If old enough to report the injury, your child may say they twisted and then heard a pop or a crack. They may or may not have fallen down. Depending on the severity of the fracture, your child may or may not be able to walk on the affected leg. However, some children are able walk on ankle fractures that require surgical intervention. If the child is too young to communicate how they were hurt (many orthopedic injuries happen too quickly to be witnessed by the care provider), they may refuse to walk on the affected extremity.
Usually, the ankle will swell shortly after the injury. Sometimes there will be numbness in the foot or toes. This may be due to swelling or nerve injuries that may occur with higher energy ankle fractures. If your child is unable to walk or reports pain with ambulation, you should go to the emergency room or an urgent care center.