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Open Reduction And Internal Fixation Of An Ankle Fracture


  • Open reduction (re-DUK-shun) and internal (in-TER-nal) fixation (fik-SA-shun) (ORIF) of an ankle fracture is surgery to repair a 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 helps you move your foot in different directions. ORIF is usually done when the fracture is large, and when nerves and blood vessels are damaged. It may be done when fractured bones are not in their normal positions or are broken into several pieces. A failed attempt to repair the ankle fracture without open surgery may also need an ORIF.
  • During ORIF, your caregiver may use wires, screws, plates (strips of metal), and pins to align broken bones. These special tools are used to hold the pieces of bones together while they grow together and get stronger. Your caregiver may also place bone chips into spaces between or around the fracture. After surgery, you will need to have a cast or splint that covers your lower leg, ankle, and foot. Physical activities will need to be avoided for some time until the affected bone heals completely. It may take months to get your leg, ankle, and foot working again after this surgery. With an ORIF, your ankle fracture may be treated and usual activities may be resumed.


Take your medicine as directed:

Call your primary healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

  • Antibiotics: This medicine is given to fight or prevent an infection caused by bacteria. Always take your antibiotics exactly as ordered by your primary healthcare provider. Do not stop taking your medicine unless directed by your primary healthcare provider. Never save antibiotics or take leftover antibiotics that were given to you for another illness.
  • Pain medicine: You may need medicine to take away or decrease pain.
    • Learn how to take your medicine. Ask what medicine and how much you should take. Be sure you know how, when, and how often to take it.
    • Do not wait until the pain is severe before you take your medicine. Tell caregivers if your pain does not decrease.
    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling someone when you get out of bed or if you need help.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

Ask your caregiver when you need to return to have your wound checked and the stitches removed. A brace that allows a little leg motion may be placed on your leg. Your caregiver may also teach you how to use crutches. Crutches will support and decrease the stress on your ankle when walking. Ask your caregiver for information about leg movements and the use of crutches.

Bathing with stitches:

Follow your primary healthcare provider's instructions on when you can bathe. Gently wash the part of your body that has the stitches. Do not rub on the stitches to dry your skin. Pat the area gently with a towel. When the area is dry, put on a clean, new bandage as directed.

Physical therapy:

You may need to see a physical therapist to teach you special exercises. These exercises help improve movement and decrease pain. Physical therapy can also help improve strength and decrease your risk for loss of function.

Your physical therapist may teach you special exercises to do at home. These may be done alone or with the help of a family member. Do only the exercises advised by your caregiver and do them only as often as your caregiver suggests. Do not do more than the range of motion exercises advised by your caregiver.

Wearing a cast or splint:

Caregivers may want you to limit your ankle or foot movement for some time. This will keep your broken bones from moving while they heal. It may also decrease pain and make you feel more comfortable. A cast or splint may be made of plaster or fiberglass.

  • Follow these instructions if you have a cast:
    • Check the skin around the cast every day. You may put lotion on any red or sore areas.
    • It is important not to get the cast wet. Before bathing, cover the cast with two plastic trash bags. Tape the bags to your skin above the cast to seal out the water. Keep your leg out of the water in case the bag breaks. If a plaster cast gets wet and soft, call your caregiver. You can dry the wet part of the cast using a hair dryer set on low or no heat.
    • Do not push down or lean on any part of the cast because it may break.
    • Do not scratch the skin under the cast by putting a sharp or pointed object inside the cast.
  • Follow these instructions if you have a splint:
    • If your splint is too tight, your toes may be numb or tingly. Gently loosen the splint so that your toes are comfortable.
    • Do not push down or lean on any part of the splint because it may break.


  • You have a fever.
  • You have chills, a cough, or feel weak and achy.
  • Your skin is itchy, swollen, or has a rash.
  • You have chest pain or trouble breathing that is getting worse over time.
  • You have questions or concerns about your condition, surgery, or medicine.


  • You have increased pain or swelling in your ankle area that does not go away.
  • Your cast or splint gets damaged or breaks.
  • Your cast or splint becomes soaked with blood.
  • Your cast feels tight and you have more swelling in your foot or toes.
  • Your skin or toes on the injured ankle turn blue or white or they feel cold, numb, or tingly.
  • You suddenly feel lightheaded and have trouble breathing.
  • You have new and sudden chest pain. You may have more pain when you take deep breaths or cough. You may cough up blood.
  • Your leg feels warm, tender, and painful. It may look swollen and red.

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.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Learn more about Open Reduction And Internal Fixation Of An Ankle Fracture (Aftercare Instructions)

Micromedex® Care Notes