What is an ankle fracture?

An ankle fracture is a break of one of or both your ankle bones.

An ankle fracture is usually caused by a twisting injury to your ankle, resulting from sports or a simple fall or trip.

There may be a break of the bone on the outer side of your ankle (fibula), the inner side (tibia), or both sides.

There may also be damage to your ankle ligaments.

What are the benefits of surgery?

Your bones should heal in a good position. If the bones heal in an incorrect position, you are more likely to get stiffness and arthritis in the future.

Are there any alternatives to surgery?

If your ankle bones are in a good position, it may be possible to treat the fracture using a cast or a walker boot.

What will happen if I decide not to have the operation?

You will be treated using a cast or walker boot. You may need to use a walking aid to keep your weight off your leg.

What does the operation involve?

Various anaesthetic techniques are possible.

The operation usually takes 30 minutes to an hour. Your surgeon will make one or more cuts to expose the broken bones on the inner and outer sides of your ankle. They will usually fix the fractures using screws and a plate, although sometimes they need to use other devices.

What complications can happen?

The healthcare team will try to reduce the risk of complications.

Any numbers which relate to risk are from studies of people who have had this operation. Your doctor may be able to tell you if the risk of a complication is higher or lower for you. Some risks are higher if you are older, obese, you are a smoker or have other health problems. These health problems include diabetes, heart disease or lung disease.

Some complications can be serious and may even cause death.

General complications of any operation

• Infection of the surgical site (wound). In some cases another operation might be needed.
• Allergic reaction to the equipment, materials or medication.
• Blood clot in your leg (deep-vein thrombosis - DVT).
• Blood clot in your lung (pulmonary embolus), if a blood clot moves through your bloodstream to your lungs.
• Difficulty passing urine.
• Chest infection — your risk will be lower if you have stopped smoking and you are free of Covid-19 (coronavirus) symptoms for at least 7 weeks before the operation.

Specific complications of this operation

• Damage to nerves. This usually gets better but may be permanent.
• Severe pain, stiffness and loss of use of your foot and ankle. Your foot and ankle can take months or years to improve. Sometimes there is permanent pain and stiffness.
• Loosening or breaking of the plate and screws. You may need another operation.
• Infection in the bone.
• Delayed union, where the fracture does not heal in a normal period of time.
• Difficulty passing urine.

Consequences of this procedure

• pain
• unsightly scarring of your skin

How soon will I recover?

You should be able to go home on the same day.

Spend most of the time during the first 2 weeks with your leg raised on pillows or a footstool so that the swelling settles.

Your ankle may be kept in a cast until the bones have healed, which usually takes about 6 weeks.

It can take several months before you are able to return to all your normal activities.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

Most people make a good recovery and get back good function.

However, your ankle may never be as strong as it was before the injury.

Summary

For some types of ankle fracture, an operation is the best way to make sure your ankle bones heal in a good position.

IMPORTANT INFORMATION

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