Ace Physiotherapy and Sports in Singapore
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ACE PHYSIO SPORTS
East gate Building, 46 East Coast Road
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Sunday (By prior appointment)
ORIF Ankle
Open Reduction Internal Fixation (ORIF) of the ankle is a surgical procedure used to treat an unstable (displaced) or complicated ankle fracture. The procedure involves opening the ankle joint to allow the broken bones to be realigned (open reduction). Once the bones are properly positioned, steel screws, rods, plates, pins, or K-wires are used to hold the bones in place (internal fixation) while they heal. If the ankle fracture is simple and stable, a less invasive approach may be used, involving immobilisation in a cast or brace to allow the bones to heal naturally. In some cases, damaged ligaments may also be repaired or tightened during surgery to restore full stability to the joint.
The ankle joint (talocrural joint) is formed by the fibula (calf bone), tibia (shin bone), and talus (wedge-shaped bone of the ankle). A variety of ankle fractures can occur, depending on the mechanism of injury. An avulsion fracture occurs when a small piece of bone is pulled off by a powerful contraction of a muscle or tendon. A comminuted fracture occurs when a section of bone shatters into multiple pieces. Orthopaedic surgeons commonly use the Weber classification system to categorise ankle fractures based on the level and type of fibular fracture, which helps guide treatment decisions.
Type A: Fracture that is below the ankle joint. This fracture is not treated with surgery.
Type B: Fracture at the same level of the ankle joint
Type C: fracture above the level of the ankle joint and which damages the surrounding the ankle ligaments. Surgery is needed in this instance.
Ankle fractures are the most common type of lower limb injury requiring surgical treatment. They are often caused by the foot rolling outwards or inwards, or by a sudden twisting movement. A fractured ankle may also involve ligament damage, making it essential to receive an accurate diagnosis and prompt treatment. Early intervention helps prevent further complications and ensures the best possible recovery outcome.
If you have experienced an ankle fracture, you may notice a range of symptoms, including:
- Severe pain around the ankle joint
- Swelling and bruising of the ankle and surrounding tissues
- Deformity or unusual positioning of the ankle
- Tenderness to touch
- Difficulty or inability to bear weight on the affected leg
- Reduced range of motion in the ankle joint
For most people, ankle fracture surgery is performed immediately. However, in some cases, you may be asked to wait several weeks if there is excessive swelling or an infection in the ankle. If this occurs, it is important to begin physiotherapy with Ace Physio Sports before the operation. Pre-operative rehabilitation helps maintain strength, mobility, and function in the surrounding joints and muscles, giving you the best chance of a successful recovery after surgery.
Physiotherapy prior to ORIF ankle
For individuals who are unable to undergo surgery immediately, it is recommended to begin physiotherapy to maintain optimal range of movement and muscle strength in the unaffected joints of the body. Ace Physio Sports will work with you to devise a personalised exercise programme aimed at preventing potential complications following surgery. Pre-operative physiotherapy may include:
- Strengthening exercises for the knee, hip, and core muscles
- Range-of-motion exercises for unaffected joints
- Circulation and swelling management for the leg and foot
- Education on safe mobility and techniques for moving around while awaiting surgery
- Balance and proprioception exercises to maintain coordination
Symptoms after ankle ORIF
Following the operation, your ankle will be placed in an aircast boot or plaster for 4–6 weeks. During this period, you will be instructed not to bear weight on the affected ankle, which includes walking, standing, or driving. During this time, you may experience a range of symptoms, including:
- Swelling around the ankle and foot
- Bruising or discoloration
- Tenderness at the surgical site
- Stiffness in the ankle joint
- Mild discomfort or pain, which can be managed with medication as advised
- Altered sensation such as numbness or tingling, which is usually temporary
It is important to continue with your physiotherapy programme at Ace Physio Sports during this period. This helps to prevent stiffness and loss of strength in other joints and muscle groups, ensuring that you maintain overall mobility and are better prepared for the next stage of your ankle rehabilitation.
Physiotherapy after ankle ORIF
After 6 weeks, you will attend a follow-up clinic where your surgeon will X-ray your ankle to assess whether the bone is healing adequately. Based on this assessment, your physiotherapists at Ace Physio Sports will determine your weight-bearing status. At this stage, your physiotherapy programme will focus on regaining optimum ankle strength and movement. Depending on your pain levels and progress, you may also be able to drive short distances safely.
Weeks 1-6
While you are non-weight bearing, physiotherapy will focus on maintaining strength and mobility in other joints and muscle groups. Additional physiotherapy during this period may include:
- Strengthening exercises for the knee, hip, and core muscles
- Range-of-motion exercises for unaffected joints
- Circulation and swelling management for the leg and foot
- Education on safe mobility while using crutches or other aids
- Balance and proprioception exercises to maintain coordination
Weeks 6-12
Your physiotherapist will review your progress, and you will now be able to continue with a more active rehabilitation programme at Ace Physio Sports. The focus at this stage will be on increasing the range of movement and strength of the affected ankle joint. This is crucial to ensure optimal recovery and to help prevent future ankle injuries. It is also important to improve joint proprioception (joint awareness), as this will have been compromised during weeks of immobilisation. Physiotherapy at this stage may include:
- Gentle ankle mobilisation exercises to restore flexibility
- Progressive strengthening exercises for the ankle, calf, and surrounding muscles
- Balance and proprioception training to improve stability
- Functional exercises to replicate everyday movements
- Stretching exercises to maintain full range of motion
Following 12 weeks
After 3 months, you should have achieved significant improvements in both strength and range of movement with Ace Physio Sports. At this stage, it is important to focus on functional activities that are relevant to your job, hobbies, or sport. Physiotherapy at this stage may include:
- Advanced strengthening exercises tailored to your daily or occupational activities
- Dynamic balance and proprioception training to restore full stability
- Functional movement drills specific to your sport or work requirements
- Gait retraining and walking exercises to ensure a normal movement pattern
- Progressive endurance exercises to improve stamina and overall fitness
Summary
Open Reduction Internal Fixation (ORIF) of the ankle is a surgical procedure used to treat a displaced or complicated fracture. During the procedure, your surgeon will open the ankle joint to realign the broken bones and use pins, screws, wires, or plates to hold the bones in the correct position. Although ORIF is an invasive procedure, the success rates are very high. Adhering to a personalised physiotherapy programme from Ace Physio Sports will help prevent post-operative complications such as extensive swelling, stiffness, pain, and weakness. Physiotherapy will also maximise your rehabilitation potential and ensure you return to your sport, job, or hobbies as safely and quickly as possible. To book an appointment with one of our experienced physiotherapists, please call +65 81535374 today!
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