ANKLE FRACTURE SURGERY MELBOURNE

Mr Troy Keith

Ankle Fracture Surgery – Questions & Answers
A Patient’s Guide:

Mr Troy Keith MBBS (Hons), FRACS (Orth), FAOrthA
Orthopaedic Foot and Ankle Surgeon

PATIENT CARE PROCESS – MR. TROY KEITH
Learn more about Mr Keith’s approach to your care:

FIRST APPOINTMENT

GP/Specialist referral

Patient consultation & assessment

Additional testing if required

TREATMENT PLAN
(Non-operative)

Pain management

Physiotherapy

Exercise / Nutrition

OPERATIVE  TREATMENT
(If necessary)

Surgical process

Hospital administration

Surgery preparation – What do you need

POST OPERATIVE CARE

Early mobilisation

Pain management

Rehabilitation

Follow up appointments – Next 12 months

ANKLE FRACTURE

What is an ankle fracture?

A broken ankle is also known as an ankle “fracture.”

This means that one or more of the bones that make up your ankle joint are broken – See figure 1 -Ankle joint anatomy below.

ANKLE ANATOMY

What are the bones in your ankle?

The ankle joint allows up and down movement of your foot. There is  also another joint below the ankle joint called the subtalar joint that allows side to side motion of your foot.

The ankle joint is made up of three bones:

1. Tibia – Your shin bone.
2. Fibula – The thinner bone on the outside of your shin bone.
3. Talus – This sits in between the ankle and your heel bone  (calcaneum).

Your ankle joint is also stabilised by ligaments and other soft tissues, which are also often injured as a result of an ankle fracture.

Figure 1

ANKLE FRACTURE

How do you fracture your ankle?

A broken or fractured ankle is an injury to the one or more of the tibia, fibula or talus bones. Most commonly, the bones of the lower leg (tibia or fibula) are fractured.

Some common causes of ankle fractures are twisting, or rolling your ankle. The impact or force from tripping or you falling onto your ankle awkwardly can fracture your ankle.

Treatment for a broken ankle depends on the exact site and severity of the bone fracture and potential soft tissue injuries surrounding the ankle.

TYPES OF ANKLE FRACTURES

Most common ankle fractures

Common ankle fractures include:

Fibula fracture – Known as lateral malleolus.

Bimalleolar ankle fracture –  Both sides “bi” are broken – fibula and tibia.

Trimalleolar ankle fracture – Breaks occur on three “tri” sides of your ankle:

  1. The outside fibula ” lateral malleolus”
  2. The inside tibia, “medial malleolus” and;
  3. The back of the tibia” posterior malleolus”.

Pilon fracture – A fracture  that goes through the middle of your ankle joint.

Trimalleolar and pilon fractures have a much higher risk of cartilage and soft tissue injury that surround the ankle.

ANKLE FRACTURE ASSESSMENT

Assessing your ankle injury

To help with the accurate diagnosis of your ankle injury:

  • A physical exam and history – It is important to identify how the injury occurred, as well as investigating the anatomical site of the injury.
  • X-ray – helps to confirm the type of fracture and if it can be treated without surgery.

Special scans are sometimes needed

These include:

  • CT scan –  Provides a 3D image of the bone injury with very fine detail.
  • MRI scan – Is a 3D image of the soft tissue injury including cartilage.
Mr Troy Keith

Mr Troy Keith MBBS (Hons), FRACS (Orth), FAOrthA
Orthopaedic Foot and Ankle Surgeon.

“It can be difficult to differentiate a broken ankle from a severe sprain without an X-ray. In complex cases a CT or MRI scan may be also needed to further look at the bones, ligaments and cartilage.”

DO YOU NEED ANKLE SURGERY?

There are a range of options Mr Keith will discuss before opting for surgery.

Ankle fractures can be successfully treated without surgery using:

  • Braces
  • Casts, and/or
  • Cam boots.

Mr Keith will discuss the options available to your specific situation

Ankle Fracture Foot Surgery Melbourne

ANKLE FRACTURE TREATMENT APPROACH

Mr Keith’s approach to your ankle injury:

Immediately following your ankle injury, you should apply ice packs and keep the foot elevated to minimise pain and swelling.

The treatment of an ankle fracture depends upon the type and stability of the fracture pattern.

Treatments starts with braces, casts, or cam boots for stable fractures. These are generally worn for 6 weeks.

If your fracture is not stable or will lead to a poor outcome, surgery will then be recommended.

With surgical treatment, the fractured bone(s) of your ankle are re-aligned into their correct position and stabilised using special plates and screws. This allows you to start moving your ankle and to begin putting weight through your foot and ankle.

Mr Troy Keith

ANKLE SURGERY

Mr Troy Keith MBBS (Hons), FRACS (Orth), FAOrthA
Orthopaedic Foot and Ankle Surgeon

Types of ankle surgery

Open reduction and internal fixation (ORIF) – This is a type of surgery used to stabilise and heal a broken bone. You might need this procedure to treat your broken ankle.

Ankle arthroscopy – This utilises a small video camera (arthroscope) to get a better look inside your ankle to inspect the cartilage and allows repair of it if needed.

Syndesmosis surgery – A syndesmosis injury or “high ankle sprain” sometimes occurs with ankle fractures. This may need to be treated at the time.

Ankle fusion surgery – Ankle fractures can lead to ankle arthritis with the cartilage in the ankle wearing down over time. This can lead to a stiff and painful ankle. Surgery to permanently stiffen your ankle to treat your pain sometimes is needed.

Ankle replacement surgery – An artificial joint can be used to replace a damaged ankle joint.

ANKLE SURGERY RECOVERY TIMELINE

A typical recovery timeline for ankle surgery is as follows:

Timeline – After surgery Description
0 – 2 weeks Need to keep your foot STRICTLY elevated to allow soft tissue healing and swelling to settle.
2 – 6 weeks You will start physiotherapy to help regain ankle motion and re-build core strength. You will need to wear a cam boot for 4 – 6 weeks.
3 – 4 months Most patients return to low impact activities such as walking and straight line jogging.
6 – 12 months Return to pre-injury level of function.

POTENTIAL COMPLICATIONS

Complications which may occur after your fracture and or operation may include:

  • Ankle stiffness
  • Ankle swelling commonly up to 6 months
  • Ankle stiffness with restricted movement
  • Infection and or wound related
  • Numbness or tingling over your foot
  • Fracture non union (not healing) or malunion (healed in a malunited position)
  • DVT (deep vein thrombosis) or PE (pulmonary embolus)
  • Further surgery to remove prominent metalware

Mr Keith will discuss with you in detail the potential risks and complications in relation to your ankle condition.

Mr Troy Keith

Mr Troy Keith MBBS (Hons), FRACS (Orth), FAOrthA
Orthopaedic Foot and Ankle Surgeon.

If you have any questions please contact my team:

VISIT CONTACT INFORMATION

ANKLE SURGERY MELBOURNE

Helpful information and frequently asked questions (FAQ’s)

Preparation for post surgery and rehabilitation

Depending on the specifics of your ankle surgery, most patients usually spend at least two or more weeks off their feet. Rehabilitation and a gradual return to your previous activity levels is the goal.

These tips are designed to protect you and help you heal as safely and quickly as possible:

  1. Prepare your living spaces for your decreased mobility after surgery:
    • Removal any items you could trip over in your living spaces
    • Preparation of meals during your rehabilitation
  2. Follow your post-surgical care instructions given to you by Mr Keith
  3. Organise your support network to help you after surgery
    • Transport home from hospital
    • The first few weeks of home care after your surgery.

Rest – Give your body the chance to perform its natural healing processes after the surgery.

Medication – Make sure you manage your pain levels and monitor your medication to help assist with your recovery.

Rehabilitation – Follow the directions of Mr Keith and your physiotherapist in relation to your recovery and use of protective devices such as casts and braces. Ease back into physical activity and your stretching and strengthening exercises.

Hygienic practices – The potential for infection is one of the risks of surgery. Keep surgical areas clean to reduce your infection risk.

Follow-up appointments – You’re not on your own after the surgery! Mr Keith will schedule follow-up appointments to monitor your progress and ensure everything is on track for your rehabilitation.

Ankle surgery recovery

The recovery time following ankle surgery varies depending on a number of factors including:

  • Complexity of surgery
  • Your age
  • General health
  • Compliance and commitment to rehabilitation instructions

For most foot and ankle operations, tenderness and swelling can take 3-4 months to resolve, while for more complicated procedures, the recovery may take a full year (or more).

How long will I need physical therapy for after ankle surgery?

Physical therapy usually starts two to four weeks after ankle surgery and can continue for the next 3-12 months depending on:

  • Commitment to the rehabilitation program
  • Ankle swelling and pain management
  • Level of activity you wish to return to
  • Foot, ankle and leg response to your physiotherapy exercise program.

Will my ankle ever be the same after a break?

Full recovery after an ankle fracture is highly dependant on the severity of the fracture/s and the soft tissue damage to the surrounding area of the ankle as well as:

  • Age
  • Activity level you wish to return to
  • Complexity or break and surgery
  • Commitment to rehabilitation program

There may be some difference in flexibility and appearance during rehabilitation period.

A discussion with Mr Keith may help give you a more accurate idea as to the potential of your ankle recovery.

Protecting your ankle after foot surgery

After ankle surgery, your foot will be in either a cast or a splint for at least two weeks. This is to ensure your ankle is protected and gives your foot time to heal after the surgery.

Mr Troy Keith

 Ankle Surgery Melbourne:
Mr Troy Keith – Foot & Ankle Surgeon

If you have any questions or would like to make an appointment, please feel free to contact my team:

VISIT CONTACT INFORMATION

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Ankle Surgery Melbourne

Mr Keith consults to patients from all over Melbourne in relation to ankle fractures and surgery. Mr Keith consults with patients at the following practice locations in Melbourne Armadale, Malvern, Richmond, Heidelberg and in Shepparton, country Victoria.