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Ankle sprains and ankle fractures have a lot in common. For starters, they both affect the ankle, they can both cause disability, and they’re both really common injuries. About 2 million ankle sprains happen every year in the United States, along with more than 130,000 ankle fractures.

Even though they bear similarities, ankle sprains and ankle fractures are very different injuries, meaning they need different treatments. At Next Step Orthopedics, Dominique Nickson, MD, is skilled in all sorts of ankle injury treatments for patients at his McKinney, Texas, practice, including treatments for sprains and fractures. Here’s how these injuries — and their treatments — differ.

Ankle sprains vs. fractures: Basic differences

One big difference between sprains and fractures: fractures involve damage primarily to bones, while sprains involve damage to ligaments, the strong, fibrous bands that connect one bone to another.

Sprains 101

Ligaments join bones at joints, and they’re designed to be a little stretchy to allow the joint to bend and move. A sprain happens when a ligament is stretched beyond its normal limits. In a mild sprain, the ligament is stretched but still whole.

In a more moderate to severe sprain, the ligament is torn, either partially or all the way through. Some very serious sprains involve bone damage if the ligament tears away part of the bone that it’s attached to.

Sprains often happen when your ligaments are twisted during a fall or when you roll your foot while walking or running. They can also happen if someone lands on your foot during sports or if you land incorrectly after a jump.

Fractures 101

A fracture is another term for a broken bone. Ankle fractures can affect one or more of the three bones that make up the joint:

  • The tibia (shin bone)
  • The fibula (the smaller bone in your lower leg)
  • The talus (a bone between your heel and lower leg bones)

Like sprains, fractures can vary in severity, depending on the number of bones involved, the type of fracture, and whether other structures — like ligaments — are involved. And, like sprains, they’re also associated with “over-twisting” the joint.

Treating sprains and fractures

Although ligaments and fractures involve different structures, treatment for both begins the same way: with a thorough physical evaluation and diagnostic imaging to understand the nature of the injury. After the exam, Dr. Nickson will prescribe treatment to restore your ankle joint and, ideally, prevent future injuries.


Most sprains are treatable with conservative treatment options, like over-the-counter anti-inflammatory medicines and RICE: rest, ice, compression, and elevation. Severe sprains — ones involving major tears, for instance — need surgery to repair.

After your ankle begins to heal, you could benefit from physical therapy aimed at strengthening the ankle to reduce your risk of developing ankle instability — a chronic condition that increases the likelihood of future sprains and fractures. Most sprains heal within a few days to a few weeks depending on the severity of the injury.


Fracture treatment depends on the type of break you have. Some fractures are treated with casting or bracing — especially breaks where the ends of the bones “line up” properly. More complex fractures often require surgery. That typically includes fractures with multiple breaks or bone displacement, where pins and screws may be needed to “rebuild” the joint.

Once the fracture has healed, Dr. Nickson typically recommends physical therapy to help your ankle regain normal, pain-free movement. Your recovery time will be based on the location, type, and severity of the fracture, as well as your age and other factors. Generally, healing takes a few months.

Get help for your ankle injury

Sprains and fractures are common causes of ankle pain, but other problems can cause painful symptoms, too. Arthritis, tendon injuries, and even problems with your feet or knees can all result in pain, swelling, and other symptoms in your ankles.

Before any ankle treatment, Dr. Nickson performs an in-depth exam to ensure the care you receive is optimized for your needs — and better ankle health. To learn more about ankle injury care and how Dr. Nickson can help you get back on your feet, call us at (972) 547-0047 or book an appointment online at Next Step Orthopedics today.

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