What is Ankle Fracture Surgery?
Ankle fracture surgery is a procedure to treat a broken or fractured ankle. An ankle fracture is a painful condition where there is a break in one or more bones forming the ankle joint. Ankle fracture surgery typically involves realigning and stabilizing the fractured bones using metal implants like plates, screws, or rods to allow proper healing and restore function.
Anatomy of the Ankle
The ankle is a hinge joint formed by three bones: the tibia, fibula, and talus. The tibia and fibula are the two bones of the lower leg, and they form a socket that holds the talus bone of the foot. The bony bumps felt on either side of the ankle are the medial malleolus (tibia) and lateral malleolus (fibula). Ligaments connect these bones and provide joint stability, while tendons attach muscles to bones and control movement. The ankle allows up-and-down motion of the foot and plays a key role in walking, running, and balance.
Indications for Ankle Fracture Surgery
Ankle fracture surgery is usually indicated when the surgeon deems that the fracture cannot heal properly with nonsurgical treatment (like casting). Your surgeon may recommend ankle fracture surgery when:
- The ankle bones are displaced (misaligned).
- There is an open fracture (bone protrudes through the skin).
- The fracture involves multiple bones or the joint surface.
- The ankle is unstable and cannot bear weight.
Procedure for Ankle Fracture Surgery
During ankle fracture surgery, the surgeon realigns and stabilizes broken bones in the ankle using metal hardware – a type of surgery referred to as open reduction and internal fixation (ORIF). In general, the procedure involves the following steps:
- The patient is given either general anesthesia (asleep) or regional anesthesia (numb from the waist down).
- The patient is positioned in a manner the surgeon has optimal access to the fractured area.
- A surgical incision is made over the fractured part of the ankle (medial, lateral, or posterior).
- Fracture Reduction: The broken bone fragments are carefully realigned (reduced) into their normal anatomical position.
- Internal Fixation: Metal plates, screws, or rods are used to stabilize the fracture. These devices hold the bones in place to allow proper healing.
- The incision is closed with sutures or staples, and a sterile dressing is applied.
Postoperative Care and Recovery
Following surgery, the ankle is kept elevated and immobilized in a splint or cast to reduce swelling and protect the surgical site. Pain is managed with medications, and patients are typically advised to avoid putting weight on the leg for several weeks, often using crutches or a walker. Follow-up appointments are scheduled to monitor healing, remove stitches, and take X-rays. As the bone heals -usually over 6 to 12 weeks - patients may transition to a walking boot and begin physical therapy to restore strength, flexibility, and balance. Full recovery can take 3 to 6 months or longer, depending on the severity of the injury and individual healing response. Compliance with the rehabilitation plan is essential for regaining normal ankle function.
Risks and Complications
Ankle fracture surgery is generally safe, but like all surgical procedures, it carries some risks and potential complications, such as:
- Infection at the incision or around the hardware
- Nerve injury leading to numbness or tingling
- Blood clots (deep vein thrombosis or pulmonary embolism)
- Delayed bone healing or nonunion
- Malunion, where bones heal in the wrong position
- Hardware irritation or loosening
- Stiffness or loss of ankle motion
- Chronic pain around the surgical site
