An ankle fracture — a break in one or more of the bones that form the ankle joint (tibia, fibula, or talus) — ranges from a relatively minor stable fracture that can be treated without surgery to a complex unstable injury requiring operative fixation. Proper diagnosis and management of ankle fractures is critical: untreated or inadequately treated ankle fractures can result in ankle arthritis, chronic instability, and permanent functional limitation. At Balance Foot & Ankle in Southeast Michigan, Dr. Tom Biernacki evaluates and treats ankle fractures with both conservative and surgical approaches tailored to the specific fracture pattern and the patient’s functional goals.

Types of Ankle Fractures

Ankle fractures are classified by which bones are broken and whether the fracture is stable or unstable. Lateral malleolus fractures (the outer bump of the fibula) are the most common and are frequently stable, particularly when the fracture is below the level of the ankle joint and the ankle mortise (the “socket” formed by the tibia and fibula) remains intact. Bimalleolar fractures involve both the lateral and medial malleolus and are typically unstable. Trimalleolar fractures add the posterior malleolus (back of the tibia) and are almost always treated surgically. High fibula fractures (Maisonneuve fractures) occur with a syndesmotic (high ankle) injury and require careful assessment. Pilon fractures — involving the weight-bearing surface of the tibia — are severe injuries often resulting from high-energy trauma and require complex surgical reconstruction.

Surgical vs. Non-Surgical Treatment

Stable lateral malleolus fractures with an intact ankle mortise are typically treated without surgery: immobilization in a boot or cast for 4–6 weeks followed by progressive weight-bearing and physical therapy. Unstable fractures — those where the ankle mortise is disrupted or the fracture fragments are significantly displaced — generally require surgical fixation to restore the normal anatomy of the ankle joint. Surgery most commonly involves open reduction and internal fixation (ORIF) using plates and screws to hold the fracture fragments in their correct position while healing occurs. Recovery after ORIF typically involves 6–12 weeks of protected weight-bearing followed by physical therapy. Hardware removal is sometimes performed after healing is complete if hardware causes discomfort.

Frequently Asked Questions

If you’ve injured your ankle, an accurate diagnosis is the first step to proper recovery. Contact Balance Foot & Ankle in Southeast Michigan for prompt evaluation and treatment.

Dr. Tom Biernacki, DPM

Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.