How is a broken ankle diagnosed in children?

After discussing your child's medical history and how the injury occurred, your doctor will do a careful examination. Your doctor will look for:

  • Swelling and tenderness
  • Bruising
  • A deformed or crooked appearance of the ankle
  • Tears or openings in the skin

Skin wounds are a sign of a potential open fracture. This type of fracture is particularly serious because once the skin is broken through, infection in both the wound and the bone can occur. To prevent infection, open fractures require immediate treatment, including irrigation to clear the wound of debris and bacteria, and surgery to repair the fracture.

During the appointment, the doctor will feel for pulses in your child's leg and foot. He or she will also check for to make sure they are able to feel in the leg/foot and for movement.

If your doctor suspects an ankle fracture, he or she will order additional tests to provide more information about your child's injury. Tests include:

  • X-rays. The most common way to evaluate a fracture is with x-rays, which provide clear images of bone. X-rays will usually show whether a bone is intact or broken.
  • Magnetic resonance imaging (MRI). If the physical examination suggests a fracture but the x-rays do not show it, your doctor may order a magnetic resonance imaging (MRI) scan. These tests provide high resolution images of both bones and soft tissues, like ligaments.
  • Computed tomography (CT). This type of scan can create a cross-section image of the ankle. It is especially useful when the fracture extends into the ankle joint.