Sports Medicine: Lateral Malleolus Avulsion Fractures

Avulsion fractures are breaks or splits in the bone.  Stress placed on the bone by a tendon or ligament causes the fracture. As the bone breaks, the part of the bone that is attached to the tendon or ligament pulls away from the rest of the bone. A common spot for avulsion fractures is at the lateral malleolus or outside ankle bone.

Signs and Symptoms

• pop sound at the time of injury
• a swollen, tender area on the outside (lateral) ankle
• bruising on the outside of the ankle or foot
• pain with walking, often with a limp

Increased Risk

• sports that require jumping and landing (basketball, gymnastics, volleyball) or pivoting and cutting (football, soccer)
• taking part in snow skiing or ice skating
• repeated injury to the ankle or foot like previous ankle sprain(s)
• poor warm-up before practice or play
• exercise on uneven ground
• poor physical conditioning (strength and flexibility)

Treatment

• Medicine
  • Anti-inflammatory medicines, such as ibuprofen (Motrin^® or Advil^®) or naproxen (Aleve^®) may be recommended. Take these as directed by your health care provider.
  • Other minor pain relievers, such as acetaminophen (Tylenol^®), may be used.
• Use of cold and heat
  • Cold should be applied for 10 to 15 minutes every 2 to 3 hours and after any activity that makes symptoms worse. Use ice packs or an ice massage.
  • Heat may be used before doing stretching and strengthening activities prescribed by your health care provider or athletic trainer. Use a heat pack or a warm soak. Apply for 10 to 15 minutes.
• Orthopedic aids
  • A walking boot or air cast may be recommended to hold the ankle and foot in place, keep it from moving, and allow it to heal properly.
  • Crutches may be needed in the beginning until you can walk without pain.
• Rehab
  • Rehab may be needed to regain motion, strength and balance, and to be able to return to sports. Your health care provider may refer you to a physical therapist or athletic trainer for more treatment.

How to Prevent

• Do correct warm-up and stretching before practice or competition.
• Maintain suitable conditioning, shoulder flexibility, muscle strength and endurance.

When to Call The Health Care Provider

Call your health care provider or the Sports Medicine team at (614) 355-6000 if:

• symptoms get worse or do not improve in 4 weeks despite treatment
• new, unexplained systems develop 

Sports Medicine: Lateral Malleolus Avulsion Fractures (PDF)

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