30 Oct What Can I Expect From Ankle Surgery?
Ankle surgery is a scary thought – but one that might be necessary if you have fallen and fractures or injured your ankle. You will usually know if you’ve broken your ankle as it will immediately swell and there will be significant discoloration (eg bruising). Doctors will order an X-ray if you have any of the following 3 signs:
- Bony tenderness within 6cm of the medial malleolus
- Bony tenderness within 6cm of the lateral malleolus
- Unable to weight bear on the ankle for more than 4 steps
These “rules” are known as the Ottawa ankle rules and are used across the world. Dependent on the result of your X-ray the doctors will decide whether or not to operate.
Different classifications of ankle fractures:
Whether you have ankle surgery with plates and screws is dependent on where the ankle fracture is and how it is classified. Usually, your doctor will diagnose the ankle fracture after ordering an X-ray. The fracture is usually obvious on X-ray and will guide the specialist doctors in their decision on whether or not to operate. Typically they will look at whether or not the fracture is displaced. Aka if it is displaced then it will need somebody to go in and reshuffle the contents of the ankles back into the right place so that it can heal properly. However, if it’s not displaced or minimally displaced then you won’t need an operation and short leg cast should suffice.
What does ankle surgery involve?
If the specialist surgeons decide to operate on the ankle then they will complete what is known as an open reduction and internal fixation. Effectively, this means they go into the joint and reduce the fracture (eg put it back into place) before fixing it into place. How they fix it into place will depend on the particular fracture. However, each surgeon has a number of tools in their arsenal. The different options include:
- Buttress plates are metal plates that are used to rigidly hold a fracture in place. These are screwed into the bone and are placed across the break.
- Kirschner wires (also known as K wires). They are placed into the bone to hold fragments together.
- In some situations, a syndesmotic screw is used. This is a screw that goes across the ankle to hold the bones of your leg in place so they remain articulated with the ankle joint.
Usually, you will be immobilized for a few weeks following the surgery, before the surgeon rex-rays the leg and makes sure everything has healed up in the correct place. At this point, you will begin physio and will be able to retrain the muscles around the ankle.
If you or somebody you know has suffered an ankle fracture and needs an expert opinion fast, then get in contact with a specialist ankle clinic that can provide individualized care dependent on your individual needs. Often this sort of individualized care just isn’t available with your family doctor.