Why Ankle Surgery is Sometimes the Best Option

by | Oct 23, 2018

If it was possible to effectively treat every foot and ankle condition with nonsurgical care, we absolutely would. Unfortunately, the simple truth of the matter is that this isn’t possible. There are simply times when ankle surgery is the best option.

The good news is that conservative treatment can help most foot and ankle conditions—but a couple of ankle injuries and conditions have a higher risk for needing surgical intervention for optimal healing.

Arthritis is a prime example. Conservative measures like exercise and medication can sometimes work well, but there are times when the condition is best addressed with procedures like ankle fusion or replacement procedures (depending, of course, on the nature and severity of the case).

At other times, severe or unstable ankle fractures may require surgery. And this certainly applies in the cases of open fractures—where a bone has broken through skin—which are, fortunately, quite rare in the ankle region. If the broken ankle is stable and the fracture is not particularly complicated, we will likely be able to use nonsurgical treatment to stabilize the area.

Chronic lateral ankle instability is another potential injury which can benefit from surgical intervention. In this case, we may recommend a lateral ankle repair or reconstruction. (Many cases of ankle instability are the result of someone trying to do too much before an ankle sprain has healed completely—which highlights the importance of not rushing back from injury!)

As we’ve noted, the actual injury or condition itself isn’t always a good indication as to whether or not surgery will be recommended. So how can you know if a surgical procedure will be your best bet for pain relief and restored functionality?

Here are some signs you might want to inquire about ankle surgery:

  1. Conservative care isn’t working. As stated, we always hope to relieve your pain without needing to resort to surgery. In most cases, we will start treating your condition with nonsurgical methods and see if it helps. When it isn’t, this is a sign surgery might be needed.
  2. You have severe pain. Intense pain is often an indication of a major issue. Many bone fractures cause severe pain and, if the broken ends do not line up correctly, surgery may be required to ensure proper healing.
  3. Impaired or restricted functionality. If your ankle doesn’t move in the correct manner, you may need surgical intervention to restore functionality. Whether or not you decide to undergo a surgery will depend on your goals and favorite activities. Those who lead an active lifestyle may find this is the best course of action to allow them to perform activities they enjoy.
  4. The condition itself. There are a variety of conditions that are more likely to necessitate surgery than others. Examples of these include: arthritis, trauma, cartilage damage, bones spurs, posterior ankle pain, and the need for ankle replacement.
  5. We are recommending it. If we don’t need to perform a surgery to address your problem, we won’t do one. We are experienced, skilled, and consistently perform successful procedures, but our goal is to use conservative care options.

Some of the key tools in deciding whether to recommend surgery or not include: x-rays, CT (computed tomography) scans, and MRI (magnetic resonance imaging) scans.

The most important factor in our decision is the stability of your ankle joint. If the result of your existing condition is an unstable joint, then surgery is likely going to be recommended. Your mobility is the primary concern in this situation, and trying to save or re-establish it becomes paramount.

In the instance of a compound fracture in an ankle, surgery becomes an obvious necessity. In part, there are high odds of infection—caused by breakage in the skin—and immediate operation is needed in order to prevent contamination. But there is also an urgent need to stabilize the fracture as quickly as possible.

Preparing for—and recovering from—your ankle surgery

Some of the considerations you need to keep in mind when preparing for ankle surgery include:

  • Schedule time off from work. You will need time both for your procedure and the recovery process, so make sure you let your employer know. As we discuss the surgery with you, we will let you know what you should expect timewise.
  • Follow instructions about when to eat (or not eat) before surgery. This will be dictated by whether or not anesthesia is going to be used, and what kind is administered.
  • Wear loose-fitting clothing. Comfortable clothing isn’t always the most stylish, but you will be glad you opted for loosing-fitting clothes when you put them back on over the surgical site.
  • Arrange a ride home. Both anesthesia and the mobility of your newly-repaired ankle itself are reasons you will likely need someone else to drive you to and from the procedure.
  • Make plans for child care. If you have children living at home, especially younger ones, you may need to ask your spouse or family members to help with child care. You will be required to spend time resting during recovery and your mobility may be limited, so chasing kids around is out of the question.

The actual procedure is, of course, an important part of the whole process, but you do not want to underestimate the importance of postsurgical care. This stage is essential for your safety and optimal recovery.

We will provide specific postoperative instructions, and your ability to heal correctly will depend on you following them, but some general considerations include:

  • Rest. Surgery is a big deal. If it wasn’t, we wouldn’t take as many measures as possible to avoid using it as a treatment option. Since it is, though, you will need to give your body the chance to perform its natural healing processes after the procedure.
  • Medication. Depending on your procedure and situation, we will likely recommend or prescribe some form of non-narcotic medication for you. The pain-relieving properties of medicine certainly plays a role, but the anti-inflammatory ones can be immensely helpful in assisting with your recovery.
  • Restricted movement. In time, the amount and range of movement will increase, but we may recommend you limit how much you move the affected ankle for at least a certain period of time.
  • Assistive devices. Braces, casts, or other devices may be prescribed to help you keep weight off of the repaired ankle, but still allow you to be mobile.
  • Physical therapy. As you recover, it will be necessary for you to gradually ease into physical movement. To that end, physical therapy is a key part of postsurgical care. Stretching and strengthening exercises are essential for making sure your movement is as natural as possible.
  • Hygienic practices. The potential for infection is one of the risks of virtually any surgery. This risk doesn’t end once the procedure is completed, though. It is essential that you keep insertion points clean to reduce your infection risk.
  • Follow-up appointments. Don’t worry, you aren’t on your own after the surgery! We will schedule follow-up appointments to monitor your progress and ensure everything is mending like it should.

At Wisconsin Foot Center, we typically explore conservative treatment options before recommending surgical procedures, but you can take comfort in the fact that we are quite experienced at performing effective ankle surgeries.

Electing to have surgery is not an easy decision. Our goal is to make it easier on you by consistently providing first-class care and treatment and earning the positive referrals our patients give.

No matter if you need conservative or surgical care, you will find the expert treatment you need here at our Hales Corners office—located less than 20 minutes away from downtown Milwaukee—so contact us today to request your appointment if you’re suffering from foot or ankle pain!

You can reach us by calling (414) 425-8400 or connecting with us through our convenient online form.

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