Ankle surgery

Overview

Ankle conditions, such as fractures (broken bones), arthritis, tendonitis, and conditions that cannot be treated despite attempts of conservative treatments like physical therapy and medications, might require surgical intervention.

Mild ankle fractures, when the ankle is stable and the shattered bone is not displaced, may not need surgery to be repaired. But when bones are unstable and need extra support to recover, surgery is done to treat the fractures.

The appropriate surgery for an individual depends on their age, activity level, and the extent of joint damage or deformity they are experiencing. Various forms of ankle surgery are designed to address distinct injuries or medical conditions that impact the ankle. 

The following conditions such as fracture, arthritis, chronic ankle stability cause by sprain, deformity, or chronic tendonitis/synovitis of the ankle usually requires ankle surgery:

Types

The extent of the procedure might range from minimally invasive arthroscopy to total ankle replacement surgery. Patient will be put to sedated throughout the procedure using either general anesthesia or local anesthesia.

The length of recovery varies depending on the type of operation. Expect to use crutches at first, then go through a stage where the patient wear a cast or walking boot.

• Ankle fusion (to treat arthritis): This procedure allows surgeons remove the damaged tissue from the affected areas of the ankle joint affected by arthritis. They next utilize screws and metal plates to permanently fuse the ankle bones together. 

Ankle fusion is very successful in reducing arthritic pain, but it also restrict the ankle’s range of motion. Adjacent joints may move more in order to make up for this restriction, which raises the risk of arthritis developing in those joints. 

• Ankle replacement: This procedure allows the surgeons carefully remove the damaged ankle joint and replace it with an artificial joint made of plastic or metal. A specific surgical glue is used to attach the replacement joint to the existing bone. In order to increase the stability of the ankle replacement, surgeons may additionally use screws. 

Artificial ankle joints are commonly advised for individuals aged 60 and above who are in good health and lead less active lifestyles. Activities involving significant impact, like running and jumping, can potentially cause harm to an artificial ankle joint. 

• Ankle arthroscopy (to treat arthritis and ankle injuries): Surgeons makes few tiny incisions in the ankle in this minimally invasive surgery. Surgeons use specialized tools to remove bone or cartilage pieces from the ankle. 
• Tendon surgery: Surgical options for chronic ankle tendonitis/synovitis can range from relatively simple treatments like removing the injured tendon tissue or healing a tear to more complex ones like Achilles repair/reconstruction and tendon transfer. A procedure entails removing a damaged tendon and replacing it with a tendon taken from the foot.
• Ankle fracture surgery: Surgery can be crucial in stabilizing fractures and promoting the bone’s healing in the case of broken ankles. During the healing process, keeping the broken bone properly aligned may be made easier with the use of screws, metal plates, and small metal wires. Depending on the type of the fracture, there are various surgical techniques that can be used. The surgeon will talk with the patient about the definite surgery required. 
• Lateral ankle ligament reconstruction (to treat chronic ankle instability or foot deformities): This treatment, also known as the Brostrom procedure, entails the surgeons making a little incision on the outside of the ankle. They next tighten the weak and lax ligaments that are to blame for the ankle’s instability. 

Risk

Ankle surgery frequently helps people regain functional use of their ankles and reduces pain brought on by illnesses like arthritis. 

Risks following ankle surgery could include:

• Infection
• Blood clots
• Bleeding
• Nerve damage or blood vessels damage in the ankle
• Joint stiffness or weakness
• Reactions to anesthesia

Outcome

The patient’s ankle is immobilized for several weeks after the procedure. To start the healing process and offer defense against further damage or injury, an ankle cast or medical boot is worn. Most patients resume their regular activities six to eight weeks after surgery. 

If the patient notice any indications of infection or other complication, they need to contact their surgeon or seek immediate medical attention.