Doctors often recommend surgery for serious ankle injuries like fractures and arthritis. In some cases, they may suggest alternatives, including pain medication, physical therapy, and steroid injections.

Ankle injuries and arthritis can cause severe pain, swelling, tenderness to touch, and difficulty in walking. Typically, doctors will try conservative treatment options to manage a person’s symptoms before resorting to more invasive options like surgery.

Before surgery, they may advise a person to try alternative treatment options. While these can work for many people, they cannot replace surgery where it is medically necessary.

This article will discuss the reasons for ankle surgery, surgery alternatives, the importance of physical therapy, and more.

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Most people with ankle injuries do not require surgery. Doctors recommend ankle surgery based on the following:

  • the severity of the symptoms
  • response to other traditional treatments
  • specific needs of an individual

Ankle surgery takes place mostly in cases of ankle fracture and ankle arthritis.

Ankle fractures are the fourth most prevalent type of fracture in adults. The ankle joint and the syndesmosis joint are most commonly associated with ankle fractures. They can occur due to twisting and rotating of the ankle, falling from a height, or acute accidents.

Ankle arthritis can be one of three types: osteoarthritis, rheumatoid arthritis, and post-traumatic arthritis.

Approximately 3.4% of the general population have ankle osteoarthritis, a condition that can occur due to age, obesity, and family history. Injuries cause post-traumatic arthritis, and rheumatoid arthritis is an autoimmune disease.

The exact cause of rheumatoid arthritis is unknown, but researchers believe some individuals possess specific genes that make them more susceptible. Environmental factors or infection can activate these genes, leading to the production of substances that attack the joints.

Ankle surgery is not always needed, and doctors usually try more conservative approaches before resorting to surgery. However, it may be necessary in situations where:

  • dislocation of the ankle joint takes place
  • broken ankle bones break through the skin, also termed open fractures
  • deformity of the ankle takes place
  • arthritis of the ankle joints that leads to pain and swelling

People experiencing severe pain and inflammation around or on the ankle must immediately consult doctors and undergo a diagnosis. This will help promptly detect injuries that might require urgent surgeries.

If alternative methods can manage a person’s symptoms, doctors will usually recommend them first.

In some cases, surgery may be necessary right away. For example, if a person experiences a sports injury and has a dislocated ankle fracture, surgery will likely be the only course of treatment.

However, in many cases, surgery may be a last resort.

Doctors will try different conservative treatment methods depending on the person’s individual condition. Some options include:

  • medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) and other painkillers
  • steroid injections
  • exercises that improve motion and flexibility
  • ankle brace
  • custom-made shoe or shoe inserts
  • lifestyle modifications such as losing weight and limiting activities that might worsen the injury

Doctors recommend physical therapy after the ankle injuries have started healing. It helps individuals to return to their daily activities and maintain a healthy lifestyle.

Physical therapy comprises different exercises that help strengthen the muscles of the lower leg and ankle and ensure that the ankle joint is stable. This can prevent further injury and improve ankle pain. Additionally, exercises can improve flexibility and ankle mobility.

Physical therapists also provide information on weight-bearing restrictions since excess weight on the injured ankle can delay recovery.

Physical therapy typically lasts about 4–6 weeks, but the duration can vary. Depending on whether or not a person needs surgery, physical therapy may be a stand-alone treatment approach or may be prescribed as a follow-up to ankle surgery.

All medical procedures and surgeries come with some risks. Possible complications of ankle surgery include:

  • bleeding
  • infection
  • damage to tendons, blood vessels, and nerve
  • joint stiffness

Older individuals, and people who smoke and have diabetes, are at a higher risk of developing complications after ankle surgery.

People experiencing chronic pain and swelling in the ankles should contact a doctor. They can advise treatment options and recommend surgery alternatives if appropriate.

Many people with ankle injuries or conditions like arthritis can manage their symptoms with surgery alternatives like pain medication and physical therapy. However, surgery is an important procedure that helps in the treatment of ankle injuries that do not respond to traditional treatment approaches.

People who experience an acute ankle injury or chronic ankle pain should contact a doctor.