Ankle Fracture Fixation

What it is

The ankle is a hinge joint comprised of 3 bones: (1) the shin bone, tibia; (2) the other bone of the lower leg, fibula; and (3) the ankle bone, talus, at the top of the foot. Most ankles are fractured or broken (the terms are interchangeable) by a twisting force. The broken bones may still be in the correct place (called an undisplaced fracture) or out of place (called displaced fracture). With fractures, the ligaments that normally hold the ankle in position may also be damaged.

Why it’s a problem

The ankle joint maintains stability and provides mobility – if it’s broken, it may not perform either of those critical functions. Left untreated or not properly repaired, even small fractures may lead to arthritis in the ankle.

Surgical treatment

The specific operation depends on the type of fracture – displaced or undisplaced – and its likelihood to stay in place and perform full function. Your surgeon can provide you with the details of your operation or treatment. An unstable fracture usually requires surgical treatment. A displaced fracture includes realigning the bones to make the joint as normal as possible. The ankle bones are then held in place with plates and
screws while they heal.

Not every fracture needs to be operated on. Some can be realigned by manipulation and then held in position with a cast only.

Recovery

Whether or not you have surgery, you will require a period of immobilization to protect the fracture: up to 6 weeks without bearing any weight on the fractured ankle. People often experience pain, stiffness, weakness and swelling at the ankle due to the immobilization period. It is important to begin progress toward regained mobility as soon as possible. Your surgeon will discuss rehabilitation and may recommend physiotherapy as the first step.

It is not uncommon to permanently lose some motion of the ankle after an ankle fracture, particularly in an upward direction. Fortunately, most people are capable of attaining a functional range of motion, which means that you are able to perform most activities after having attained complete recovery.

As the swelling improves after surgery, the plates and screws used to fix the fracture may become prominent and rub on your shoe. If this is the case, they may need to be removed. Otherwise, the plates and screws can be left in place for the rest of your life.

Although most people recover completely after an ankle fracture, some develop ankle arthritis, depending on the severity of the fracture and cartilage damage at the time of the injury. Each fracture is different so you should talk to your surgeon about your specific fracture and what you might expect long-term.