(201) 733-5255

Ankle Fracture Fixation

Treatment for ankle fractures depends on the severity of the injury, but often involves surgical fixation of the fractured bones to allow for proper healing and restore the patient’s mobility. Ankle fracture fixation can involve a variety of techniques, including open reduction and internal fixation (ORIF), external fixation, and minimally invasive surgery.

The ankle is made of three bones, the shinbone (tibia), the smaller lower leg bone (fibula) and the talus bone in the foot which makes up the lower part of the ankle joint. An ankle fracture may involve all three of these bones, or only one or two bones. The broken bones may be in alignment or out of alignment. Ankle fractures are classified based on the location of the fracture, and the number of bones involved.

One of the most common surgical techniques used to treat ankle fractures is open reduction and internal fixation (ORIF). ORIF is designed to bring the bones back into alignment to stabilize and heal the broken bones. The process of open reduction involves the repositioning of the fractured bone fragments to restore their proper alignment, while internal fixation is the surgical method used to physically connect the bones in ORIF. ORIF is the gold standard treatment for unstable fractures.

It is an urgent procedure performed under general anesthesia. During ORIF the surgeon makes an incision to expose the fractured bone and then uses screws, plates, or other hardware to fix the bone in place. ORIF is the preferred treatment for unstable ankle fractures, because it allows for immediate weight-bearing and can result in quicker recovery times compared to other surgical and non-surgical treatments.

After surgery, you will wake with your lower leg, ankle and foot in a cast or splint to hold the bones in place while they heal, usually 6-12 weeks.  Post-operative care involves pain management and restricted weight bearing for about six weeks.  You will receive complete post-operative instructions from your LALL Orthopedics+ surgeon.

Complications from ORIF are common to all types of surgery and include infection, bleeding, nerve damage, blood clots and failure to heal.


Another surgical technique used to treat ankle fractures is external fixation. External fixation involves using pins or screws that are attached to an external frame to hold the fractured bone in place. This technique is often used for complex ankle fractures or when the patient’s overall health may not allow for more invasive surgical techniques. External fixation is less invasive than ORIF and can be used in cases where there is soft tissue damage or other complications that may make ORIF more difficult.

Minimally invasive surgical fixation is a satisfactory method to treat certain types of ankle fractures in high-risk patients that can be helpful to avoid complications with conventional open reduction and internal fixation.

Recovery from ankle fracture fixation can vary depending on the severity of the injury and the type of surgical technique used. Patients who undergo ORIF can often bear weight on the affected foot immediately after surgery, although they may require crutches or a walker for a period of time. External fixation may require a longer period of immobilization and rehabilitation, as the pins or wires used to hold the bone in place can cause discomfort and may require additional care.

Regardless of the type of surgical technique used, rehabilitation is an important part of the recovery process for ankle fracture fixation. Physical therapy can help to improve range of motion, reduce pain and swelling, and restore strength and mobility to the affected foot. Patients may also be advised to avoid certain activities, such as high-impact sports, until the fracture is fully healed.

When you or a loved one suffers with an ankle injury that affects stability and function, contact LALL Orthopedics + for world-class care, close to home. We have offices in Belvidere, Illinois, Paramus, New Jersey and Philadelphia, PA.

Dr. Ajay C. Lall is a former dual sport NCAA collegiate athlete (football and track & field), American board certified, triple fellowship-trained expert orthopedic surgeon who specializes in diagnosing and treating ankle injuries. He treats non-athletes and athletes at all levels of play from collegiate to professional to the Olympic level. Dr. Lall is a world-renowned orthopedic surgeon who cares for all patients like family. Contact LALL Orthopedics + to schedule a consultation, receive the correct diagnosis, and undergo state-of-the-art treatment options.

At a Glance

Ajay C. Lall, MD, MS, FAAOS

  • Board Certified – Orthopedic Surgery
  • Triple Fellowship Trained
  • Performs over 750 Surgeries Per Year
  • Learn more