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What Should I Expect From Ankle Fracture Surgery and Recovery?

Your ankle fracture may not require surgery – read more about that here. But if it does, here are a few things you should know. 


How can I prepare for ankle fracture surgery?

First, the best thing to do is to minimize swelling by not walking on the ankle and by elevating your ankle. Decreased swelling helps control pain and aids the incision in healing.

Talk to your orthopedic surgeon about post-operative protocols. You also want to let your primary care physician know you are undergoing surgery, in case pre-operative testing needs to be completed. You may want to obtain items to help in your recovery, such as crutches, walker, knee scooter, and/or a shower chair.


What are surgical treatments for ankle fractures?

There are many different ways to surgically fix an ankle fracture. The orthopedic surgeons at Southwest Orthopedic Group individualize surgical care for ankle fractures based on the type of fracture and medical comorbidities.

Ankle fracture surgery is known as open reduction and internal fixation. In general, an incision is made on the outside of the ankle (over the fibula), and a plate with screws are used to stabilize the bone. If the medial (inside) ankle is also broken, a second incision is made on the inside of the ankle, and additional screws and/or a plate can be used. If there are any additional fracture fragments or ligament damage, they are also fixed at this time. The plate and screws can be stainless steel or titanium.

Sometimes, an ankle arthroscopy (scope) is performed at the same time as the ankle fracture surgery. This procedure places a camera into the ankle joint to evaluate the cartilage and remove any loose fragments of bone as well as inflammatory cells from your ankle joint.

What are the risks of ankle fracture surgery?

The risks associated with ankle fracture surgery are similar to any surgery. If you have diabetes, neuropathy, or are a smoker, then your risks are elevated. Patients can have swelling and stiffness after ankle fracture surgery. Speak to your orthopedic surgeon about your specific risks.


What to expect after ankle fracture surgery?

Initially, most patients are typically placed into a splint. Ankle fracture surgery is usually completed without an overnight hospital stay, unless a medical comorbidity requires additional observation. Initially, there can be pain and swelling that is controlled with medication and elevation of the ankle. Stitches can be removed in approximately two weeks.


What is the recovery time from ankle fracture surgery?

While the bones are healing, the ankle is protected with a cast and/or a walking boot. Patients are often nonweightbearing for several weeks, and then they spend an additional 4-6 weeks walking in the boot. Most patients will require physical therapy for range of motion, strength, and endurance.


How long will there be swelling after an ankle fracture surgery?

Prolonged swelling is one of the most common complaints after an ankle fracture surgery. Swelling often persists for up to a year after surgery.


Can my ankle hardware (plates and screws) be removed?

Ankle hardware is not routinely removed if it isn’t causing problems. In a few patients, the plate and screws can cause some pain directly over the hardware. In these patients, the hardware can be removed after the fracture is completely healed, which we recommend approximately 12 months from the initial surgery.


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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