When treating a broken ankle, or ankle fracture, surgical intervention may be necessary to stabilize the bones and ensure proper healing. Two common approaches for surgical treatment are internal fixation and external fixation. Both methods have their own advantages, and the choice of which to use depends on the severity of the fracture, the patient’s overall health, and the specific needs of the case. Dr. Daniel Romanelli is experienced in both techniques and will determine the most appropriate treatment based on your condition.

Internal Fixation

Internal fixation involves the use of metal hardware, such as plates, screws, or pins, which are placed inside the body to stabilize the broken bones. This method is typically recommended when the bones are displaced and need to be realigned for proper healing.

Procedure
  • During surgery, Dr. Romanelli will make an incision near the fracture site to access the broken bones.
  • The bones are carefully repositioned (reduced) to their proper alignment.
  • Metal screws, plates, or pins are then used to secure the bones in place, ensuring stability while the bones heal.
  • The incision is closed, and the hardware remains inside the body permanently or until it is removed in a future procedure (if necessary).
Benefits of Internal Fixation
  • Stability: Internal fixation provides strong and stable support to the fractured bones, allowing for earlier weight-bearing and a faster return to mobility in some cases.
  • Minimally Visible: Since the hardware is placed inside the body, there are no external devices that require ongoing care.
  • Lower Risk of Infection: With no external hardware protruding through the skin, the risk of infection is reduced.
When is Internal Fixation Used?
  • Internal fixation is often used for more severe fractures, particularly when multiple bones are involved or when the bones are significantly displaced.
  • It is a preferred method when early mobility is desired, as the internal hardware provides the necessary stability for the bones to heal correctly.

External Fixation

External fixation involves the use of a metal frame placed outside the body, with pins or screws that are inserted into the bones through the skin to hold the bones in place. This technique is typically used in cases of severe fractures, open fractures, or when swelling is too great to safely perform internal fixation immediately.

Procedure
  • In external fixation, pins or screws are inserted into the bones above and below the fracture site through small incisions in the skin.
  • These pins are connected to a metal frame that sits outside the body, which stabilizes the bones while they heal.
  • The frame can be adjusted to ensure proper alignment during the healing process.
Benefits of External Fixation
  • Quick Stabilization: External fixation is often used in emergency situations where immediate stabilization is necessary, especially for open fractures or cases involving significant soft tissue damage.
  • Adjustability: The external frame can be adjusted during the healing process to ensure proper bone alignment.
  • Temporary Solution: External fixation is usually temporary, with the frame removed once the bones have healed sufficiently or when internal fixation can be safely performed.
When is External Fixation Used?
  • External fixation is commonly used in high-energy trauma cases where the skin or soft tissue is damaged, making it unsafe to perform internal fixation immediately.
  • It is also used when there is significant swelling, as internal fixation may increase the risk of complications if performed too early.

Which Fixation is Right for You?

The decision between internal and external fixation depends on several factors, including the type and severity of the fracture, the condition of the surrounding tissue, and the patient’s overall health. Dr. Romanelli will evaluate these factors and discuss the best treatment option with you.

  • Internal Fixation is generally preferred for most stable fractures, especially when early mobilization is important for the patient’s recovery.
  • External Fixation is often used as a temporary solution for more complex fractures or when immediate stabilization is needed, with internal fixation performed later if necessary.

Recovery and Rehabilitation

Both internal and external fixation require a period of immobilization, followed by physical therapy to restore strength, flexibility, and range of motion to the ankle. Dr. Romanelli and his team will guide you through the recovery process, ensuring that your treatment plan is personalized for optimal healing.

Whether internal or external fixation is recommended, Dr. Romanelli’s expertise and personalized approach ensure that you receive the best possible care for your broken ankle. Let us help you regain full function and mobility with the most appropriate treatment for your specific needs.