All You Want to Know About Ankle Fracture Surgery

What is an Ankle Fracture?

The upper part of the ankle joint comes from the fibula (outer leg) and tibia (shin). The fibula forms the near, front, and inner part of the ankle joint. The lower fibula forms the outer part of the ankle joint. The ends of these bones are called malleoli. There are two malleoli on the fibula (lateral) and on the tibia (medial and posterior).

Ankle fractures are very common, and these fractures occur when the malleoli are broken. Ankle fractures can happen after car accidents, falls, or twisting of the ankle. One, two, or all three malleoli can be broken.

Symptoms of an ankle include swelling, pain, bruising, and problems with ankle motion. X-rays help to determine if treatment from an orthopaedic surgeon is required. The orthopedic surgeon treats the patients by the surgical options in which they use ortho implants and instruments that are provided by the orthopedic implant distributors.

What are the Goals of Ankle Fracture Surgery?

The primary goal is to get the ankle joint to heal with a normal shape. Once the ankle is put back together, the next step is to regain normal motion. The long-term goal of repairing a broken ankle is to reduce the chance of ankle arthritis in the future.

What Signs Indicate Surgery may be needed?

When the ankle fracture is in a bad position or unstable, surgery is required to repair the ankle. In some cases, the bones of the ankle may poke through the skin. These are known as open ankle fractures and need surgery which is performed using surgical instruments.

When Should I Avoid Surgery?

Ankle fracture surgery is not needed if the ankle is stable and is in position despite the fracture. Ankle fracture surgery may be too risky when patients have a serious medical condition.

What can I Expect During the Procedure?

Antibiotics are given just before the start of the surgery. Once the patient receives anesthesia and antibiotics, the surgery can safely begin. Incisions are made through the skin of the ankle where the bones are broken. The breaks in the bone are then repositioned and held in place with orthopedic implants. After the ankle fracture is repaired, the leg of the patient is placed in a protective splint made of plaster. Some patients can stay overnight in the hospital while others can go home after surgery the same day.

Specific Technique

Most ankle fracture surgery open reduction and internal fixation (ORIF). An incision is made over the ankle to see the bones that are fractured. Like a jigsaw puzzle, the parts of the broken bones are placed back together (open reduction).  The broken bones are then held together (internal fixation) in this correct position with metal Orthopedic Bone Plates and/or bone screws. This internal fixation provides stability; thus, movement can begin shortly after surgery as the ankle fracture heals.

What Happens After Surgery?

Surgical treatment of ankle fractures allows patients to regain ankle function while the joint and bone heal. Immediately after ankle surgery, your ankle will be immobilized for a few weeks. Once the wounds are healed, you will be fitted for either a boot or a cast. Several surgeons use a removal boot. The boot protects the ankle as it heals but can be removed to allow wound checks, washing, and icing.

Once the broken bones begin to heal, you can put weight on the ankle. This starts in the boot. You are then allowed to wean out of the boot or cast. You can return to normal routine works once the bones are fully healed. Some patients may need physical therapy for their ankle to regain full strength and movement. While everyone is different, it can take up to a year after ankle surgery for some patients to regain full ankle function.

Potential Complications

There are complications that relate to orthopedic surgery in general. These include the risks associated with infection, anesthesia, damage to blood vessels and nerves, and bleeding or blood clots.

Problems after ankle surgery include weakness, ankle joint stiffness, and arthritis. Possible complications after ankle fracture surgery are infection and problems with healing. Factors that increase risks after ankle fracture surgery include steroid use, diabetes, and cigarette smoking.

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