“How do you fix a broken ankle?”
My friend broke his ankle. How do you fix a broken ankle?
7 Answers
Seek immediate medical evaluation by a qualified foot and ankle specialist. If there is a fracture of any kind, the injured ligaments and fragments need to be properly treated to ensure stable ankle alignment and healing. Without proper treatment, chronic ankle malalignment and instability will lead to irreversible post-traumatic arthritis that will greatly limit function and treatment options later.
Surgery and Rehab
X-RAYS are important to assess the overall injury. In some cases x-rays do not show the entire deformity and CT scans and/or MRIs are necessary to fully evaluate the area. Stress views are x-rays that are taken with the foot slightly manipulated to further evaluate the injury. They give us information regarding the ligaments that had been injured during the trauma.
Treatment of ankle fractures depends on the degree of injury to the soft tissue, ligaments and bones. Nondisplaced fractures can be treated effectively by a nonweightbearing cast in most cases. This may be necessary for a period of 6-8 weeks. Some fractures are stable and can be treated with a walking cast.
Fractures that are more displaced may require closed manipulation and casting. Sometimes this can be done in the physician’s office. At other times it may be necessary to have a general anesthetic to relax the muscles and allow manipulation of the bones into their proper position. At times this is accompanied by percutaneous pins or screws placed through the fracture site to give the fracture stability.
When fractures are grossly malaligned and the joint cannot be put into its normal position surgery is performed to place the bones and ligaments into their normal anatomical position. The procedure is called an open reduction and internal fixation. These procedures are done in most cases under a general anesthetic. Incisions are placed over the affected bone and small screws and plates are placed onto the bone to stabilize and fix the fracture. Sometimes ligaments may be repaired during the procedure. Ligaments would be fixed if expected to have ankle instability following the injury.
The prognosis of ankle fractures is dependent on the degree of injury. The more of the joint that has been affected determines the prognosis. High energy injuries to the ankle would cause more disruption to the joint surface. High energy injuries are commonly found in patients falling from a significant height or getting in a motor vehicle accident. The worse the cartilage damage at the time of injury, the worse the long-term prognosis.
Isolated fractures of the bones that have minimal to no disruption of the joint surface have an excellent long-term prognosis provided that there is excellent anatomic position of the fractures. In most cases the hardware placed on the bones can be left in the area unless they cause discomfort following the healing process.
Patients with ankle fractures are not uncommon. Chronic stiffness and pain in the joint can develop even after a perfect anatomic reduction and internal fixation. This is due to some disruption of the joint surface and the lining of the joint. This can be treated arthroscopically in most cases to lessen stiffness and pain and improve range of motion. Malunions can develop in the joint in which the bones do not heal in their perfect anatomical position. This can be corrected following the healing process. It is expected that the prognosis would be worse and arthritis would set in. Delayed union or nonunion are relatively uncommon following ankle fractures. If during the healing process the fractures appear to be healing very slowly, bone stimulators may be necessary to enhance healing. If the fracture goes on to a nonunion, surgery may be necessary to freshen the fracture and try fixation to stabilize the fracture and allow it to go on to uneventful healing.
If the fracture has completely disrupted the joint surface (pilon fracture) then at some point arthritis would set in, which may necessitate surgical procedures which can include an arthroscopy, total ankle replacement or an ankle fusion.
Treatment of ankle fractures depends on the degree of injury to the soft tissue, ligaments and bones. Nondisplaced fractures can be treated effectively by a nonweightbearing cast in most cases. This may be necessary for a period of 6-8 weeks. Some fractures are stable and can be treated with a walking cast.
Fractures that are more displaced may require closed manipulation and casting. Sometimes this can be done in the physician’s office. At other times it may be necessary to have a general anesthetic to relax the muscles and allow manipulation of the bones into their proper position. At times this is accompanied by percutaneous pins or screws placed through the fracture site to give the fracture stability.
When fractures are grossly malaligned and the joint cannot be put into its normal position surgery is performed to place the bones and ligaments into their normal anatomical position. The procedure is called an open reduction and internal fixation. These procedures are done in most cases under a general anesthetic. Incisions are placed over the affected bone and small screws and plates are placed onto the bone to stabilize and fix the fracture. Sometimes ligaments may be repaired during the procedure. Ligaments would be fixed if expected to have ankle instability following the injury.
The prognosis of ankle fractures is dependent on the degree of injury. The more of the joint that has been affected determines the prognosis. High energy injuries to the ankle would cause more disruption to the joint surface. High energy injuries are commonly found in patients falling from a significant height or getting in a motor vehicle accident. The worse the cartilage damage at the time of injury, the worse the long-term prognosis.
Isolated fractures of the bones that have minimal to no disruption of the joint surface have an excellent long-term prognosis provided that there is excellent anatomic position of the fractures. In most cases the hardware placed on the bones can be left in the area unless they cause discomfort following the healing process.
Patients with ankle fractures are not uncommon. Chronic stiffness and pain in the joint can develop even after a perfect anatomic reduction and internal fixation. This is due to some disruption of the joint surface and the lining of the joint. This can be treated arthroscopically in most cases to lessen stiffness and pain and improve range of motion. Malunions can develop in the joint in which the bones do not heal in their perfect anatomical position. This can be corrected following the healing process. It is expected that the prognosis would be worse and arthritis would set in. Delayed union or nonunion are relatively uncommon following ankle fractures. If during the healing process the fractures appear to be healing very slowly, bone stimulators may be necessary to enhance healing. If the fracture goes on to a nonunion, surgery may be necessary to freshen the fracture and try fixation to stabilize the fracture and allow it to go on to uneventful healing.
If the fracture has completely disrupted the joint surface (pilon fracture) then at some point arthritis would set in, which may necessitate surgical procedures which can include an arthroscopy, total ankle replacement or an ankle fusion.
With plates and screws. Sometimes a syndesmotic screw or device. It depends on how severe of a break and what structures are involved.
There are several factors that will determine what is needed to be done. I recommend you have your friend make an appointment with a foot and ankle surgeon (podiatrist) for diagnosis and treatment options.
Depending on the severity, if there is bone displacement more than likely open reduction.
Depends on how it is broken. There are many types of ankle fractures. I would discuss the details with the treating doctor.
