Broken Ankle (Open Reduction & Fixation)

What Is Broken Ankle—Open Reduction and Fixation Surgery?

There are several options available to doctors when treating a broken ankle, such as manipulating the bones and adding a cast.  However, when the use of a cast is insufficient to aid healing for a broken ankle, the best option is usually an open reduction and fixation surgery.   

This surgery could involve either internal fixation, where screws and metal plates are fitted inside the body, or external fixation, where a metal rod is bolted through the skin into the uninjured sections of the bone around the fracture. 

For a broken ankle, when an open reduction and internal fixation (ORIF) surgery is performed, the surgeon makes an incision over the fracture to expose it.  The bone fragments are realigned with bone-grasping forceps and bone clamps.  A metal plate that fits the size and length of the fracture is placed over the fracture and holes are drilled through the plate into the bone.  The surgeon then inserts screws into the holes and has them tightened.  The size, type, and number of all implants used during the procedure are recorded in the patient’s permanent medical record.  In some cases, X-rays are necessary to ensure that the bone is properly aligned.  The wound is then irrigated and closed in layers, sometimes with a drain inserted for the removal of excess blood at the fracture site.  Finally, the wound is dressed and the ankle is set in a splint or cast.