Ankle Fracture Surgery

Ankle fracture refers to the condition in which one or more bones crack or break in the ankle joint. Ankle fracture surgery is required to realign the damaged bones and get rid of the pain and swelling. The surgery puts the bones back in place, initiating the healing process.

Here are some of the primary benefits of the surgery:

1. Painless because it performed under general anaesthesia
2. Reduction in the risk of post-traumatic arthritis.
3. Assist in proper repositioning and healing of the ankle.

A person with the following conditions might require surgery:

1. Displaced bone
2. Open fracture (bone breaks and pierces through the skin)
3. Unstable ankle
4. Shattered or broken bone
5. Misaligned pieces of leg bone

1. For minor cases when the bones are not out of place or barely out of place, the doctor may reposition them correctly and apply a cast so that they stay in place. The cast ensures that the bones stay intact in the same position so that they can heal properly. It also protects the bones from further impact or damage.
2. When the bone is completely out of place, the doctors may suggest a surgical procedure known as Open Reduction and Internal Fixation (ORIF). It includes the following steps:
   1. Small incisions are made through the skin at the site where the bones are broken.
   2. The broken bones are repositioned correctly.
   3. If the bone has been shattered into small pieces, a metal rod or balls are put in place of the bones.
   4. After the bones are repositioned, they are held together with screws and plates.
   5. The fixing of the bones in place is called open reduction, and holding them together with screws and plates is called internal fixation. ORIF ensures that the ankle remains stable so that the patient can start moving after their surgery and completely resort to normal physical movement after the fracture heals.

Before the surgery, the doctor will discuss the person’s medical history and symptoms. Depending on the severity of the fracture, the surgical process will be decided. Some additional tests are also recommended to understand the condition of the fracture.

1. X-Rays: This diagnostic imaging helps confirm if the bone is broken or displaced. It also shows how many bones have been affected due to the fracture and where. With the x-ray imaging, the doctor can also confirm if there is any damage in the surrounding bones.
2. Stress Test: This test allows the doctor to check if there is any need for surgery on the ankle. The doctor puts pressure on the ankle and then takes the imaging test to check if the fracture can heal on its own or would require surgery.
3. Computed Tomography Scan (CT scan): The scan helps get a cross-section image of the ankle to further evaluate the injury.
4. Magnetic Resonance Imaging Scan (MRI Scan): This test provides high-resolution images of the soft tissues and bones in the ankle. It can also help in the evaluation of the ankle ligaments.

1. Consent form is signed before the surgery by the patient and a family member (if needed).
2. Hair is removed from the surgical site.
3. Information is provided about change of clothes, dentures removal, jewellery removal, enema, if applicable.
4. Vitals are noted by the medical staff such as blood pressure, sugar level, etc.
5. Last meal is recorded.
6. Medication (if advised by the doctor) is provided with a sip of water.
7. Patient is shifted to the operation theatre.

1. The patient is made to lie down on the operating table. 
2. General anaesthesia is administered to the patient. 
3. The surgical site is cleaned and prepped for operation. 
4. Vitals are monitored throughout the surgery.

1. After the surgery, the doctor may advise the patient to take rest till the bone can take the pressure or the weight of the body. So, the person may need some time off from work and assistance in walking and performing other day-to-day activities. One may also need to use braces while walking.
2. The person will be prescribed some medications, such as painkillers and antibiotics to avoid pain and infection. Even after the surgery, the fracture may take a few weeks to heal. The bone healing is monitored by regular check-ups and x-rays. 
3. The doctor may also suggest some home exercise programs and physical therapy to keep the muscles in the ankle active. This will also strengthen the muscles, which fastens the healing process.

First Follow Up Appointment

After the surgery, if there are any complications, such as pain, swelling, redness, and inflammation, it is important to inform the doctor about it. Depending on the healing process, the medications will/ will not be continued. The doctor may ask for a regular bandage change and cleaning at the points where the incisions were made.

If a person experiences any of the following symptoms, they should immediately consult with a doctor:

1. Redness
2. Swelling
3. Pain
4. Inability to move the injured area