Patients with a fractured medial malleolus typically experience a sudden onset of sharp, intense inner ankle or lower leg pain at the time of injury. This often causes the patient to limp so as to protect the medial malleolus. In severe cases, particularly involving a displaced fracture of the medial malleolus, weight bearing may be impossible. Pain is usually felt on the front or inner aspect of the ankle or lower leg and can occasionally settle quickly with rest leaving patients with an ache at the site of injury that may be particularly prominent at night or first thing in the morning. Occasionally patients may experience symptoms in the Achilles or calf region.
Patients with a medial malleolus fracture may also experience swelling, bruising and pain on firmly touching the affected region of bone. Pain may also increase during certain movements of the foot or ankle or when standing or walking (particularly up hills or on uneven surfaces) or when attempting to stand or walk. In severe medial malleolus fractures (with bony displacement), an obvious deformity may be noticeable. Occasionally patients may also experience pins and needles or numbness in the lower leg, foot or ankle.