Ankle Fracture ORIF

The surgical repair of an ankle fracture using special screws and metal plates to the outside of the bone.

Ankle Fracture ORIF

There are three bones that make up the ankle joint: the tibia (shinbone), the fibula (smaller bone of the lower leg) and the talus (bone found between the heel bone and the tibia/fibula). Ankle fractures can be caused by direct impact to the area, twisting or rotating the ankle, “rolling” the ankle, or tripping/falling. When speaking in terms of ankle fractures, there are three boney areas that we refer to: the medial malleolus (the inside protrusion of the tibia that we associate with the ankle), the lateral malleolus (the outside protrusion of the fibula that we associate with the ankle) and the poster malleolus (the back part of the tibia). These fractures are classified according to the area of the bone that is broken (i.e. medial malleolus fracture). Nonsurgical treatment may be utilized by your doctor if the ankle remains stable and the fractured bones are still in anatomic alignment or, in some cases, if the patient is not a surgical candidate. A CAM boot or a cast will be applied and non-weight bearing measures are taken to allow the fracture to heal. Serial x-rays are then used to ensure proper fracture healing occurs. If the fracture is more severe where displacement has occurred, the ankle joint is unstable, dislocation of the ankle joint is present, multiple bones are involved or ligamentous injury is present, surgical intervention (also known as open reduction with internal fixation or ORIF) with hardware placement may be required. This surgery can be done in an ambulatory surgery center but is sometimes performed at a hospital. During the procedure, your surgeon will identify the fracture(s) using intraoperative x-ray and will reduce the bones back to their proper anatomic alignment. Then, the reduced fracture(s) are held together using special screws and metal plates to the outside of the bone. A splint is applied following surgery to immobilize the ankle and allow for adequate healing. Weight bearing restrictions are also implemented to reduce any stress to the newly repaired fracture. The healing process usually takes approximately six to eight weeks but can take longer for patients with particularly bad fractures or with chronic medical conditions that hinder timely bone healing. Once enough fracture healing has occurred, the cast or boot will be removed and a brace is often implemented as a step-down approach of support to the ankle. Rehabilitation is important, regardless of how the ankle fracture is treated. Your doctor and physical therapist will begin a physical therapy regimen once the fracture has adequately healed and the ankle is deemed stable. Your doctor will also allow you to start putting weight on your ankle after determining that the fracture has become stable enough to do so.

DRUJ Instability/Arthritis, Ulnocarpal Impaction, DIP Pinning for Mallet Finger


Our world-class orthopedic surgeons have years of experience treating foot and ankle conditions. We believe that even the simplest problems should be evaluated by a specialist.

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As our patient, you will have an in-depth consultation with one of our doctors. We will create an individualized treatment plan together, tailored to your problem and lifestyle. Our doctors prefer non-invasive treatments whenever possible, including physical therapy and/or injections. If your problem ultimately does require surgery, our doctors prefer the least invasive surgical techniques possible. Our goals are the same as yours: to get you back to living your best life, pain free. 

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