Ankle fractures in the athlete: epidemiology, anatomy and management considerations

Abstract

Ankle fractures are a common injury in both sporting professionals and amateurs, with football and rugby contributing most to these injuries in the UK population. Mechanism of injury varies but commonly involves excess rotational forces around a fixed plantigrade foot. Classification of ankle fractures is discussed along with a description of the anatomy involved. Management of these injuries can be operative or non-operative and is judged based on the stability and displacement of the ankle mortise. Debate persists around optimal methods of fixation, particularly with regards to syndesmotic injury and deltoid ligament repair and the various options are outlined. A return to sport is possible and, in fact, expected in most of these fractures sustained in a sportsperson and, hence, a focus on early mobility and weight-bearing is encouraged in this population. Here we discuss these considerations in the context of athletes.