Ankle avulsion fracture

Doctors may call an ankle avulsion fracture, or a 5th metatarsal fracture, a fracture, a break or a crack. These words all mean the same thing.

When you have a fracture, the bone isn't the only part that's affected. You'll also have injured some of the soft tissues around it. Soft tissues include the:

• muscles
• ligaments
• tendons
• nerves

Most of the healing in an ankle avulsion fracture happens between 4 to 6 weeks after the injury. You may still have aches and some discomfort after that, and this is normal. It often shows up when you try activities you haven't done for a while.

The area can also stay more sensitive for several months after the injury, and that is normal too.

Smoking affects all the tissues in your body, and it slows down the healing of a fracture. In some people, it can stop the healing altogether.

If you stop smoking while your ankle avulsion fracture heals, you give yourself the best chance of a good recovery. Get help to stop smoking.

Some medical conditions, such as diabetes, can slow down healing after an ankle avulsion fracture. Eating a healthy diet and staying active will help your recovery.

Some medicines can slow down the healing of a fracture, so if you're worried about any medicine you take, talk to a doctor about it.

Anti-inflammatory medicines such as Ibuprofen or Naproxen have been shown to delay healing.

An ankle avulsion fracture is a minor fracture. It's often treated in the same way as a strain or sprain. Some people may be fitted with a boot or plaster, and some might be given crutches.

Walking on your foot can help your recovery, though it may be uncomfortable at first. Help and instructions for using crutches are available.

Some discomfort around the fracture is normal. You may feel it in:

• other soft tissues
• nearby joints
• areas that have been immobilised

The pain can change from one day to the next, and it doesn't always depend on what you're doing. Pain at rest is common too.

Even after the fracture has healed, some pain is normal. Some people also find the fracture site becomes uncomfortable in colder weather.

Your local pharmacy can give you advice on managing pain after a fracture.

Swelling is the start of healing, so with an ankle avulsion fracture you should expect it. It usually shows up near the fracture first, and it often spreads down your leg.

How much swelling you have changes with:

• your position
• your activity
• the time of day

Some swelling is normal even after the fracture has healed. It can last for several months.

Swelling from an ankle avulsion fracture can get quite uncomfortable, and it can limit how well you move. There are still a few things you can do to help it. You can:

• raise your foot above your heart when you're resting, and you can support it with pillows to do this
• keep the other joints in your leg moving normally
• avoid too much rest and too much activity
• massage the swelling from your foot towards your groin

You'll often see bruising after an ankle avulsion fracture, and it's nothing unusual. The bruise can spread widely, and it may show up quite far from the fracture itself. It can look very purple at first, and the colour may change as you recover.

With an ankle avulsion fracture, go back to your usual activities slowly, at a pace that feels right for you and as you feel able.

Keep doing the activities you can manage, as far as your pain allows. As time goes on, slowly do a little more.

With an ankle avulsion fracture, you may find things harder at first because your ankle is less flexible and weaker. This gets better as you build up gradually to all your usual activities.

Feeling frustrated or low after an ankle avulsion fracture is normal. It should get better as you get back to your usual life.

Many people lose confidence after a fracture, and that's quite common.

Advice about preventing falls.

After a fracture, you may be sent a letter inviting you for a scan of your bone density. It's routine to be checked for any further risk of fracture, especially if you:

• are over the age of 50
• have increased risk factors for fracture

There are things you can do yourself to help your recovery after an ankle fracture.

In the first couple of weeks after your ankle avulsion fracture, there are three things to focus on:

• put weight on your foot as much as you're able to
• manage your pain and swelling
• move your foot and ankle more, using gentle exercises

Between 2 to 6 weeks after your ankle avulsion fracture, you should:

• put your full weight through your leg
• start balance exercises

Somewhere between 6 and 12 weeks after your ankle avulsion fracture, you can:

• return to full function
• resume normal day to day activity
• return to higher impact activity

If your ankle still isn't working as it should after 6 weeks of following this advice, talk to a doctor about your symptoms.

Practise gentle foot and ankle exercises to build up your strength and movement after an ankle avulsion fracture. If the exercises make your symptoms worse, or they cause new pain, stop them.