Ankle Fractures: When Is Surgery Necessary?

Ankle fractures are common and usually happen when there’s a direct impact due to a sports injury, car accident, or high-impact fall on the foot. Treatment for a broken ankle depends on the type and severity of the break. 

Not all ankle fractures need surgery, but it may be necessary if the break is severe.

At Hansen Foot & Ankle in Mill Creek, Washington, our foot and ankle specialist, Dr. Nathan Hansen, only performs surgery for an ankle fracture when it’s the best treatment option.

Here, we want to explain when surgery is necessary for ankle fractures.

About your ankle fracture

Your ankle joint connects the two bones in the lower part of your leg (tibia and fibula) to the small bone between the lower leg bones and the heel bone (talus). The tibia and fibula have different parts that make up the ankle joint, including:

• Medial malleolus: The bump on the inside of your ankle (tibia)
• Posterior malleolus: Back part of the tibia
• Lateral malleolus: The bump on the outer part of your ankle (fibula).

When you come in with complaints of ankle pain, we take X-rays to confirm or rule out a fracture. We use the image from the X-ray to determine what bone or bones are broken, which we use to determine ankle fracture type. For example, a medial malleolus fracture is a break in the bony bump at the inside end of the tibia.

Talus fractures are uncommon and usually only occur from high-impact auto accidents.

When your ankle fracture needs surgery

The type of ankle fracture is only one way we determine how to care for your injury. We also use the position of the broken bones to decide whether or not you need surgery.

The terms nondisplaced, displaced, or open fracture describe the positioning of the broken pieces.

Nondisplaced fracture

A nondisplaced ankle fracture means your bones are barely out of place. Hairline and stress fractures are nondisplaced breaks. You probably don’t need surgery for this type of ankle fracture.

Displaced fracture

A displaced ankle fracture is when you have broken pieces of bone that are out of alignment. You may even have a dislocation of the joint. You need ankle surgery for a displaced fracture to properly align the bones for healing.

Open fracture

An open ankle fracture is when you have bone piercing the skin. This type of fracture needs surgery to reset the bones and reduce the risk of infection.

We may also recommend ankle surgery for a fracture that didn’t heal well, causing a visible deformity or continued pain. 

What happens during ankle surgery

Dr. Hansen customizes your ankle surgery plan based on the type and severity of your fracture. We perform what’s called an open reduction internal fixation (ORIF) when repairing a broken ankle. 

During an ORIF, we realign the bones so they’re in the proper position and use pins, screws, or plates to keep them in place while the fracture heals. We immobilize the ankle with a cast or walking boot after surgery. You need to limit weight-bearing activities for a time so the bones can heal.

After an ankle fracture, you can expect a change in your usual routine. Recovery from an ankle fracture takes several weeks or months and requires physical therapy to restore mobility and strength.

Do you have ankle pain? Are you concerned about an ankle fracture? Call our office at 425-537-3777 today or click the schedule now button to book a consultation with Dr. Hansen.