Ankle Fractures: When Is Surgery Necessary?

Ankle fractures are common and can happen when the ankle is directly impacted by a sports injury, car accident, or high-impact fall on the foot. Treatment for a fractured ankle varies based on the nature and severity of the fracture.

While not all ankle fractures require surgery, certain circumstances necessitate surgical intervention.

At Forward Foot & Ankle, serving the residents of Midtown Manhattan and Staten Island, New York, our skilled foot and ankle specialists carefully evaluate each case, recommending surgery only when it's the best course of action.

Here, we want to dive into the reasons why surgery may be necessary for an ankle fracture. 

Understanding 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: Bump on the inner side of the ankle (tibia)
• Posterior malleolus: The back of the tibia
• Lateral malleolus: Bump on the outer side of the ankle (fibula).

When you visit our team for ankle pain, we take diagnostic X-rays to determine whether you have a fracture. The X-ray images help us to know which bone or bones are broken, which in turn helps us determine the type of fracture. For instance, a medial malleolus fracture is a break in the bony bump at the inside end of the tibia.

When surgery is needed for your ankle fracture 

The type of ankle fracture is only one way we determine the best treatment plan for your injury. The position of the broken bones also helps us to decide whether or not you need surgery.

The terms nondisplaced, displaced, and open fracture describe the positioning of the broken bones in your ankle.

Nondisplaced fracture

A nondisplaced ankle fracture means your bones are barely out of place. Hairline and stress fractures are nondisplaced breaks. Surgery is most likely not necessary for this type of ankle fracture.

Displaced fracture

A displaced fracture occurs when broken pieces of bone are out of alignment, often accompanied by joint dislocation. Ankle surgery is needed to properly align the bones for healing.

Open fracture

An open ankle fracture occurs when bone penetrates the skin. This type of fracture requires surgery to reset the bones and reduce the risk of infection.

We might also recommend ankle surgery for fractures that didn't heal well, causing a visible deformity or persistent discomfort.

What happens during ankle surgery

Our team tailors the surgical approach according to the fracture's type and severity. We specialize in performing open reduction internal fixation (ORIF) procedures for fractured ankles.

During an ORIF, we realign the bones in their proper position and use pins, screws, or plates to keep them in place while the fracture heals. After surgery, we immobilize the ankle with a cast or walking boot. It's important to limit weight-bearing activities for a while afterward so the bones can heal.

It's normal to experience a change in routine after an ankle fracture. Recovery can take several weeks or months and requires physical therapy to restore mobility and strength.  

Experiencing ankle pain? Are you concerned about an ankle fracture? Request an appointment online or over the phone to meet with our team at Forward Foot & Ankle.