Fracture Care · Knee, leg & ankle
Ankle fracture
Ankle Fracture (Bimalleolar or Trimalleolar) — Open Reduction and Internal Fixation (ORIF)
The condition
The ankle joint is formed by the ends of the shin bone (tibia) and the thinner outer leg bone (fibula), whose bony bumps (malleoli) hold the ankle bone in place. A twisting fall can break one or more of them, sometimes tearing the ligament between the two leg bones. An unstable fracture lets the joint shift.
The surgery
This is a typically outpatient surgery through one or more incisions around the ankle. The broken bones are put back in place and held with plates and screws. If the ligament between the leg bones (syndesmosis) is torn, it is stabilized with a screw or a strong suture device. The final plan is determined during surgery.
Recovery at a glance
- Splint & boot
- Splint, crutches, and strict elevation for 2 weeks, then a walking boot. Ankle motion out of the boot starts at 2 weeks.
- Weight-bearing
- From 2 weeks, full weight in the boot as comfort allows (some fractures stay protected until 6 weeks). Boot to shoe between 6 and 8 weeks.
- Daily life
- Desk work often within 1–2 weeks if you can keep the leg elevated. No driving while taking narcotic pain medication.
- Running
- Typically 10–12 weeks, once single-leg calf raises and hopping are pain-free.
- Activity
- Full release typically 3–4 months, with a normal walk and balance.
A general guide. Your restrictions and timeline may change based on what is found and done at surgery.
Risks & benefits
Benefits: Restoring the ankle's alignment gives the best chance of a stable, comfortable ankle and lowers the risk of arthritis. Risks are uncommon and include infection, blood clots, wound-healing problems (higher with diabetes or smoking), hardware irritation that may require removal, numbness on the top or outside of the foot, ankle arthritis over time, injury to nearby structures (such as nerves, blood vessels, or cartilage), stiffness, persistent pain, and the need for further surgery. These will be reviewed with you in detail before surgery.
Patient Surgical Information
Open, save or print. Bring your questions to your pre-op visit.
Before & after every surgery