Ankle Fracture Repair in Los Angeles

What Is an Ankle Fracture?

A break in the tibia, fibula, or talus near or around the ankle joint is considered an ankle fracture. There are many types of ankle fractures, depending on the severity, location, and number of bones involved.

The bones can break in a straight line or a twisted, complex pattern. A more severe fracture involves the joint and cartilage. One, two, or three bones can break at a time, and the tibia may break in multiple areas. The severity of the fracture is usually based on the severity of the injury.

In some cases, a sprain or tear of the ligament spanning between the two leg bones (tibiofibular syndesmotic ligament) may separate the bones and widen the ankle joint, further complicating the fracture.

At Foot and Ankle Specialty Group, we’re here to help mend your broken ankle. Our state-of-the-art facility in Beverly Hills is led by the top ankle surgeon in Los Angeles, Dr. David J. Soomekh.

Types of Ankle Fractures

Lateral Malleolus Fracture: A lateral malleolus fracture is a fracture of the fibula. The level at which the fibula fractures can vary, and the treatment approach depends on this level.

Medial Malleolus Fracture: A medial malleolus fracture is a break in the tibia at the inside of the lower leg. These fractures can occur at different levels of the medial malleolus and often accompany fractures of the fibula (lateral malleolus), the back of the tibia (posterior malleolus), or injuries to the ankle ligaments.

Posterior Malleolus Fracture: A posterior malleolus fracture is a fracture at the back of the tibia at the ankle joint level. In most cases, a posterior malleolus fracture occurs alongside a lateral malleolus (fibula) fracture due to shared ligament attachments. A fracture of the medial malleolus may also be present.

Bimalleolar Fracture: "Bimalleolar" means that two of the ankle's three parts (malleoli) are broken. In most cases, this involves fractures of both the lateral and medial malleolus, resulting in an unstable ankle.

Trimalleolar Fracture: "Trimalleolar" means that all three malleoli of the ankle are broken. These are unstable injuries and may be associated with a dislocation.

Syndesmotic Injury: The syndesmosis joint, located between the tibia and fibula, is held together by ligaments. A syndesmotic injury, which may involve only the ligament, is also known as a high ankle sprain. Depending on the severity of instability, these injuries may not require surgery, but they typically take longer to heal than standard ankle sprains.

Signs and Symptoms of a Broken Ankle

When excessive force is applied to the ankle’s soft tissue structures and bones, a patient may hear or feel a "pop" as ligaments tear and bones break. The first signs are sharp pain on the outer or inner ankle, followed by immediate swelling, sometimes as large as a tennis ball. Common symptoms of a broken ankle include:

• Immediate and severe pain
• Swelling
• Bruising
• Tenderness to touch
• Inability to bear weight on the injured foot
• Deformity, particularly if the ankle joint is also dislocated

Causes of an Ankle Fracture

An ankle fracture is usually caused by significant trauma. Patients with poor bone quality (osteoporosis), high arches (pes cavus), diabetic neuropathy, or ankle instability are at higher risk. High-impact sports and activities with excessive lateral movement, especially without proper warm-up or experience, can increase the likelihood of an ankle fracture. Common causes of a broken ankle include:

• Twisting or rotating the ankle
• Rolling the ankle
• Tripping or falling
• Impact during a car accident

Diagnosing Ankle Fractures

Diagnosing ankle fractures involves a clinical examination and X-rays. Dr. Soomekh uses the following methods:

• Patient Consultation: Listening to your symptoms and goals
• Hands-on Evaluation: Assessing the ankle’s stability and the strength of the ligaments and tendons
• Digital X-rays: Taken in the office to determine the severity of the fracture or dislocation
• CT Scan (if needed): Used in complex cases to provide a three-dimensional view of the injury

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Let’s Meet the Ankle Joint

The ankle joint plays a very important role in gait. When it flexes downward and pushes off the ground, it propels the body forward. With each step, a significant force and pressure are imparted upon this joint. The ankle joint has a complex construct that withstands these forces. Most of its motion is in flexion, and it is rigid in side-to-side and rotational motion. Its mortise-type anatomy makes it more complex than the hip or knee joints.

The bones that make up the ankle joint are:

• The Talus (ankle bone)
• The Lateral Malleolus of the Fibula (outer leg bone)
• The Tibial Plafond (leg bone)
• The Medial Malleolus of the Tibia (inner leg bone)

Preventing Ankle Fractures

The best way to prevent an ankle fracture is to maintain strength, muscle balance, and flexibility.

• The Talus (ankle bone)
• The Lateral Malleolus of the Fibula (outer leg bone)
• The Tibial Plafond (leg bone)
• The Medial Malleolus of the Tibia (inner leg bone)

Ankle Fracture Treatment Options

Dr. Soomekh emphasizes that early diagnosis and treatment of an ankle fracture lead to better recovery and long-term outcomes. Patients who "walk off" an ankle injury or delay treatment are more likely to experience chronic pain and loss of function.

Conservative Treatment for Ankle Fractures

If the fracture is mild, well-aligned, and the joint is stable, non-surgical treatment is an option.

• The patient will be placed in a cast and remain non-weight-bearing on crutches for up to six weeks.
• A walking boot will be worn for an additional two weeks.
• Physical therapy will begin after cast removal to support rehabilitation.
• Custom orthotics will be recommended for added support.

For unhealthy or at-risk patients with severe fractures, non-surgical treatment may also be considered.

Pain and swelling usually last for two to three days. During the first two weeks, ice therapy and non-steroidal anti-inflammatory drugs (NSAIDs) are recommended for relief.

Surgical Treatment for Ankle Fractures

Surgical repair is required when an ankle fracture is severe, unstable, or misaligned.

The goal of ankle fracture surgery is to:

• Realign bones and joints
• Stabilize the fracture during healing
• Restore mobility and function

Dr. Soomekh performs these procedures in an outpatient setting using the most advanced surgical techniques and materials.

Open Reduction and Internal Fixation (ORIF)

When the ankle fracture is displaced or the joint is unstable, surgery is necessary.

• The bone fragments are repositioned (reduced) to their normal alignment.
• The bones are stabilized with screws and metal plates (internal fixation).
• These implants hold the bones together during healing and can be left in place permanently or removed if needed.

In some cases, surgery may be recommended, even if the fracture is aligned, to reduce the risk of nonunion and allow earlier mobility. For syndesmotic ligament injuries, a specialized anchor and stitch system is used for reinforcement.

Dr. Soomekh may incorporate advanced stem cell therapy to enhance healing.

Ankle fracture repair typically requires:

• Four to six weeks in a cast with crutches
• Two to three weeks in a walking boot for transition
• Physical therapy for rehabilitation