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Your Ultimate Guide to Ankle Fracture Surgery

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Your Ultimate Guide to Ankle Fracture Surgery

Orthopaedics & Joint Replacement | Posted on 12/31/2022 by Dr. Lalit Modi


Have you fractured your ankle recently, or do you think you might have one of late? Ankle fractures are also referred to as broken ankles. It occurs when one or several other bones are broken or compromised. The fractures or breaks can occur in varied ways and at times based on the seriousness there might be a need for ankle fracture surgery.

It is crucial to understand ankle fracture surgery in-depth if recommended by your doctor. It involves the ankle anatomy which is formed of three different bones. These three bones are the tibia, fibula, and talus.

In this write-up, we will be covering everything about ankle fractures and how you can be sure whether you have a broken ankle or not depending on your symptoms. We will also include a discussion on other treatment options for you.

The information given in this write-up is only for informational purposes and it is recommended to consult a professional doctor.

What is an ankle fracture?

An ankle fracture is a breakage of one or both of your ankle bones. It usually occurs because of a twisted ankle causing ankle injury. You can experience the problem from sports or even a simple fall or trip. When experiencing this condition, there is a probability that there is a bone breakage on the outer ankle side, the inner side, and maybe on both sides.

At the same time, you can break more than one ankle joint bone. If more ankle bones are broken, then the severity of the injury will also be more. A serious fracture needs ankle surgery and it might take more than two weeks to completely recover from an ankle fracture surgery.

What are the types of ankle fractures?

There are varied types of ankle fractures that can happen depending on the three bones and their malleoli. First, you must understand the two overarching categories which include:

  • Stable fractures: This fracture occurs when an ankle bone is broken, but the joint still can move and the leg has stability. The treatment for these types of fractures involves a boot or walking cast as an alternative to ankle surgery.
  • Unstable fractures: These fractures also occur when the bone is broken and the joint of an ankle has moved out of place affecting the joint and leg stability. For these types of fractures, a doctor usually recommends surgery.

There are other types of ankle fractures other than these two which are:

  • Fibula-only fracture: It is among the common type of ankle fracture which is related to the fibula bone. There is a formation of lump on the outside feet because of this bone which can break due to a twisted ankle.
  • Bimalleolar ankle fracture: This type is also one of the common fractures an individual can experience. This fracture affects both the fibula and the tibia base. This fracture type is known to be serious and can be the result of high-impact incidents such as serious twists, car accidents, or falls.
  • Trimalleolar fractures: This type is the most severe ankle fracture surgery type and when it occurs, the tibia back gets broken. This fracture is also an outcome of high-impact incidents.
  • Tibia-only fracture: Like the other two types of fractures, this fracture type also is caused by high-impact incidents. One can experience the breakage of the tibia bone in one place or it can be shattered in several places.
  • Maisonneuve fracture: It is usually diagnosed as an ankle sprain, and is caused in the fibula bone which is closer to the knee than to the ankle joint. The pain can be felt in the ankle even if the fracture is not close to the ankle and it also makes the leg feel unstable.

Are there any ankle fracture symptoms?

Yes, there are ankle fracture symptoms you can experience. Some of the symptoms are easily diagnosed while others might be complex to diagnose. Every individual experiences pain differently, so the symptoms below might be present or not. Here are the common symptoms:

  • Instant and excruciating pain
  • Swelling
  • Discoloration
  • Bruising
  • Pain when trying to walk or move your ankle
  • Inflammation
  • Abnormality, bumps, or swollen bone
  • Gentle to the touch or difficulty moving the ankle

If you have had an accident recently or twisted your ankle, and are experiencing any ankle symptoms mentioned above, then you must reach out to a professional orthopedic doctor immediately. Depending on the seriousness of the fracture, your doctor will initiate a diagnosis, discuss treatment options, and will clear if your problem requires ankle fracture surgery.

How is the ankle fracture diagnosed?

Your orthopedic doctor will begin with evaluating the tender points, abnormalities, swelling, and bruising. The doctor will ask you to move so that he/she can assess your form. If your symptoms represent that you have fractured your ankle, then your doctor will continue with testing. Here are the common tests your doctor might involve for ankle fracture diagnosis:

  • X-rays are ordered for the broken or fractured ankle as it helps in viewing the fractures. It is difficult to view the fracture on an X-ray if the fracture is small.
  • A bone scan is another test recommended by a doctor. It is done by injecting radioactive material under your skin in small amounts. The material is useful in highlighting bone anomalies, primarily if the bone is broken.
  • Magnetic resource imaging or MRI scans are useful for testing purposes as they are useful in showing the ligaments and bones by using a robust magnetic field and radio waves.
  • Computerized tomography or CT scan is used for comparing and making cross-sectional body images. It assists your doctor see a comprehensive injured bone image and soft tissues around it.

Once all your tests are completed and your doctor confirms a broken or fractured ankle, the next step will be to identify the right treatment options for you.

What are the treatment options for an ankle fracture?

To recommend ankle fracture treatment, your doctor will first evaluate the seriousness of the broken ankle. If there is no need for ankle fracture surgery, then your doctor will recommend:

  • Over-the-counter- drugs for pain relief.
  • Recommends boot or walking cast for a specific time.
  • Physical therapy after the bone is completely healed.

Ankle fracture surgery treatment

Ankle fracture surgery is usually recommended in severe cases. If your doctor recommends ankle fracture surgery, then your doctor will suggest:

  • Over-the-counter medications and pain reliever
  • Reduction is performed by your doctor if you have an unstable fracture which means the fracture's two ends aren’t aligned or stable.
  • Surgery is performed in severe cases and your orthopedic doctor will involve using screws, pins, and plates for repairing the broken bones and putting them back into place.

Types of ankle fracture surgery

Your doctor might recommend different types of ankle fracture surgery depending on how severe the injury is:

  • Open reduction: It is a surgery that involves opening the ankle and repositioning bones so that they line up appropriately.
  • Internal fixation: It involves the placement of wires, rods, plates, and screws into the fractured ankle so that it can hold its original position.

It doesn’t matter what type of ankle surgery is recommended, the primary objective is rebuilding and supporting the ankle so that recovery after ankle fracture surgery is smooth and heals in the correct position. After surgical treatment, there is a probability that you won’t be able to bear weight for around two weeks or up to eight weeks. After the ankle is healed properly, physical therapy can help in strengthening the ankle and returning to normal movement.

What are the benefits of ankle fracture surgery?

The primary benefit of ankle fracture surgery is it can help in ankle healing properly and reduces the probability of developing traumatic arthritis.

What are the side effects of ankle fracture surgery?

Every surgery comes with risks, even if they are common or not. So, like any other surgery, you must be mindful of ankle fracture surgery complications or side effects. Here are the risks that are related to the surgery:

  • Blood clotting
  • Nerve or Blood vessel damage
  • Risk of infections
  • Excessive bleeding
  • Skin issues

Here are other risks specific to ankle fractures surgery which include:

  • Weakness in the ankle joint
  • Stiffness in the ankle joint
  • Arthritis
  • A fracture not recovering accurately
  • People with a disease like diabetes or who have habits such as smoking might take a longer time to recover.

Get in touch with your doctor to understand the risks of your procedure and what are the chances of complications.


Ankle fractures are among the problems which require timely treatment hence it is important to consult your doctor immediately after symptoms are observed. If you have gone through ankle fracture surgery, you must know that there is still a probability of re-injuring your fractured ankle if you begin moving too fast to resume activities. There will be times you might feel agitated, anxious, or frustrated waiting for your ankle to recover. Make sure to speak to your orthopedic doctor about all your concerns. The doctor will certainly give your recommendations about their programs and services that can help you.


How long after ankle fracture surgery can you walk on a fractured ankle?

Your healthcare expert will assist you with this and will tell you when it is okay to put weight on your fractured ankle. In general, it takes more than six to ten weeks. Make sure not to put weight on the ankle too soon as it might hinder recovery.

Is ankle surgery risky?

Yes, ankle surgery is among the riskiest surgery as it causes complications such as infection, heavy bleeding, and blood clots. It can also cause damage to the nerves and blood vessels in the ankle.

Is ankle fracture surgery painful?

Yes, you can anticipate being in some degree of pain after the surgery. However, the pain begins subsiding after a few days or weeks, depending on the surgery type.