What is the treatment for a malleolus fracture?

After a bimalleolar fracture¹

A bimalleolar fracture means that both sides of your ankle are broken. This injury is often unstable and requires careful care.

First, the medical team checks that your general condition is good. The doctor then checks the flow of blood in your foot as well as your sensitivity. If the blood circulates poorly, the ankle must be put back in place quickly to avoid complications. The skin is also examined carefully, especially if there is a wound, as this increases the risk of infection.

Two types of treatment are possible:

Non-surgical treatment:

If the fracture is stable or if an operation is not an option for you, treatment without surgery may be proposed. It rests on a cast under the knee or a walking boot for about six weeks. In some people, especially in the case of diabetes, immobilization may be longer. A follow-up X-ray is done after a few days (about 1 week) to check that the bones have not moved. Treatment to prevent phlebitis (clots in the veins) is also prescribed during the period without support.

Treatment with surgery:

In most cases, surgery is necessary because the ankle is unstable. The surgeon puts the bones back in the right position, then secures them with a plate and screws on the outer side, and screws (or sometimes a plate) on the inner side. He also checks the condition of the ligaments that hold the ankle together. If these ligaments are damaged, additional screws can be placed to increase stability.

After the operation, you will usually not be able to put your foot down for several weeks. Treatment to prevent clots is maintained until the support is completely recovered. Bone consolidation takes several weeks, but it often takes several months and rehabilitation to regain a stable and comfortable ankle.

After a trimalleolar fracture²

The trimalleolar fracture is more complex because all three malleoli are affected. It almost always requires surgery. Immobilization and lack of support can last for about 6 weeks.

Bone consolidation usually occurs within a few weeks, but functional recovery is longer than for a simple fracture. Rehabilitation is essential to limit stiffness and regain stable walking.