An Easier Recovery From Ankle Fracture Trauma

June 19th, 2015

As an orthopaedic surgeon, ankle fractures are among of the most common injuries I treat. Over two decades of treating countless patients with ankle fracture, my treatment has evolved, toward a better way for my patients to recover. I discovered that the typical casts and weightbearing restrictions implemented on patients after surgery were not always the best option. Instead, providing my patients with a removable boot and allowing immediate weight bearing offers many a better result. Now, the methods I use to treat ankle fracture patients at Rothman Institute are being shared and practiced all over the world.

My Background
Simply put, all I’ve done for 20 years is fix broken bones. Sometimes I fix broken bones that other surgeons can’t fix. They are often unusual fractures, or ones that are hard to treat. Many times I care for fractures that have not healed properly after treatment. As a result, fixing the routine ones has become straight forward. Because I have taken care of so many really badly injured people, I’ve become accustomed to really pushing for the optimal outcome, even with the more straightforward ones. I push the limits to give patients a better outcome than they would get with any other surgeon.
Ankle Fractures & Typical Treatment
Ankle fractures, which typically involve a combination of  breaks in the bones of the ankle and injuries to the ligaments that hold them together, are common injuries. They are often caused by the ankle rolling inward or outward. They can range from less-serious avulsion injuries to more severe situations in which multiple bones have breaks.
Often, I find that surgery is required to treat ankle fractures. Such a procedure allows me to restore proper alignment to the broken bone, which is essential for full recovery. Because arthritis is not an uncommon occurrence after an ankle fracture, performing surgery to recreate a normal ankle joint is often the most effective way to minimize this risk.  
A Modern Approach To Ankle Fracture Trauma

Many surgeons who fix ankle fractures place patients in a cast afterward and restrict weight bearing. I always felt that was overkill. I have been placing most patients in removable boots after surgery, and letting them bear weight right away for over 15 years.

For years this was unusual. While in Seattle, at the University of Washington, we decided to write this article giving some evidence to this practice. Interestingly, a large group of Canadian surgeons studied this very issue at the same time and found the same thing we did: patients have a much easier time after ankle fracture surgery with this protocol, without the risk many surgeons assume it entails.
This study concluded that, in certain ankle fracture patients, immediate weight bearing as tolerated is “a safe alternative to a period of protected weight-bearing”, such as a cast. In fact, this earlier weight-bearing was shown to be associated with several benefits, including better mobility, a decreased hospital stay, and even an earlier return to work. Certainly, not having to wear a cast and being able to bear weight make it much easier to get around.


Bottom line, because of this practice, my patients have a much easier recovery from ankle fracture surgery. It may not matter in the long run, but some people care about the short run as well as the long run. I would bet that if you could give patients the choice up front, the vast majority would want this treatment protocol for their ankle fracture. I sure would.
Rothman Institute
This approach to ankle fracture treatment and recovery is just one example of how the team at Rothman Institute is making revolutionary strides in orthopaedics every day. As international leaders in research and development, we are constantly looking for better way to serve our patients. Of course, we do not stop with just our patients; my story is just one example of the way that our methods have been forerunners in innovation that help patients all over the world. 
For more information about ankle fracture treatments at Rothman Institute, or to schedule an appointment, contact us today at 1-800-321-9999.


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