Broken ankles are rarely life-threatening emergencies, but there’s no doubt that they’re extremely painful. First aid can go a long way toward reducing pain and starting the treatment process. Learn to recognize a broken ankle to decide how to treat it.
- pain (almost always present)
- deformity (ankle appears misshapen)
- tender to touch
- patient is unable to bear weight on the ankle
Not all ankle injuries are fractures, but there’s no way to tell in the field without an X-ray. For that reason, we always treat ankle injuries as if they are broken until we get them to the hospital and find out otherwise. The signs and symptoms of a broken ankle are the same as a sprained ankle. Signs and symptoms of a broken ankle:
Steps to Treat a Broken Ankle
Safety First! Make sure the patient is in a safe location. It is more important to worry about rescuer and patient ongoing safety than to worry about one broken ankle.
- Check ABCs. Make sure the patient has an Airway, is Breathing, and has Circulation.
- Control bleeding.
- Look for other injuries. If a patient shows signs of injury to the head, neck, or back, DO NOT move the patient.
- Cover any broken skin with sterile dressings. If needed, the wound can be rinsed — try to use sterile water or saline solution. Open wounds may require stitches.
- If an ambulance is responding, have the patient remain still and wait for the ambulance. Proceed to step 8 (ice on the break).
- If an ambulance is unavailable, it may be necessary to splint the broken ankle. Before splinting, check circulation, sensation, and motion.
Check circulation by comparing the color and temperature of the injured ankle against the uninjured ankle.
- Check sensation by asking the patient which toe you are touching.
- Check motion by having the patient wiggle his or her toes.
- To splint a broken ankle, splint the ankle with a pillow. You can also fashion a foot splint out of cardboard. Be sure to immobilize the foot and shin area as well. Any movement will result in pressure on the ankle. Do not wrap the ankle too tight.
- After splinting, recheck circulation, sensation, and motion.
- Put an ice pack on the break to reduce swelling. Put a sheet or towel between the ice and the skin to prevent frostbite. Leave ice on for 15 minutes, then remove ice for 15 minutes.
- Remember, do not move a patient with suspected head, neck, or back injuries unless it is to keep rescuers or patient safe.
- Always practice universal precautions and use personal protective equipment whenever you may come in contact with blood or body fluids.
- Call 911 for a leg broken above the knee, a broken hip, a broken pelvis, a neck or back injury, or a head injury. It is still acceptable to summon an ambulance for a broken ankle, but try to call on the ambulance agency’s non-emergency line if known.