The problem with ankle fractures are they are specific bony and soft tissue anatomy. It gives you ankle stability and when that's disrupted, there can be instability, poor alignment. Almost everybody's had some sort of ankle injury, like an ankle sprain or rolled their ankle at some point. The signs of an ankle fracture that might be more significant would be considerable swelling, bruising, especially pain with bearing weight or walking or standing, and those are the ones that really should be evaluated with a physical exam likely an x-ray. We sort of think of lower energy rotational ankle fractures that might occur from a slip and fall. But there are other types of ankle fractures that are higher energy such as a fall from height or motor vehicle crash. So a lot of the rotational ankle fractures that aren't very displaced can often be treated in a cast or boot. They may still have a period of restricted weight bearing, though that's not always the case. The ankle fractures that have more significant displacement or shift through the fracture site that cause the ankle joint to be poorly aligned almost always require surgery just because of the risk of arthritis that could follow. I think someone should come to UVA for their care because we take care of the entire spectrum of injury that occurs with ankle fractures.