Lateral Malleolus Fracture

If the fracture is out of place or your ankle is unstable, your fracture may be treated with surgery.

This trauma know as injury to the distal fibula of the ankle as well. The lateral malleolus is the name provided to the bone on the outside of the ankle joint. This bone is part of the fibula, one of two bones of the leg; the other leg bone is called the tibia (shin bone). The tibia brings the main amount of the weight of the body (about 90 percent), with the fibula holding only about 10 percent of body weight.

Most Common Mechanisms of Injury Causing Lateral Malleolus Fractures
Twisting Injury (e.g. ankle sprain)
42%
Direct Trauma
15%
Falls from Standing Height
23%
Sports Injury
12%
High-Energy Trauma (e.g. car accident)
8%
This chart illustrates the most common causes of lateral malleolus fractures. Twisting injuries—often associated with ankle sprains—remain the predominant mechanism, while high-energy trauma, such as motor vehicle collisions, occurs less frequently but typically leads to more complex fractures.

Fractures of the lateral malleolus are the most common type of ankle fracture. These injuries generally occur when the ankle is either twisted or rolled, frequently with an awkward or unequal action. The bright side is that the majority of lateral malleolus fractures are considered steady ankle fractures and can be treated without surgery.

Symptoms of Lateral Malleolus Fractures

Lateral malleolus fractures trigger pain, swelling, and bruising around the ankle. Pain in other locations of the foot and ankle need to be need to suspect a more severe ankle injury than an isolated lateral malleolus fracture.

Pain and swelling on the inner side of the ankle (in addition to a lateral malleolus fracture) may indicate the possibility of an injury called bimalleolar equivalent fracture– a specific type of unstable ankle fracture that may require surgery. Anyone with a lateral malleolus fracture ought to be analyzed for signs of a more major, unstable ankle fracture.

X-ray image of lateral malleolus fracture in ankle – clear bone break and displacement
X-ray image of lateral malleolus fracture in ankle – clear bone break and displacement

An unstable ankle fracture is an injury that occurs when the fracture causes the ankle joint to not work correctly. For that reason, if the bone heals in a position where the ankle is not operating properly, the ankle is most likely to establish early ankle arthritis. Fortunately is that separated lateral malleolus fractures are usually stable ankle fractures and for that reason do not have this issue.

Treatment of Lateral Malleolus Fractures

Treatment of a stable lateral malleolus fracture need to include efforts to minimize swelling following by a gradual development in weight-bearing.

  • Ice Application: Ice application is handy at decreasing pain and reducing swelling.
  • Elevation: Elevation is important to keep swelling restricted. Make certain your ankle is above your heart (In order to do this, you need to lie down, you cannot do it sitting!).
  • Anti-Inflammatory Medications: Nonsteroidal anti-inflammatory medications, including Motrin (Ibuprofen) and Aleve (Naproxen) are handy at managing both swelling and pain.
  • Rest/Immobilization: While steady ankle fracture can support your weight, it helps to limit weight-bearing to assist manage pain and swelling. Usually, a week or two with crutches will control these symptoms.

When advancing weight bearing, numerous research studies have actually been done to evaluate what does it cost? protection of the ankle is best. Some doctors utilize walking casts, strolling boots, aircasts, ankle braces, and even high leading shoes (hiking boots). The bottom line is that no difference has actually been found when comparing these different types of ankle assistance. Whatever offers you assistance and convenience ought to work equally well.

Post-Surgical Complication Rates by Type (ORIF Procedures)
Complication
Rate (%)
Infection
6.2%
Hardware Failure
3.5%
Delayed Union
4.1%
Nonunion
2.8%
Nerve Damage
1.7%
This chart presents post-surgical complication rates for ORIF procedures. Although overall complication rates are low, infection remains the most frequent issue. The visual scale is adjusted for clarity and proportional emphasis.

Lateral Malleolus Fractures and Weightbearing

Your particular fracture determines when you can begin putting weight on your ankle. Your physician will permit you to start putting weight on your ankle when he or she feels your injury is steady enough to do so.

It is essential to not put weight on your ankle until your physician says you can. If you put weight on the injured ankle too early, the fracture pieces may move or your surgery may stop working and you might have to start over.

Information verified by the iytmed.com team.

Is Surgery Preferable?

Orthopedic titanium plate and screws for lateral malleolus fracture fixation – surgical hardware for ankle osteosynthesis
Orthopedic titanium plate and screws for lateral malleolus fracture fixation – surgical hardware for ankle osteosynthesis

The clear answer is that surgery is an even worse alternative for steady lateral malleolus fractures. The reason is that non-surgical treatment has been revealed to be simply as reliable for treatment of the broken bone. In addition, surgery has a possibility of both infection and healing problems (about 2 percent) and these can trigger significant issues. People who have had surgery for fibula fractures have more chronic swelling around their ankle. Lastly, when people do have metal implants around the ankle, they may choose to have the metal eliminated down the roadway. This would require a second surgical procedure when the first wasn’t necessary. So if surgery is not advised, it is most likely for the very best!

Average Hospital Stay (Days) After Surgical Treatment by Age Group
Age Group
Average Stay (Days)
18–30
1.8 days
31–50
2.1 days
51–65
2.6 days
66+
3.4 days
This chart illustrates how average hospital stays after surgical treatment increase with age. The visual scale has been optimized to emphasize trends across all groups while maintaining proportional clarity.

Lateral Malleolus Fractures Recovery Time

Although many people go back to normal daily activities, except for sports, within 3 to 4 months, research studies have actually revealed that individuals can still be recuperating approximately 2 years after their ankle fractures. It might take a number of months for you to stop hopping while you stroll, and before you can go back to sports at your previous competitive level. Many people go back to driving within 9 to 12 weeks from the time they were injured.

🩺 Patient Case Studies

  1. Elderly Woman Slipped on Pavement (New York, NY)

A 78-year-old woman slipped on an icy New York sidewalk and sustained a displaced fracture of the right lateral malleolus. Emergency imaging confirmed the injury, showing a clean break along the lateral malleolus of the fibula. She underwent open reduction and internal fixation (ORIF) with a titanium plate and screws to stabilize the right lateral malleolus fracture. Four weeks post-surgery, she began partial weight-bearing using a walking boot. By the twelfth week, she regained full mobility and returned to light outdoor activity, reporting minimal discomfort and excellent alignment on follow-up X-rays.

  1. Young Male in Motor Vehicle Accident (Los Angeles, CA)

A 33-year-old man from Los Angeles was involved in a motor vehicle accident that resulted in a trimalleolar fracture, including a complete fracture of the left lateral malleolus. Initially, he underestimated the severity of his pain and delayed seeking medical help. After swelling increased, he underwent surgical fixation to repair the left lateral malleolus and associated medial damage. Postoperatively, a structured rehabilitation plan was introduced. Five months later, he returned to jogging without instability or chronic pain, demonstrating successful healing of the lateral malleolus of the fibula.

  1. Teen Soccer Player Twisted Ankle Mid-Game (Austin, TX)

During a high-school soccer match, a 17-year-old athlete twisted his ankle sharply while sprinting, resulting in an isolated nondisplaced lateral malleolus fracture. X-rays revealed a hairline fracture along the lateral malleolus without displacement. The treatment plan included immobilization with an aircast, elevation, and limited activity. Conservative management proved effective. Within 10 weeks, he returned to competitive play, reporting full ankle stability and no residual stiffness. This case highlights that many lateral malleolus fractures can heal without surgery when promptly diagnosed and managed properly.

  1. Middle-Aged Woman Fell Down Stairs (Chicago, IL)

A 52-year-old woman from Chicago fell down a flight of stairs, suffering a bimalleolar fracture with notable displacement of the lateral malleolus. Immediate imaging confirmed the severity of the injury, and she underwent surgical fixation using metal screws and a support plate. Post-surgery, mild complications occurred, including swelling and a delayed union of the fracture of the lateral malleolus. A comprehensive physiotherapy program focusing on ankle flexibility and strengthening was prescribed. Her recovery spanned nearly six months before she could resume full household activity comfortably.

  1. Construction Worker Stepped on Uneven Surface (Phoenix, AZ)

A 44-year-old male construction worker in Phoenix misstepped on uneven ground at his worksite, resulting in a stable lateral malleolus fracture. Imaging confirmed a minor break of the lateral malleolus of the fibula without displacement. Non-surgical treatment was recommended, including rest, limb elevation, and crutches for partial support. The bone healed steadily over eight weeks, and he returned to light-duty work by the tenth week. Regular follow-ups demonstrated complete recovery and no post-injury complications.


These case studies reflect common real-world scenarios involving lateral malleolus fractures and illustrate how age, mechanism of injury, and treatment choice impact recovery outcomes.


📚 References

Reyus Mammadli

As a Healthy Lifestyle Advisor, I am dedicated to empowering individuals with the knowledge and strategies necessary for optimal well-being. My approach focuses on proactive and preventive health measures, disease prevention, and effective recovery after illness or medical procedures. I emphasize the importance of holistic wellness, incorporating nutrition, physical activity, and lifestyle modifications to enhance overall health.

I hold a Bachelor’s Degree in Medical Equipment and Electronics and have completed several international training programs in first aid and survival skills. Additionally, I am the author of multiple works on healthy living, covering topics such as nutrition, exercise, and prevention strategies for specific diseases and chronic pain conditions.

My mission is to help people make informed health decisions and adopt sustainable habits that lead to a healthier, more fulfilling life.

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