Can a Fractured Ankle Shift Without Weight Bearing? Surgery Insights

Can a bone fracture be displaced?

Hello, I would like to ask about my ankle, which has been fractured for 3 weeks.
The doctor mentioned during my follow-up visit that there is a possibility of displacement and that I may need surgery.
However, if I haven't put any weight on my foot, can displacement still occur? If I do need surgery, how long will it take before I can put weight on my foot and walk? Also, if I opt for a self-funded metal plate, will the recovery time be shorter?

Liu Xiaojie, 30~39 year old female. Ask Date: 2016/02/24

Dr. Shi Guozheng reply Orthopedics

If there is a displacement of the ankle joint with lateral and medial malleolus involvement, it may lead to arthritis and persistent pain in the future.
Therefore, if there is a significant displacement, the best management approach is surgical reduction and fixation, which can be done using standard metal plates.
If one prefers to use self-funded options, that is also acceptable.
If the fixation is done properly, approximately four weeks later, the patient can begin to bear weight and walk.
Until then, it is essential to walk carefully to avoid any further displacement.

Reply Date: 2016/02/24

More Info

When dealing with a fractured ankle, particularly one that has been diagnosed with a possible displacement after three weeks of non-weight bearing, it’s essential to understand the mechanics of bone healing and the implications of surgical intervention.
Firstly, it is indeed possible for a fractured ankle to shift or displace even when no weight is being placed on it. This can occur due to several factors, including the nature of the fracture itself, the stability of the fracture site, and the surrounding soft tissue structures. Fractures can be classified as stable or unstable; unstable fractures are more prone to displacement regardless of weight-bearing status. Additionally, muscle contractions or movements of the foot and ankle can also contribute to the shifting of the fracture fragments.

If your doctor has indicated that surgery may be necessary, it is likely because they believe that the fracture is unstable and that surgical intervention would provide a more secure alignment of the bone fragments. Surgery typically involves the use of plates, screws, or rods to stabilize the fracture, allowing for proper healing.
Regarding your question about how long it will take before you can bear weight on your ankle post-surgery, this can vary significantly based on several factors, including the type of fracture, the surgical technique used, and your overall health. Generally, after surgery, patients may be placed in a cast or a walking boot for several weeks to allow the bone to heal properly. Weight-bearing is usually introduced gradually, often starting with partial weight-bearing using crutches or a walker, and then progressing to full weight-bearing as tolerated. This process can take anywhere from a few weeks to several months, depending on the individual case.

As for the use of self-funded screws or implants, the type of hardware used does not necessarily correlate with a shorter recovery period. The healing time is primarily determined by the nature of the fracture, the surgical technique, and your adherence to rehabilitation protocols. While some advanced materials may offer benefits in terms of strength or reduced risk of infection, the biological healing process of the bone remains the same.
In conclusion, if you are facing the possibility of surgery for your fractured ankle, it is crucial to have an open discussion with your orthopedic surgeon. They can provide insights tailored to your specific situation, including the risks and benefits of surgery, the expected timeline for recovery, and the rehabilitation process. Remember that following your doctor's advice and engaging in a structured rehabilitation program will be key to achieving the best possible outcome.

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