451309]
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