Ankle injuries, especially for athletes, are very common. In the United States, approximately two million acute ankle sprains occur each year. Surgery isn’t usually necessary for many ankle problems like a sprain. However, when ankles are badly broken or unstable, surgery may be the best route to take.
Why settle on ankle surgery?
Your doctor may recommend surgery on an ankle to treat issues that don’t respond well to therapy and medications. This may include things like arthritis and tendonitis, but also more obvious concerns.
“Any break that creates an unstable joint or is likely to heal with an increased risk of arthritis needs surgery,” said Tina Kurkowski, Marshfield Clinic Health System orthopedic nurse practitioner. “Also, any ankle fracture that is an open fracture (when the bone sticks out of the skin) will need surgery.”
The overall goal of surgery is to restore the joint anatomically, decrease the risk of arthritis and increase the chances of post-injury function.
Keep in mind that ankle fractures come in different forms of severity. Some are considered mild if the ankle remains relatively stable. For these incidents, Kurkowski says your doctor may use non-operative treatments like a cast or fracture boot until the fracture heals.
When is hardware helpful?
You may have once heard someone say they have “screws” or “pins” in their joints for stabilization. Those pieces of hardware are part of some types of ankle surgery.
During some ankle fracture surgeries, screws, metal plates or small metal wires may hold broken bone in place during the healing process. During an ankle fusion, doctors will remove damaged tissues from the ankle and then fuse bones together permanently with screws and metal plates. Lastly, like many other joints, ankles can require replacement surgery. This may involve plastic or metal replacement joints.
“In many cases, the hardware will not need to be removed after the ankle heals,” said Kurkowski. “It can stay inside unless it is causing a problem such as irritation.”
Don’t skip the rehab
If you undergo ankle surgery, your rehabilitation timeline will depend on the severity of the injury. But regardless of how your doctor treats the fracture, rehab is very important.
“When your physician allows you to start moving your ankle, physical therapy and home exercise programs are key,” said Kurkowski. “Eventually, you’ll also start doing strengthening exercises. It may take several months for the muscles around your ankle to get strong enough to walk without a limp, but exercises will help you get there.”