Submitted By David A. Porter M.D. PhD.
08.19.2009

The ankle might be one of the most beat up, underappreciated structures in the human body. Everyday movements such as walking and climbing stairs require the joint to be in working condition, while athletic activities such as jumping, cutting, and sprinting demand even higher performance. In fact, 10 – 15 percent of athletic injuries occur at the ankle. Considering this, it shouldn’t come as a surprise that ankle fractures are so common.

The word ‘ankle fracture’ is used when bones in the ankle are broken.  This definition does not identify the specific location of the injury, so there are many different structures that can be involved in an ankle fracture. There are two bones that make up the ankle: the weight-bearing shinbone called the tibia, and the non-weight-bearing fibula bone. There are two rounded projections, one on each side of the ankle, called malleoli (single: malleolus). The medial (inner) malleolus is formed by the end of the tibia, and the lateral (outer) malleolus is formed by the end of the fibula. Fractures frequently occur across these structures, but a fracture can occur anywhere along either bone.

Depending on the severity of the injury, ankle fractures can be treated non-operatively with immobilization and rest but the preferred method of treatment, especially for athletes, is surgical. The method used to surgically fix an ankle fracture is called Open Reduction and Internal Fixation or ORIF. ‘Open’ refers to a surgical incision that allows the surgeon to see the fractured bone in order to fix it. ‘Reduction’ refers to correcting the placement of the bone, and ‘internal fixation’ refers to placing screws through the bone, across the fracture in order to keep the fragments in place so the bone can heal itself. Sometimes a metal plate is also used for further stabilization.

Our research shows that this method, coupled with early weight-bearing and range of motion exercises during rehab, usually results in a complete return to activities with little strength or agility lost. Patients can expect to wear a walking boot and be on crutches for a few weeks after surgery, and then progress into a brace. Athletes can get back to play in as little as two to four months after surgery.