Ankle Surgery

Ankle Surgery

Overview

Ankle surgery is a treatment option recommended to people with severe pain or injuries in the ankle joint. Depending on certain factors like your age, overall health, and the severity of the pain, your doctor may determine the type of ankle surgery suitable for you.

About Ankle

Human feet are made up of 26 bones and over 33 joints arranged in arches and columns that vary in flexibility and stiffness. Various common problems can occur in this complex structure.

The foot is usually separated into three different parts:

The hind-foot (back of your foot) is made up of calcaneus (heel bone) and your ankle (talus). They are joined together by your subtalar joint that allows the foot to move from one side to another.

The ankle bone is joined to your leg bones (tibia and fibula) at the ankle joint, which acts like a hinge. This allows the foot to bend up and down.

What is Ankle Surgery?

Surgery is not the only solution for many ankle problems. Most of the ankle issues can be solved with therapy and medicines. However, when ankles are unstable, deformed, badly broken or is causing constant pain, surgery could be the only solution.

Ankle surgery may be needed to treat broken bone (fracture), tendonitis, arthritis and problems that cannot be resolved with therapy and medicines.

Surgery for the fracture of an ankle is done when the ankle bones are unstable and require more support to heal. A few milder fractures – when the ankle is stable and the broken bone is not out of place – may not require surgical repair.

Different types of ankle surgery treat different medical conditions or injuries affecting the ankle. Ankle problems that may need surgery include:

1. Arthritis that causes pain and immobility 
2. Fractured ankle
3. Ankle deformity 
4. Chronic ankle instability from numerous sprains or other causes
5. Chronic synovitis/tendonitis of the ankle

The two most common ankle surgery procedures are ankle fusion and ankle replacement. 

The ankle fusion procedure is performed to allow the bones to fuse as one. During the procedure, the surgeon roughens the bones’ ends and joins them with screws and metals. This procedure has been effective in relieving arthritis pain. 

The ankle replacement procedure is performed to replace the damaged parts of the bones with an artificial plastic-and-metal replacement joint. The artificial joint allows a more natural movement of the ankle, thereby reducing the chances of developing arthritis in the future. 

Usually, an ankle replacement procedure is recommended to healthy people with a lesser-active lifestyle above the age of 60 years. Some high-impact activities such as jumping and running may damage the artificial joint. 

Do you qualify for ankle surgery?

The doctor may recommend you undergo ankle surgery if you show the following symptoms:

• Severe ankle pain
• Inflammation in the ankle joint
• Difficulty during routine activities like walking (due to stiffness of the ankle joint)
• An obvious deformity in the ankle
• Infection in the ankle joint known as septic arthritis
• Severe injuries to the ankle joint such as a torn ligament or fracture

If you experience pain and discomfort in your ankle or notice any other changes, seek immediate medical assistance. An early diagnosis and suitable treatment can help prevent your symptoms from worsening and causing further complications.

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Why is ankle surgery done?

Ankle surgery may help treat broken ankle bones, reduce ankle pain, and manage other problems where treatments such as therapy or medication fail to work. 

Ankle surgery for broken bones is useful if the bones become unstable and need extra support to heal. However, in mild fractures where the ankle is unstable, and the bones are not out of place, ankle surgery may not be needed. 

Different types of ankle surgeries are performed to treat various injuries and medical conditions that affect the ankle.

What are the different types of ankle surgeries?

Ankle surgeries can range from a minimally invasive ankle arthroscopy to ankle replacement surgery. To carry out these surgeries, the surgeon will give you either local anesthesia or general anesthesia. 

The following are some of the common ankle surgeries:

• Ankle arthroscopy

Ankle arthroscopy is a minimally invasive surgical procedure that involves making tiny incisions in your ankle region. During the procedure, the surgeon will remove parts and areas of your bone and cartilage that may be causing problems in your ankle. Usually, this procedure is recommended if you have ankle injuries or arthritis. 

• Tendon surgery

This  procedure is carried out if you have chronic tendonitis or synovitis in the ankle. The type of tendon surgery that may be performed depends on the severity of the tendon damage. If you have a damaged tendon tissue, the surgeon may surgically remove it or repair the tear. If your problem is severe, the surgeon may have to perform an Achilles tendon repair or reconstruction and tendon transfer. This complex procedure involves removing the damaged tendon and replacing it with another tendon.

• Ankle fracture surgery

If you develop a broken or fractured ankle, the doctor may recommend ankle fracture surgery to stabilize the break and heal the bone. The surgeon will use tiny metal wires, metal plates, and screws to help hold the broken bone stable during the healing process. There are different types of ankle fracture surgeries. Depending on your ankle fracture, the doctor may recommend the one best suited for you.

• Ankle fusion surgery

Ankle fusion surgery involves fusing the broken bones of the ankle. During the procedure, the surgeon may remove the damaged areas of the ankle bones and then fuse them permanently. This is done with the help of metal plates and screws. This surgical procedure usually treats ankle arthritis.

• Ankle replacement surgery

Ankle replacement surgery involves removing the damaged ankle joint and replacing it with an artificial joint made up of metal or plastic. The replacement joint is attached to the ankle bones with the help of special surgical glue. In some cases, the surgeon may also use metal screws to help stabilize the artificial ankle joint.

• Lateral ankle ligament reconstruction surgery (Brostrom Procedure)

This surgical procedure is performed in cases of foot deformities and severe ankle instability. During the procedure, the surgeon will make a tiny incision outside of your ankle to tighten any loose and weakened ligaments that may be causing instability in your ankle.

What are the benefits of ankle surgery?

The benefits of ankle surgery are:

• Better function and mobility of the ankle
• Relief from pain and other symptoms 
• Ability to perform routine functions without any problems

Are there any risks or complications of ankle surgery?

Every surgery carries some risks and complications, and ankle surgery is no different. Although most patients face no complications, a few patients may experience the following:

• Infection in the incision site
• Blood clots or bleeding, also known as deep vein thrombosis
• Weakness or stiffness in the ankle joint
• Damage to the nerves or blood vessels around the ankle
• Adverse ereactions due to anesthesia
• Irritation due to the hardware placed in the ankle joint
• Bone misalignment

Conclusion

Ankle surgery is a treatment approach that your doctor may recommend if other treatment options such as medications and home remedies fail. Depending on your age, the area damaged, causes, and severity of ankle damage, your doctor may devise an appropriate treatment plan.

FAQs

Can you feel the metal plates and screws inside your ankle?

In some cases, if the metal plates and screws are placed in areas with very little muscle or soft tissues, such as the outside of your ankle, you may be able to feel them.

How long does it take to recover from ankle surgery?

Depending on the type of ankle surgery, full recovery can take anywhere between three to four months. In complicated procedures for severe ankle damage, complete recovery may even take a full year. However, you can consult with your doctor about how soon you can start using your ankle for routine activities like walking.