Ankle Injuries That Might Need Surgery

A twisted ankle can seem like a minor inconvenience, but sometimes it’s more serious than just a simple sprain. While many ankle injuries heal with rest, ice, and time, others are severe enough to require surgical intervention. Knowing the difference is crucial for a full and proper recovery.

This guide will walk you through the types of ankle injuries that frequently need surgery. Understanding these conditions can help you make informed decisions about your health and know when it’s time to consult a specialist. If you're experiencing severe ankle pain or instability, seeking professional medical advice is the most important step you can take.

Understanding Ankle Injuries

The ankle joint is a complex structure made up of bones, ligaments, and tendons that work together to provide stability and movement. An injury to any of these components can range from mild to severe. Common ankle injuries include sprains, which involve stretched or torn ligaments, and fractures, which are breaks in one or more of the bones.

Most people have experienced a mild ankle sprain at some point, which typically resolves with the RICE method (Rest, Ice, Compression, and Elevation). However, when the damage is more extensive, these conservative treatments may not be enough to restore full function and stability to the ankle. In these cases, surgery becomes a necessary option to repair the damage and prevent long-term problems like chronic pain, instability, and arthritis.

Common Ankle Injuries Requiring Surgery

Several types of ankle injuries are severe enough that they often warrant a surgical procedure. An orthopedic surgeon can assess the extent of the damage through physical examination and imaging tests like X-rays, CT scans, or MRIs to determine the best course of action.

Severe Ankle Fractures

An ankle fracture involves a break in one or more of the bones that make up the ankle joint: the tibia (shinbone), fibula (smaller bone in the lower leg), and talus. The severity of the fracture will determine the need for surgery.

Displaced Fractures: When a bone breaks and the pieces move out of their normal alignment, it's called a displaced fracture. These almost always require surgery to realign the bones and fix them in place with screws, plates, or rods. This procedure, known as open reduction and internal fixation (ORIF), is essential for proper healing and restoring the joint's function.
Open Fractures: If the broken bone pierces the skin, it is an open or compound fracture. This type of injury carries a high risk of infection and requires immediate surgical treatment to clean the wound and repair the bone.
Bimalleolar and Trimalleolar Fractures: These are complex fractures involving breaks in two (bimalleolar) or three (trimalleolar) of the bony knobs (malleoli) at the base of the tibia and fibula. Due to the significant instability they cause, these fractures typically require surgery to ensure the ankle joint heals correctly.

Without surgery, severe fractures can heal improperly, leading to chronic pain, limited mobility, and an increased risk of developing arthritis later in life.

Severe Ankle Sprains and Ligament Tears

While most sprains heal on their own, a severe sprain can involve a complete tear of one or more ligaments, leading to significant instability. This is often referred to as a "high ankle sprain" when it involves the ligaments connecting the tibia and fibula (the syndesmosis).

Surgery may be recommended for:

Complete Ligament Tears: If a key ligament, such as the anterior talofibular ligament (ATFL), is completely torn, the ankle can become chronically unstable. If conservative treatments like physical therapy and bracing fail to restore stability, surgery may be needed to repair or reconstruct the ligament.
Chronic Ankle Instability: For individuals who experience repeated ankle sprains and persistent feelings of the ankle "giving way," surgery can tighten the ligaments and restore stability. This can prevent further injuries and the long-term wear and tear that leads to arthritis.
High Ankle Sprains (Syndesmotic Injuries): These injuries are common in athletes and can cause significant instability between the tibia and fibula. If the gap between the bones is too wide, a surgeon may need to insert screws or a specialized suture device to hold the bones together while the ligaments heal.

An orthopedic surgeon in Altamonte Springs, FL, can perform diagnostic tests, like an MRI, to get a clear picture of the ligament damage and decide if surgery is the best option for you.

Achilles Tendon Ruptures

The Achilles tendon is the largest tendon in the body, connecting the calf muscles to the heel bone. A sudden, forceful movement can cause this tendon to rupture completely. While some Achilles tendon ruptures can be treated non-surgically with a cast or boot, surgery is often recommended, especially for active individuals.

Surgical repair involves stitching the torn ends of the tendon back together. The benefits of surgery include:

Lower Risk of Re-rupture: Studies have shown that the rate of re-rupturing the tendon is significantly lower after surgical repair compared to non-surgical treatment.
Improved Strength and Function: Surgery can lead to better recovery of calf muscle strength and overall function, which is particularly important for athletes or those with physically demanding jobs.

Talar Dome Lesions

A talar dome lesion, also known as osteochondritis dissecans (OCD), is an injury to the cartilage and underlying bone of the talus (the ankle bone). These injuries often occur after a severe ankle sprain or fracture. If a piece of cartilage and bone becomes loose, it can cause pain, clicking, and a feeling of the ankle catching or locking up.

If the lesion is small and stable, it may heal with rest and immobilization. However, if the fragment is loose or if conservative treatment fails, surgery may be necessary. Surgical options include:

Arthroscopy: A minimally invasive procedure where a surgeon removes the loose fragments and stimulates the bone to encourage new cartilage growth (microfracture).
Grafting: In more severe cases, a surgeon may need to transplant a piece of bone and cartilage to repair the damaged area.

When to See a Specialist

If you experience any of the following symptoms after an ankle injury, it's essential to seek medical attention from an orthopedic specialist:

Inability to bear weight on the injured ankle.
Obvious deformity or misalignment of the ankle bones.
Severe pain and swelling that doesn't improve with rest and ice.
A popping or snapping sound at the time of injury.
Numbness or a "pins and needles" sensation in your foot.
An open wound where the bone is visible.

Ignoring a severe ankle injury can have lasting consequences. A consultation with an experienced orthopedic professional will ensure you receive an accurate diagnosis and a treatment plan tailored to your specific needs.

Your Next Steps to Recovery

Living with severe ankle pain or instability can significantly impact your quality of life, preventing you from enjoying daily activities and staying active. While the thought of surgery can be daunting, it is often the most effective path to a full recovery for serious ankle injuries. Modern surgical techniques are designed to restore stability, reduce pain, and get you back on your feet.

If you believe you have a severe ankle injury and are looking for an experienced orthopedic surgeon in Altamonte Springs, FL, our team is here to help. At Central Florida Bone & Joint Institute, we specialize in diagnosing and treating a wide range of musculoskeletal conditions. We are committed to providing personalized care to help you achieve the best possible outcome.

Contact Central Florida Bone & Joint Institute today to schedule a consultation and take the first step toward healing.