Why some broken ankles need surgery and others don’t

Everyone has different thresholds for pain, and this is especially true when it comes to feet and ankles. An injury that puts one person out of the game and on the bench might feel like simple soreness to another individual. Consider, for example, the New Zealand woman who ended up running a marathon with a broken ankle. According to a report from Runner’s World, after only a little way into the event, she felt her ankle collapse. She taped it up at a rest station and started back in on the race. Eventually, the injury caught up with her and she had to run slower and felt “excruciating” pain. Still, she finished (albeit in nine hours and last place).

While I would never advise a patient to run on an injured ankle, much less finish a lengthy race like Motatapu Marathon or the New York Marathon with one, it’s interesting to consider how different injuries affect people in different ways. For example, if this runner had broken her ankle at a different spot on her limb, it might have impacted her ability to finish. Additionally, it’s fascinating how only slight variations in breaks can influence how something is treated.

An ankle fracture can be any type of break or crack in the tibia, fibula, or talus. Common causes include athletic injuries, slips and falls, and auto accidents. I see a variety of ankle injuries in my clinic. With some patients, it’s clear from the get-go that a surgery–whether it’s an arthroscopy, ligament reconstruction, or fusion–will be necessary. Other times, it’s not so clear and requires a much more intensive evaluation to determine the best treatment for an ideal outcome. The general rule is that the more bones that are broken, the more complicated and severe the fraction, and, in turn, the more complicated the required treatment.

A basic and stable fracture can actually heal on its own within a few weeks and with the support of a cast or brace, ice, and anti-inflammatory medicines. Of course, timing is important for this type of injury. Delaying treatment can worsen the break and lead to more complex treatment. In instances where the break is more severe or when bones need to be repositioned, surgery is the best bet. In these cases, we will work to make incisions as minimal as possible with natural joint retention and healing time in mind.

Regardless of the chosen treatment method, if you have a broken ankle, you can expect to be off of it for several weeks, and you may experience swelling, bruising, tenderness, and other pain. Day-to-day activities, including putting on shoes, might be difficult. Rehabilitation and patience will be key for a complete fix.

An injured ankle is no fun. Thankfully, there are a variety of options for helping one heal. If you are experiencing what you think is an ankle fracture or break, don’t put off a visit to an expert. I’d be happy to take a look at your injury and assist you with the next steps for a complete recovery.