Treatment of Ankle Fractures
Ankle fractures are an extremely common injury that may occur secondary to relatively low mechanisms of injury (i.e. slipping on the ice) or major trauma (i.e. falling from a height or a motor vehicle accident). Certain ankle fracture patterns maintain the overall stability of the ankle joint, while others are significantly unstable and require surgery to realign the bones and joints appropriately. Many of these injuries often also have a significant soft tissue component to the injury, and in some scenarios, the cartilage lining of the joint may also be injured. These additional factors often have a major implication on outcomes if not treated appropriately initially.
Symptoms of an Ankle Fracture
The major problems following an ankle fracture are stiffness, chronic pain, and arthritis of the ankle joint, particularly following inappropriate realignment of the bones and the joint surface. Even a few millimeters of misstep of the joint can lead to arthritis and subsequent disability, as the ankle would be unable to tolerate even the most minimal amount of malalignment well.
Surgery Options for Fracture Ankles
When surgery is necessary, rigid plates and screws are utilized to fix the inside and outside of the ankle joint to provide maximal stability. After surgery, immobilization in a splint is required until the incisions have healed. After healing of the incisions, early motion of the ankle is initiated to maximize function and outcome while minimizing stiffness. Patients are generally to remain non-weight-bearing for these first 2 weeks. At 2 to 6 weeks, weight bearing is allowed in a protected walking boot for an additional 6 weeks, and then patients are transitioned into a regular shoe with a gradual increase in activity allowed. During the recovery, physical therapy, low-impact strengthening, and aquatic exercise is encouraged and initiated as soon as possible. Continued improvement occurs for up to 6 to 12 months. In general, the outcomes after ankle fracture surgery are quite good, particularly in the short term. In the long term, arthritis may occur but with a lower likelihood if appropriately realigned surgically initially.
Subtalar Joint Arthrodesis in Chicagoland
Dr. Vora treats ankle fractures with an aggressive rehabilitation method to maximize outcomes. He has published and lectured locally and nationally on the treatment of ankle fractures. In addition, the use of arthroscopy (minimally invasive surgery that pokes holes in the skin to place a camera in the ankle joint) to additionally treat other conditions of the cartilage that may not be visible with standard surgery is often utilized in attempt to maximize outcomes for patients with this condition. Dr. Vora has designed specific implants used to treat ankle fractures that are utilized nationally and internationally.