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, a fragment of the involved bone breaks through the skin and causes an open wound. 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 has 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 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 provide stability to the ankle. If any of the ligaments or soft tissues have an injury, 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, the 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.

X-Ray Image of painful ankle

Ankle  x-ray

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 on the outside of the limb to stabilize the bones. Once the wounds are healing and the physician deems the patient is ready for a permanent implant, the MD removes the external fixator
  • 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.
  • Compound Ankle Fracture

    Walking Boot

Post-Operative Recovery after Ankle Surgery

The time it takes for the patient to fully return to daily living activities 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. Exercises are for the patient’s best interest in mind to help them return to activity as quickly and safely as possible.

Related Articles: Lower ankle sprain and Ankle Fracture. 

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.  To schedule for physical therapy, please call 904-858-7045.

Schedule with a JOI Orthopedic Foot and Ankle Doctor, call 904-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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