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Surgical Ankle Fracture

There are many varieties of ankle fracture that can occur.  Ankle fractures can be classified by the mechanism that caused that fracture, or the number of locations that have fractured, or by the location of the fracture of the fibula (the bone on the outside of the ankle) relative to the ankle joint line.

Perhaps the most important “classification” of ankle fracture to both the doctor and the patient is whether the fracture will need surgical correction or not.

In some fractures, the amount displacement (shifting) of the fracture will determine the need for surgery.  In others, the need for surgery may be determined by the total number of fractures present at the ankle and the degree of instability that they create for the ankle joint.  In still others, there may be other factors involved in making the decision to operate or not.

A two-part fracture (1&2): unstable and with some displacement.

A one-part fracture (1) with associated ligament tear (2) – very displaced.

Open Reduction with Internal Fixation

The name of the surgical procedure for repairing ankle fracture is called an open reduction with internal fixation.

During the procedure, your surgeon will restore the original alignment of the fractured bones and hold them in place with surgical hardware, typically:

  • bone screws and a bone plate on the outside bone of the ankle (fibula)
  • bone screws at the inner knob of the ankle (medial malleolus) – if fractured
  • bone screw(s) at the posterior malleolus (back part of the tibia) – if fracture and of sufficient size

The open reduction with internal fixation of an ankle fracture with unstable syndesmosis procedure typically is performed on an outpatient basis.  The anesthesia format is typically spinal or general anesthesia.

After surgical correction of one-part fracture (see the before image above).

After surgical correction of two-part fracture (see the before image above).



Additional Resources

For a great general resource for preparing for foot and ankle surgery and the associated recovery process, please review information  developed by the Foot and Ankle Surgery Department at the Kaiser Permanente Medical Center in Santa Rosa. :