Ankle Sprain vs Fracture: Explained in Detail

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Ankle Sprain vs Fracture: Ankle sprains are caused by straining or ripping the ligaments that stabilise the joint, resulting in discomfort, swelling, and bruising on the outside of the ankle. Fractures are genuine fractures in one of the three ankle bones, which are frequently accompanied by acute pain, deformity, inability to bear weight, and, occasionally, a popping sound. While both can result from similar errors, such as twisting or rolling the ankle, sprains usually heal within weeks with RICE (rest, ice, compression, elevation) and physical therapy, whereas fractures require medical treatment, occasionally surgery, and a months-long healing process.

Difference Between Ankle Sprain and Fracture

Both an ankle sprain and an ankle fracture can damage the ankle joint, although they involve separate structures and have unique features. Following are the differences given below:


Ankle Sprain

Ankle Fracture

Nature of Injury

Stretching or tearing of ligaments

Break or crack in one or more bones


Twisting or rolling of the ankle

Direct impact or force, like a fall or heavy object


Pain, swelling, bruising, difficulty moving

Similar, may include visible deformity in severe cases

Diagnostic Methods

Physical examination, imaging in severe cases

X-rays for identification of location and extent


R.I.C.E (Rest, Ice, Compression, Elevation), PT

Immobilization (casting/surgery) followed by rehabilitation

Recovery Time

Generally shorter

Variable, depends on severity and treatment

Long-Term Effects

Minimal if treated appropriately

May include arthritis or joint stiffness depending on severity


Rare, chronic instability in some cases

Malunion, nonunion, nerve damage

Risk Factors

Common in athletes, especially those in certain sports

More common in older individuals, weakened bones


More prone to recurrence if not fully healed

Less common, but possible if residual weakness or instability

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What is Ankle Sprain?

An ankle sprain is a tear or stretch of the ligaments that support the ankle joint. It's a common injury caused by rolling or twisting the ankle. Symptoms include pain, swelling, bruising, and difficulty putting weight on the ankle. Most sprains heal within a few weeks with rest, ice, compression, and elevation (RICE).

Key Features of Ankle Sprain:

  • Swelling and pain are usually concentrated in the outside ankle (lateral malleolus) or the inner ankle (medial malleolus). Swelling may worsen over time and feel warm to the touch.
  • Difficulty and tenderness Bearing Weight: It is painful to touch the wounded region, and placing weight on the afflicted ankle is difficult, resulting in limping.
  • Due to ligament injury, it is painful to move the ankle joint, limiting typical mobility such as rolling or bending the foot.
  • This may emerge later, beginning as a reddish-purple ring around the ankle and gradually dying out.

What is Fracture?

An ankle fracture is a break in one or more of the bones that make up the ankle joint. It's usually caused by a more severe injury than a sprain, such as a fall or a direct blow to the ankle. Symptoms include severe pain, swelling, bruising, deformity of the ankle, and inability to bear weight. Ankle fractures often require medical treatment, such as casting or surgery, and can take several months to heal completely.

Key Features of Fracture:

  • Severe pain is typically characterised as abrupt and acute, making it difficult or highly unpleasant to place any weight on the ankle.
  • The ankle may seem noticeably deformed or out of alignment when compared to a healthy ankle.
  • Excruciating pain upon contacting the probable fracture location. A crackling feeling may be felt or heard in some circumstances when shattered bone particles move.
  • Difficulty or full inability to move the ankle joint owing to shattered bone fragments interfering with mobility.

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Similarities between Ankle Sprain and Fracture

  • Pain: Both ankle sprains and fractures cause pain around the affected area.
  • Swelling: Swelling is a common symptom for both injuries.
  • Bruising: Bruising may occur in both ankle sprains and fractures.
  • Difficulty Walking: Both injuries can make it difficult to bear weight on the affected ankle.
  • Imaging Studies: X-rays and other imaging studies are used to diagnose both ankle sprains and fractures.

Though both are frequently caused by twists or falls, distinguishing between an ankle sprain and a fracture can be difficult. The essential distinction is that sprains assault the ligaments, which are the strong bands that link bones, whereas fractures penetrate the bones itself. This divergence results in a variety of symptoms. Sprains often result in localised pain, edema, and soreness around the soft tissue, with some weight bearing often permitted despite discomfort. Fractures, on the other hand, frequently cause excruciating pain, quick and considerable swelling, and trouble bearing weight on the damaged ankle. In extreme situations, the form of the ankle may seem skewed. While both require prompt medical treatment, a fracture necessitates rapid intervention owing to the potential of consequences such as bone misalignment or nerve damage. Remember, when in doubt, err on the side of caution and seek professional assessment to ensure your ankle heals as smoothly and completely as possible.

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What is the primary difference between an ankle sprain and a fracture?

An ankle sprain involves damage to ligaments, while a fracture is a break in the bone. Ligaments connect bones to each other, and fractures occur when bones themselves are broken.

What are the common symptoms shared between ankle sprains and fractures?

Both ankle sprains and fractures may exhibit symptoms such as pain, swelling, bruising, and difficulty bearing weight. However, the severity and specific locations of these symptoms can vary.

How can I distinguish between an ankle sprain and a fracture based on symptoms?

X-rays are typically needed to definitively diagnose a fracture, as they can reveal bone abnormalities. Ankle sprains are usually diagnosed based on symptoms, clinical examination, and sometimes imaging to rule out fractures.

Are there specific risk factors that make someone more prone to ankle sprains or fractures?

Factors such as previous injuries, inadequate footwear, poor conditioning, and sports participation can increase the risk of both ankle sprains and fractures.

What is the usual course of treatment for an ankle sprain?

Treatment for ankle sprains often involves rest, ice, compression, and elevation (RICE), along with physical therapy to strengthen the affected ligaments.

How is a fractured ankle typically treated?

Treatment for a fractured ankle depends on the severity and type of fracture. Options may include casting, surgery, or immobilisation with a boot or brace.