Open Reduction Internal Fixation of the Ankle
An ankle fracture is a common injury that involves a break in one or more of the bones that make up the ankle joint. This may include a crack or break in the the tibia, fibula, or talus. The more bones that are broken, the more complicated and severe the fracture is. Common causes of an ankle fracture may include a sports injury, a motor vehicle accident or a fall. Treatment for an ankle fracture can vary depending on the severity of the condition. While mild fractures may be treated through nonsurgical methods, more severe fractures may require surgery to realign the bones and ensure that they heal correctly.
Severe ankle fractures that will not heal properly with splinting or casting alone, may benefit from a procedure known as open reduction internal fixation. Open reduction internal fixation is a surgical technique that secures the bones in place with the help of screws, plates, wires, rods and pins. These tools allow the bones to heal properly, restoring function to the joint with no damage or discomfort to the patient. Depending on the severity of the fracture, these devices are sometimes removed from the ankle after it has healed from the surgery.
The Open Reduction Internal Fixation Procedure
Open reduction internal fixation takes place in two phases. First, an incision is made in the ankle and the broken bone is realigned and put back into place. Next, a plate with screws, a pin, or a rod that goes through the bone will be attached to the bone to hold the broken parts together. The steel rods, screws, or plates can be permanent, or temporary and may be removed when healing takes place. The incision is then closed with staples or stitches. A cast or brace is usually applied after this procedure
Risks of Open Reduction Internal Fixation
While it is considered a safe procedure, risks of open reduction internal fixation may include:
After the surgery, some patients may experience joint pain or movement from the inserted devices.
Recovery and Results
After the open reduction internal fixation procedure, the ankle fracture may take several months to heal depending on the severity of the initial injury. Initial recovery treatments focus on controlling pain and swelling with the use of ice and anti-inflammatory medication. After the cast is removed, movement may still be restricted until the bone is strong enough for regular activity.
Physical therapy can help patients to gradually restore full movement of the ankle and treatments focus on improving range of motion without putting excessive strain on the healing bone or ligaments. As the ankle heals, muscle-stengthening exercises as well as range of motion exercises and balance training are may all be used to increase movement and mobility. Full recovery after open reduction internal fixation may take up to 6 months.