Medial Ankle Avulsion Fracture

Patient Information Leaflet

Healing

• This is a small break to the inside of the ankle and is medically treated like a sprain.
• It normally takes about six weeks to heal.
• Smoking will slow down your healing.
• We would advise that you stop smoking while your fracture heals.
• Talk to your GP or go to www.smokefree.nhs.uk for more information.

Pain and swelling

• Your ankle may be swollen and painful.
• Swelling is often worse at the end of the day.
• It is normal to have mild pain and swelling for three to six months after your injury.
• Taking pain medication, elevating your ankle and using ice or cold packs will help.
• More information can be found later in this leaflet.

Walking and your boot

• The boot protects your ankle and will make you more comfortable.
• Wear the boot when you are standing and walking for the first two weeks. You can take it off at night and at rest.
• Please inform us if you are diabetic; you may need a special boot.
• You are allowed to put weight through your foot.
• You may find it easier to use crutches in the early stages.

Exercises

• It is important to start exercises as soon as possible. Exercise instructions are detailed later in this leaflet.

Follow up

• You do not usually need another appointment for this injury. Most people get better by looking after it themselves.
• Please contact our team if:
  • You still have a lot of pain or swelling after 12 weeks, or
  • You are still wearing the boot after 6 weeks.

Any questions?

• If you are worried about your symptoms, cannot follow this recovery plan, or have pain somewhere other than your ankle, please contact the Virtual Fracture Clinic team.

Caring for your injury: Week 1-2

• Remember to wear your boot whenever standing and walking for the first two weeks.
• You can remove the boot when resting and at night. Wear a long sock in your boot.
• Using a cold pack will help with your 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 isn’t in direct contact with your skin.
• Try to rest your ankle, especially in the first 24-72 hours.
• Raise your ankle on a stool or cushions so that it is above the level of your hip. This will help to reduce your swelling.

Exercises

• Moving your ankle and foot early is important. It helps your blood flow and lowers the chance of getting a blood clot.
• Do these exercises 3 to 4 times a day. Start them straight away. Stop if they cause pain.

Caring for your injury: Week 3-6

• You should now stop using your boot, if you haven’t already.
• Start by walking without the boot around your own home.
• Build up to walking without it outside or for longer walks.
• You should not be using your boot after six weeks post injury.
• It is normal to still have mild discomfort and swelling.
• This may continue for three to six months.

Activity and Exercise

• Slowly increase how much activity you do.
• Avoid activities that put a lot of impact on your ankle for 3 months. This includes running, jumping and dancing.
• You can now move on to the next level of your exercises.

Stretches

Balance

Level 1: These exercises are for people who couldn’t stand on one leg before their injury.

Level 2: These exercises are for people who could stand on one leg before their injury.

Frequently Asked Questions

I am struggling with my boot. What do I do?

• The boot has a thicker sole; this 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 Virtual Fracture Clinic.

I am diabetic, does this change things?

• If you have diabetes, please contact us to talk about your boot.
• This is especially important if you have skin problems or cannot feel sensations in your foot.
• We may give you a special boot made for people with diabetes.

When can I start driving?

• You can return to driving when:
  • You are no longer using your boot
  • You can walk comfortably
  • You can perform an emergency stop pain free
  • Always test your ability to drive in a safe environment first.

How can I get a certificate for work?

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

What do I do with my boot and crutches when I no longer need them?

• We cannot use the boots again, so please do not return your boot to the hospital.
• You can return your crutches to the Fracture Clinic or Accident & Emergency department.

With thanks to Brighton and Sussex University Hospitals NHS Trust for kindly sharing their information sheets with us with full permission to use contents and images.