Ankle Fracture Treatment: Surgery or No Surgery?

If you’ve read our previous ankle fracture blog posts, then you’ll know that there are many types of ankle fractures.

But do they all need surgery? Or can ankle fractures heal without surgery?

Some ankle fractures are stable, or only involve a ‘chip’ of bone. These fractures can often be treated successfully without surgery.

Other ankle fractures involve multiple parts of the ankle or also have ligament damage, and these often require surgery.

The orthopedic surgeons at Southwest Orthopedic Group can diagnose ankle fractures on x-rays and customize treatments to each patient.


What is non-operative treatment for ankle fractures?

First, ice and elevation can help control pain and swelling. Patients may need over-the-counter pain medication, such as Ibuprofen or Tylenol.

A splint can be used to stabilize the ankle and help control swelling. Once the initial swelling resolves, the patient can use a walking boot or a cast. If the fracture is stable, patients can start walking in the boot when directed.

After an ankle fracture, patients typically use crutches, walkers, or a wheelchair to keep weight off the affected limb.


What is the difference between a splint and a cast?

A splint is made of either plaster or fiberglass. An ankle splint often has a posterior piece and a side-to-side piece, but there is space between the plaster or fiberglass to allow for swelling. Splints provide good stabilization to ankle fractures.

A cast is circumferential around the ankle and is made of fiberglass. A cast is also well-padded and is typically used after the initial swelling resolves.

Both casts and splints extend from your toes to the upper calf muscle to provide adequate support.


When does an ankle fracture need surgery?

If your ankle fracture is unstable, it may need surgery. The main goal of the surgery is to restore alignment to the ankle joint to minimize the risk of problems in the future. Surgery involves stabilizing the broken bones and repairing any ligament damage. This method is called ‘open reduction’ and ‘internal fixation.’ Talk to your orthopedic surgeon about the specifics of your ankle fracture surgery.

In general, plates and screws are used to stability the bones. If there is ligament damage, screws, specialized ‘suture button devices,’ or ‘anchors’ can repair and stabilize the ligaments. Plates can be made of stainless steel or titanium.


The American Orthopaedic Foot & Ankle Society (AOFAS) has more information about ankle fractures at FootCareMD.


For more questions or to set up an evaluation, contact Dr. Stautberg’s office at 281-977-4870.

Eugene Stautberg, MD

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