What is a Compound Ankle Fracture?

By Alex Herington, ATC, LAT

What is a Compound Ankle Fracture?

The quick answer, a compound ankle fracture can be debilitating and needs medical attention. Ankle injuries are among the most common types of injuries, ranging from sprains to fractures. However, compound (or open) ankle fractures are less common than the typical ankle sprain and can become far more problematic. In compound ankle fractures, an open wound is caused by a fragment of the involved bone breaking through the skin. If you ever find yourself in this situation, JOI has the most experienced team of orthopedic surgeons in North Florida to get you back on the road to a full recovery.

Anatomy of the ankle joint.

Image of illustration of human ankle anatomy.

Anatomy of the Ankle

  • The ankle joint is composed of three bones:
    • Tibia (Shinbone): Makes up the inside or medial side of the ankle joint.
    • Fibula: Parallels the tibia and makes up the outside or lateral side of the joint.
      • The far ends of the tibia and fibula come together to form an arch and sit atop the talus. The singular form is referred to as the malleolus.
      • The tibia makes up the posterior and medial malleoli, while the fibula makes up the lateral malleolus.
    • The talus transfers the forces from the tibia to the heel bone (calcaneus).
    • The bones of the ankle joint are held together by a joint capsule. Several ligaments that provide stability to the ankle. If any of the ligaments or soft tissues are injured, it may lead to chronic ankle pain and instability.

How Do You Get a Compound Ankle Fracture?

A variety of different mechanisms causes compound ankle fractures. However, they most commonly occur from a high energy event such as a fall from a height, motor vehicle accident, or a sports injury. Often, these injuries will be present with other significant injuries.

If you would like to learn more about Tibia and Fibula Fractures, this ARTICLE may help.

What are Compound Ankle Fracture Treatments?

Compound ankle fractures require a different treatment than closed (no break in the skin from a bone fragment) fractures. Due to the break in the skin, bacteria, and other contaminants from the outside environment may cause an infection. For this reason, it is of the utmost importance to seek emergent medical treatment.

  • Since compound fractures pose an immediate threat of infection, cleansing of the wound, and administering antibiotics are necessary steps to prevent further contamination of the tissues.
    • Following the tissues’ debridement, the patient will be placed in a splint until the surgical team determines that it is safe to proceed with the surgery.
  • If the wound is more complex than a puncture, and the tissue and bones are not yet ready for a permanent implant, an external fixator can be placed on the involved limb to heal wounds.
    • An external fixator is a frame that is attached outside of the limb to stabilize the bones. Once the wounds are healed, and the physician deems the patient ready for a permanent implant, the external fixator will be removed.
  • The primary surgical intervention often involves fixation with plates and screws to stabilize the fractures and allow the bones to heal in an anatomically correct position.
  • Following the surgery, the patient will be placed in a cast or boot and remain non-weight bearing until the physician determines the bones and incisions have healed, and the patient is ready to progress to therapy.

Post-Operative Recovery after Ankle Surgery

The time it takes for the patient to return to daily living activities fully can vary greatly depending on the severity of the injury. It is common for patients to experience pain, stiffness, and weakness for several weeks to months after the surgery. Your physician and physical therapist will develop an individualized program specific to the injured body part. This will include a range of motion and strengthening exercises to help restore function. The recovery time will also depend on the patient’s cooperation; these exercises are given with the patient’s best interest in mind to help them return to activity as quickly and safely as possible.

Where Do I Go If I Think I Fractured My Ankle?

The Jacksonville Orthopaedic Institute has the area’s top Foot & Ankle Specialists to help you. With several convenient locations, we are ready to get you on the Road to Recovery.

Schedule with a JOI Orthopedic Foot and Ankle Doctor, call JOI-2000, schedule online, or click the link below.

By: Alex Herington, ATC, LAT

JOI physicians can treat a compound ankle fracture.

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