ANKLE FRACTURE SURGERY - Silverman Ankle & Foot



PILON FRACTURE SURGERY

High energy ankle fractures, Pilon Fractures, often cause severe damage to the joint (articular) surface. Although arthritis is common after these injuries, surgery is performed to decrease the severity of the arthritis and to improve the results of potential future procedures such as fusion or replacement. Healing in Pilon fractures is routinely delayed in comparison to typical ankle injuries. The surgery is performed as an inpatient.

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Pre-operative Care

The surgical center will inform you when to arrive and how to prepare for surgery. You will be given antibiotics just before surgery to help prevent infection.

Operative Care

During the surgery you will undergo general anesthesia. A tourniquet will be placed around your thigh. Incisions may be made along the front, lateral, and medial sides of the ankle. Small incisions are made to minimize injury and percutaneously fix the fracture. Local bone graft or bone graft substitute may be used. The fractured bones are put back together and plates, screws, or wires are used to fix the bones in place. An external fixator (pins through the skin attached to metal bars outside the skin) is commonly applied. X-Rays taken during the surgery confirm the correction. The wounds are closed with staples.

Immediate Post-Operative Care

Once your anesthesiologist is satisfied that have recovered you will be permitted to leave the post-anesthesia center. Patients with more severe injuries require an inpatient stay. During this recovery time your family member may take your prescription to the nearest pharmacy. You will be given crutches. Take your narcotic pain control medications during this early post-operative period. Remember, post operative pain is much easier to control with prevention. Call to schedule your post-operative visit at 2 weeks when you feel able.

To schedule surgery, please contact us at 952-224-8500 immediately to reserve your surgical time. If you have questions after surgery, please contact my office and ask for my medical assistant.

Post-Operative Course – Pilon Facture

This timeline is a general guideline. Your post-operative course may vary.

|Elevation |23 hours / day for 10 days; swelling may last over 4 months. |

|Motion |Move your ankle and toes when the block resolves. This will decrease pain and swelling, and improve healing. |

|Walking |No weight bearing for at least 8 and often 12 weeks. |

|Bathing |Keep cast dry. Use a Xerosox. There are no restrictions after the cast is removed. If you have an External fixator, |

| |wash daily and follow instructions. |

|Dressing |Please see pin care instructions if you have an external fixator otherwise, keep casts clean and dry. |

|Pain Control |Expect to use strong narcotics for the first 3-5 days. Wean off as soon as you are comfortable using Tylenol or Ultram|

| |(Rx only). |

|Work |Return depends on specific demands. It is safe to return to sedentary work at 10 days post-op. Return to heavy labor |

| |will take at least 3 months. |

|Driving |Patients with left foot surgery may drive an automatic transmission. Patients with right foot surgery must wait until |

| |healing is adequate and they feel safe. |

| |Routine Clinic Visits |

|2 weeks |XR, Cast and suture or staple removal |

|6 weeks |XR, Cast change. The time to return for your next visit varies significantly with type of injury |

|10 weeks |XR: Fracture brace applied |

|3- 6 months |XR If necessary, your external fixator may be removed in the office or under sedation in an operating room |

| |Strength improves over then next year. Minimal feelings of discomfort may linger, your overall comfort level improves |

| |over a year. |

| | |

| | |

|********** |If at any time during your post-operative period you notice any drainage or foul odor from your incision, a temperature|

| |of more than 100.4 degrees and/or increased swelling or tenderness, you should contact our office. |

Before surgery, consider ordering a Full-leg XEROSOX, a waterproof cast sock from and select the on line store from Additional Resources. If you have troublesome swelling after cast removal you may order a Pedifix Compression Anklet under Ankle Sprain/ Pain.

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Lateral

Malleolus

(Fibula)

Tibia

Calcaneus

Talus

Posterior

Malleolus

Side View

Medial Malleolus

(Tibia)

Talus

Front View

Articular Surface

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