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Open Reduction and Internal Fixation for Ankle Fractures

When it comes to treating ankle fractures, particularly those where bones are severely misaligned or broken, Open Reduction and Internal Fixation (ORIF) is a common and effective surgical procedure.

Contact Orthopedic Foot & Ankle Center today in Greater Columbus, OH, for a clearer understanding of how ORIF helps restore function to the ankle joint, allowing patients to return to their daily activities.

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Do I Need Surgery?

Visiting an orthopedic surgeon doesn’t mean that surgery is necessary. Our orthopedic doctors always prefer to use non-surgical procedures to treat injuries.

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What is Ankle Fracture Open Reduction and Internal Fixation?

Ankle fractures occur when one or more of the bones in the ankle joint, such as the tibia, fibula, or talus, are broken. Depending on the severity, these fractures can involve a simple crack in the bone or multiple breaks where the bones are displaced or punctured through the skin.

Open Reduction and Internal Fixation (ORIF) is a surgical method used to treat complex ankle fractures. The procedure is divided into two parts: Open Reduction, where the surgeon repositions the broken bones into their correct alignment, and Internal Fixation, where screws, plates, or rods are used to hold the bones in place while they heal. Internal fixation refers to the hardware that remains inside the body, providing stability to the ankle joint as the bones heal properly.

What Are the Reasons for ORIF?

There are various reasons why an orthopedic surgeon might recommend ORIF for an ankle fracture. Typically, this procedure is advised when:

  1. The Bones Are Severely Misaligned: If the bones broke and are not in proper alignment, they may not heal correctly on their own, leading to long-term complications such as arthritis or chronic pain.
  2. Broken Bones Punctured the Skin: Open fractures, where broken bones have pierced through the skin, are at a higher risk for infection and often require surgical intervention to clean the wound and stabilize the bone.
  3. Multiple Fractures: In cases where there are multiple breaks in the ankle bones, ORIF may be the best option to ensure the bones are properly aligned and stabilized for healing.
  4. Failed Non-Surgical Treatment: If a patient has attempted non-surgical treatments such as casting or bracing and the bones have not healed properly, ORIF may be necessary to correct the alignment.
  5. Joint Dislocation: Sometimes, ankle fractures are accompanied by a dislocation of the ankle joint. ORIF helps to realign the joint and stabilize the bones simultaneously.
A doctor examining a patient after open reduction and internal fixation to treat an ankle fracture in Columbus, Ohio.

What Are the Risks and Benefits of ORIF?

Like any surgical procedure, ORIF carries both risks and benefits that should be carefully considered.

Benefits:

Risks:

  • Infection: As with any surgery, there is a risk of infection, particularly with open fractures where the skin has been broken.
  • Hardware Complications: In some cases, the internal fixation hardware may cause irritation or need to be removed in a later procedure.
  • Blood Clots: Surgery increases the risk of developing blood clots in the legs, which can be serious if not addressed promptly.
  • Nerve Damage: There is a small risk of nerve damage during the procedure, which could result in numbness or weakness in the foot or ankle.
  • Delayed Healing: Sometimes, the bones may not heal as expected, requiring additional interventions or prolonged recovery time.

Preparing for the Procedure

Preparation for ORIF surgery involves several steps to ensure the best possible outcome. Patients should:

  • Undergo Pre-Surgical Evaluations: Your surgeon may order X-rays, CT scans, or MRIs to get a detailed view of the fracture and plan the surgery.
  • Discuss Medical History: It’s essential to inform your surgeon about any underlying medical conditions, allergies, or medications you are taking, including over-the-counter pain medicines or supplements.
  • Follow Fasting Instructions: You’ll likely be instructed not to eat or drink anything after midnight on the day of your surgery to reduce the risk of complications from anesthesia.
  • Arrange for Post-Surgery Care: Make arrangements for someone to drive you home after the procedure and help with daily tasks as you begin your recovery.

What to Expect During Surgery

The ORIF procedure for ankle fractures is typically performed under general anesthesia, meaning you’ll be asleep during the surgery. Here’s what happens during the procedure:

  1. Incision: The surgeon makes an incision near the fracture site to access the broken bones.
  2. Open Reduction: The surgeon carefully realigns the bones to their proper position.
  3. Internal Fixation: Once the bones are aligned, the surgeon secures them using screws, plates, or rods. These devices are typically made of stainless steel or titanium and are designed to remain in the body unless they cause complications.
  4. Closing the Incision: After the bones are stabilized, the incision is closed with sutures or staples, and a sterile dressing is applied.
 

The duration of the surgery can vary depending on the complexity of the fracture but typically lasts between one to two hours.

Recovery for ORIF

Recovery from ORIF surgery is a gradual process that requires patience and adherence to your surgeon’s instructions. Here’s what you can expect:

Immediate Post-Surgery Care:

  • Hospital Stay: Most patients stay in the hospital for one to two days after surgery. During this time, your surgical team will monitor your progress and manage your pain with medicines.
  • Immobilization: Your ankle may be placed in a cast or splint to keep it immobilized and protected during the initial healing phase.
 

Home Recovery:

  • Elevate the Ankle: Keeping your ankle elevated as much as possible can help reduce swelling and pain.
  • Pain Management: You’ll be prescribed pain medicines to manage discomfort. Be sure to take these as directed to stay ahead of the pain.
  • Physical Therapy: Physical therapy is a crucial part of the recovery process. Your therapist will guide you through exercises to restore strength, flexibility, and range of motion in the ankle joint.
  • Gradual Weight Bearing: Depending on the extent of your injury and your progress, your surgeon will advise you when it’s safe to start bearing weight on the ankle. This process is typically gradual, starting with partial weight-bearing and progressing to full weight-bearing as the bones heal properly.
 

Long-Term Recovery:

  • Follow-Up Appointments: Regular follow-up appointments with your surgeon are essential to monitor the healing process and make any necessary adjustments to your treatment plan.
  • Return to Activities: Full recovery from ORIF surgery can take several months. Most patients can return to their normal activities, including sports, within six to twelve months, depending on the severity of the fracture and their adherence to the rehabilitation program.

Getting Back on Your Feet with Expert Care

Open Reduction and Internal Fixation is a proven method for treating complex ankle fractures, offering patients the best chance for a full recovery and a return to normal activities.

If you or a loved one has experienced an ankle fracture and are considering ORIF, the experienced team at Orthopedic Foot & Ankle Center in Columbus, Ohio, is here to provide expert care and guidance through every step of the process.

Our specialists are committed to helping you heal properly and regain the full function of your ankle joint. Schedule an appointment today to learn more about your treatment options and start your journey to recovery!

 

Medically reviewed by Roberto A. Brandão, DPM

Our Sports Medicine Specialist​s​

TERRENCE M. PHILBIN, DO

Board Certified Orthopedic Surgeon

CHRISTOPHER F. HYER, DPM

Board Certified, Fellowship Trained Foot & Ankle Surgeon

PATRICK E. BULL, DO

Board Certified Orthopedic Surgeon

MARK A. PRISSEL, DPM

Board Certified, Fellowship Trained Foot & Ankle Surgeon

RANDALL C. THOMAS JR., DPM

Board Certified Foot & Ankle Surgeon

COREY J. GRIFFITH, DPM

Board Certified Foot & Ankle Surgeon

ROBERTO A. BRANDÃO, DPM

Board Certified, Fellowship Trained Foot & Ankle Surgeon
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