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ORIF of an Ankle Fracture

Medically reviewed by Last updated on Aug 31, 2022.

What do I need to know about open reduction and internal fixation (ORIF) of an ankle fracture?

ORIF of an ankle fracture is surgery to fix a broken ankle. You may need surgery to repair a talar fracture. The talus is a square, flat bone on top of the heel bone. It connects your heel bone with the tibia and fibula (lower leg bones) to form the ankle. Open reduction means the bones will be put back into the correct position. Internal fixation means hardware (such as wires, screws, pins, or plates) is used to hold the bones in place while they heal.

Heel, toes, ankle

How do I prepare for ORIF?

  • Your surgeon will tell you how to prepare for surgery. He or she may tell you not to eat or drink anything after midnight on the day of surgery. Arrange to have someone drive you home after surgery.
  • Tell your surgeon about all medicines you currently take. He or she will tell you if you need to stop any medicine for surgery, and when to stop. He or she will tell you which medicines to take or not take on the day of surgery.
  • Tell your surgeon about all your allergies. Tell him or her if you had an allergic reaction to anesthesia or antibiotics.
  • You may need blood or urine tests. You may also need x-rays, a CT scan, or an MRI of your ankle and foot. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.

What will happen during ORIF?

  • You will be given general anesthesia to keep you asleep and free from pain during surgery. An incision will be made on or around your ankle. Your surgeon will use wires, screws, plates, or pins to put the broken bones back together. A bone graft may be placed in or around the fracture to make the broken bone stronger. Natural bone will grow around the graft.
  • Your surgeon may flush the area to remove small, loose pieces of broken bone. Damaged blood vessels and nerves will also be repaired. X-rays may be taken to see if the bones are in the correct position. The incision will be closed with stitches or medical tape and covered with bandages.

What should I expect after ORIF?

You will be taken to a room to rest until you are fully awake. Healthcare providers will monitor you closely for any problems. Do not get out of bed until your healthcare provider says it is okay. When your healthcare provider sees that you are okay, you will be taken to your hospital room.

  • A cast or splint may be put on your lower leg, ankle, and foot. This will help prevent movement so your bones can heal.
  • Medicines may be given to relieve or prevent pain, nausea, or an infection caused by bacteria.

What are the risks of ORIF for an ankle fracture?

Nerves, blood vessels, ligaments, or muscles may be damaged during surgery. Your leg, ankle, or foot may become stiff, numb, and weak. You may still have ankle pain. Your broken ankle may not heal properly. You may not be able to walk or move your foot and leg the way you did before your injury. You may have trouble going back to your usual activities. You may develop a life-threatening blood clot.

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