External Fixation Of An Ankle Fracture


  • External (eks-TER-nal) fixation (fik-SA-shun) of an ankle fracture is surgery to repair your broken ankle. An ankle fracture is a break in any of the bones of your ankle. The ankle joint is made up of the tibia, fibula, and talus bones. The tibia and fibula are the two bones in your lower leg. The talus is a square, flat bone on top of the calcaneus (heel bone). The ankle joint lets you move your foot in different directions. External fixation is done when fractured bones are not in their normal positions or are broken into several pieces. It is also done when bones stick out through skin, or when deep cuts reach down to the bones.

  • With external fixation, pins and devices sticking out of the ankle will hold together broken pieces of bone inside it. While being held together, the pieces of broken bone will grow together and get stronger. This may bring back your ankle's usual appearance and your leg's usual length. Physical activities may need to be avoided for some time until your bone heals completely. It may take months to get full function of your leg, ankle, and foot after this surgery. With external fixation, your ankle fracture may be treated and usual activities may be resumed.


You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.


There are always risks with surgery, such as bleeding and infection. Other parts of your ankle and foot, such as nerves, blood vessels, ligaments, muscles, and bones may be damaged. Your leg, ankle, or foot may become stiff, numb, and weak. Even after a successful surgery, you may still have ankle pain or problems moving your leg or foot. You may have trouble going back to your usual activities, including sports. If left untreated, the pain and problems you may have with your injury may get worse. Your ankle may be crooked and your legs may not be the same length. Call your caregiver if you are worried or have questions about your surgery, medicine, or care.


Before your surgery:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

  • Anesthesia: This medicine is given to make you comfortable. You may not feel discomfort, pressure, or pain. An adult will need to drive you home and should stay with you for 24 hours. Ask your caregiver if you can drive or use machinery within 24 hours. Also ask if and when you can drink alcohol or use over-the-counter medicine. You may not want to make important decisions until 24 hours have passed.

  • An IV is a small tube placed in your vein that is used to give you medicine or liquids.

  • Pre-op care: You may be given medicine right before your procedure or surgery. This medicine may make you feel relaxed and sleepy. You are taken on a stretcher to the room where your procedure or surgery will be done, and then you are moved to a table or bed.

  • Monitoring:

    • Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.

    • Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.

    • Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

During surgery:

  • Your caregiver cleans your leg, ankle, and foot with soap and water. This soap may make your skin yellow, but it will be cleaned off later. Sheets are put over you to keep the area clean.

  • Your caregiver aligns the broken bones together by carefully pushing, pulling, and turning the leg, ankle, or foot. He tries to do this without making a cut on your skin. For hard to reach bones, he may have to make very small cuts on your skin. He may use a fluoroscope (x-ray) to help him insert pins and correctly align the bones. Holes are made on the bones by using a drill to insert screws and long metal pins. These pins are placed through the affected bone and will stick out through your skin. Other rods and devices are attached to them to hold your leg, ankle, and foot steady. An x-ray may be done to see if the bones were set in the right way. Bandages are wrapped around the areas where pins were inserted.

After surgery:

You are taken to a room where your heart and breathing will be monitored. Do not get out of bed until your caregiver says it is okay. A bandage may cover wounds to help prevent infection. You may be able to go home after some time passes. An adult will need to drive you home and should stay with you for 24 hours. If you cannot go home, you will be taken to a hospital room.

  • You will be able to drink liquids and eat certain foods once your stomach function returns after surgery. You may be given ice chips at first. Then you will get liquids such as water, broth, juice, and clear soft drinks. If your stomach does not become upset, you may then be given soft foods, such as ice cream and applesauce. Once you can eat soft foods easily, you may slowly begin to eat solid foods.

  • Medicines: You may need one or more of the following:

    • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.

    • Antinausea medicine: This medicine may be given to calm your stomach and to help prevent vomiting.

    • Pain medicine: Caregivers may give you medicine to take away or decrease your pain.

      • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.

      • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about External Fixation Of An Ankle Fracture (Inpatient Care)