How To Treat Trimalleolar Ankle Fractures

How To Treat Trimalleolar Ankle Fractures

Your ankle is a complex joint, and fractures can occur in a number of different ways. One type of ankle fracture is known as a trimalleolar fracture, and it involves a break of your malleoli. Your ankle is comprised of the medial, lateral and posterior malleoli, and they are housed at the end of your tibia along the inner aspect, at your fibula along the outer aspect, and at the back of your tibia, respectively. They create a small triangle in your ankle, and a fracture to this area can create problems for your ankle joint stability. We take a closer look at the fracture and its treatment options below.
Causes and Symptoms of Trimalleolar Fractures

The common causes of a trimalleolar fracture are similar to any type of ankle fracture, in that a car accident, fall or trauma from sports are the most likely culprits. Symptoms of the condition include:

Severe pain
Ankle and foot tenderness
Difficultly walking or putting weight on the ankle.
Bruising or discoloration
Visual ankle deformity
Significant swelling

Needless to say that based on the symptoms, there will be a clear indication that something is wrong with your ankle. You may even suspect an ankle fracture, but odds are you won’t know exactly how your ankle is fractured. We’ll get into diagnosing and treating a trimalleolar fracture in the next section.
Diagnosing and Treating Trimalleolar Fractures

A diagnosis of a trimalleolar fracture is typically made with an X-ray or MRI of the injury site. Doctors are not just looking to see if a fracture has occurred, they are also identifying exactly how each bone has fractured. If a malleoli is fractured, you’ll be diagnosed with a trimalleolar fracture.

Due to the nature of the fracture on the ankle joint, a trimalleolar fracture is considered an unstable fracture. Unstable fractures are unlikely to heal correctly on their own. The only time that unstable trimalleolar fractures are left to heal on their own is when surgery would pose too big of a threat to the patient due to health concerns or other potential complications.

However, for most individuals, surgery is both possible and effective at treating the fracture. Based on your specific fracture, you may have any number of different types of hardware inserted into your ankle, be it pins, screws, plates or bone wiring. The underlying goal here is to realign the bones and stabilize the ankle so that it heals properly and you can return to normal functioning once healing has run its course. Your surgeon may also insert a bone graft to help with bone healing in the event some pieces of bone fractured into too small of pieces to be pieced back together.

The patient is typically placed in a cast or brace following the surgery to help keep the leg protected during healing. It usually takes about six weeks for a bone to heal following a fracture, but many patients also have ligament or tendon damage following a trimalleolar fracture, and those can take longer to heal.

A general timeline is that you’ll be in a cast for six weeks following the injury, then you can return to some normal activities like walking and driving by 9-12 weeks. Some limping is still normal 2-4 months down the road, but many people are back to full everyday activities by 3-4 months post-surgery. A return to sporting activities may take a little longer depending on the level of competition, typically between 4-6 months. The good news is that in most cases, patients make a full recovery following a trimalleolar fracture if they seek out a skilled surgeon and practice proper post-op guidelines for physical therapy and aftercare. For more information, reach out to Dr. Silverman’s office today.

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