Foot and Ankle Fracture Repair (ORIF)

Ankle Fracture Repair, or Open reduction and internal fixation (ORIF), is a type of surgery used to stabilize and heal a broken bone. This procedure may be used to treat a broken ankle. Three bones make up the ankle joint. These are the tibia (shinbone), the fibula (the smaller bone in your leg), and the talus (a bone in your foot).


Different kinds of injuries can damage the lower tibia, lower fibula, or talus. In some cases, you might break more than one of these bones. In certain types of fractures, your bone breaks but the pieces still line up correctly. In other types of fractures, the injury can move the bone fragments out of alignment.

If you fracture your ankle, you might need ORIF to move your bones back into place and help them heal. During an open reduction surgery, orthopedic surgeons reposition your bone pieces so that they are back in their proper alignment. In a closed reduction, a healthcare provider physically moves the bones back into place without surgically exposing the bone.

Ankle Injury
Usually due to an underlying injury, ankle pain refers to any kind of sudden or worsening discomfort affecting any part of the ankle.

Bone Injury
A single foot contains 26 bones, any of which can be linked to a source of discomfort. A bone injury can affect the shape, balance or function of the foot.

Bone Union Problem
A bone is “healed” when it is strong enough to allow for normal activities. A bone union problem is a bone that does not heal properly or is taking longer than expected.

Broken Ankle (Ankle Fracture)
A fracture is a partial or complete break in a bone.

Compartment Syndrome
Compartment syndrome occurs when excessive pressure builds up inside an enclosed muscle space in the body, most commonly after exercising.

Fifth Metatarsal Fracture (Jones Fracture)
A Jones fracture occurs in the fifth metatarsal — the long bone on the outside of the foot that connects to the little toe.

Foot Fractures
Ankle fractures are common foot injuries most often caused by your ankle rolling inward or outward. A fracture is a partial or complete break in a bone.

Heel Bone Fractures
The heel bone is often compared to a hard-boiled egg due to its thin, hard covering on the outside and its soft, spongy bone on the inside. Once the outer shell is broken, the bone tends to collapse and become fragmented.

High Ankle Sprain
The high ankle ligaments are located above the ankle, as opposed to the more commonly injured ligaments on the outside of the ankle.

Lisfranc Injury
A lisfranc injury occurs as a result of direct or indirect forces exerted on the foot. A direct force often involves something heavy falling on the foot.

Metatarsal and Toe Fractures
Fractures of the toe and metatarsal bones in your foot are common and breaks in the metatarsal bones may be caused by either stress or trauma.

Pilon Fracture
Fractures of the toe and metatarsal bones in your foot are common and breaks in the metatarsal bones may be caused by either stress or trauma.

Sesamoid Injury
A sesamoid acts as a pulley to help a tendon flex and curl. A sesamoid injury affects the bone’s ability to provide leverage while walking and jumping.

Stress Fracture
A stress fracture is a small crack or severe bruising within a bone and is mostly caused by overuse and repetitive activities.

Talus Fracture
The talus is the bone in the back of the foot that connects the leg and the foot. It joins with the two leg bones (tibia and fibula) to form the ankle joint and allows for upward and downward motion of the ankle.


Internal fixation refers to the method of physically reconnecting the bones. This might involve special screws, plates, rods, wires, or nails that your doctor places inside your bones to hold them in their correct place. This prevents the bones from healing abnormally.

Surgery will depend on the location and severity of your injury. The whole operation may take a few hours. In general, you can expect the following:

  • You will receive general anesthesia. This will make you sleep through the operation so that you won’t feel any pain or discomfort during the operation.
  • Your doctor will carefully monitor your vital signs, like your heart rate and blood pressure, during the operation.
  • After cleaning the affected area, your will make an incision through the skin and muscle of your leg.
  • Your doctor will put the pieces of your tibia or fibula back into alignment (“reduction”).
  • Next, your doctor will secure the pieces of your tibia or fibula to each other (“fixation”). To do this, your doctor will use tools like screws, metal plates, nails, wires, or pins. For a fracture in the middle part of the tibia, doctors often use a specially designed long metal rod that passes through the middle of the bone.
  • Your doctor may make other repairs, if necessary.
  • After your bone is secured, your doctor will close the layers of skin and muscle around your leg.
Disclaimer: The Relief Institute has made reasonable efforts to present accurate information on this website; however, it is possible that information found on this website could potentially be out-of-date or limited in nature. Any medical and health-related information presented on this website is general in nature. The Relief Institute does not furnish or render professional health care services or medical care. Therefore, the information presented on this website is not a substitute for professional medical advice, diagnosis or treatment, nor is it intended to provide you with a specific diagnosis or treatment for a specific ailment. The information is made available to you for educational and informational purposes and does not constitute the practice of medicine and/or as a substitute for consultation with your personal health care provider. Click here to view our full disclaimer.