Ankle injuries occur when the ankle is affected by fractures, dislocations and ligament tears. Simple dislocations or tears in the side and internal ligaments can be treated conservatively. However, the patient requires surgery if the ankle joint is injured or displaced. The same applies if the syndesmosis (ligament between the tibia and the fibula) is injured.
The ankle is a complex joint. It is made up of the fibula (outer ankle bone), the shin bone (inner ankle bone) and the talus. It is stabilised by side ligaments, an internal ligament and the syndesmosis ligament (connection between the inner and outer part of the ankle). If the ankle is injured, this can result in a fracture or dislocation of the joint, or a tear in the ligaments or syndesmosis. Tears in the side ligaments or the inner ligaments are treated conservatively provided that no bones are injured. Dislocations of the ankle which have not injured the joint or the bone are also treated conservatively. However, ankle fractures involving the joint or a tear in the syndesmosis require surgery.
What preparations are carried out before the procedure?
Firstly, an x-ray examination is carried out to determine the extent of the injury. In some cases, computed tomography or an MRI are also carried out.
All the usual pre-operative assessments are required, such as a blood test, blood pressure measurement and an ECG. The patient must stop taking blood-thinning medication and should have an empty stomach for the procedure.
How is the operation performed?
Ankle fracture surgery is carried out under general anaesthetic or with spinal anaesthesia. To begin with, incisions are made in the skin to expose the fracture. Then any displaced bone parts are set and any fragments are fixed in the correct ankle axis with screws and plates. An angle plate is often used in the process. to fix the ankle fracture at the right angle. If the syndesmosis is injured or the ligaments are torn, they are sutured in the manner.
Finally, the surgical wound is closed. The operation usually takes one to two hours.
What is the success rate of this procedure?
The success rates for surgical treatment of joint injuries are good. It is important for the healing process and the operative result to start targeted physiotherapy exercises for the ankle early.
What are the possible complications and risks of this procedure?
Ankle fracture surgery usually proceeds without major complications. As with all surgery, the operation may occasionally lead to infections, nerve damage, post-operative haemorrhaging or blood clots. In rare cases, pseudo-osteoarthritis can appear in the area of the fracture (partial healing of the fracture with formation of a false joint) or osteoarthritis in the ankle.
What happens after the operation?
Soon after the surgery, the ankle is mobilised and manipulated with physiotherapy exercises. The ankle hand can be used as normal after approx. six to eight weeks. The healing process is monitored with regular follow-up checks. Sport which puts considerable strain on the ankle, such as jogging or tennis, can be taken up again three months after the operation at the earliest.