What is it?
Many foot and ankle fractures heal well in a cast or boot. If the bones are out of position or the joint is unstable, surgery may be recommended to put the bones back in line and hold them with plates, screws or other fixation while they heal (open reduction and internal fixation). Foot and ankle trauma is one of Mr Jeyaseelan's special interests, and he also treats fractures that have healed badly or not healed at all.
Who might it help?
- Ankle fractures that are displaced or unstable
- Fractures of the lower shin (pilon), heel bone, talus or midfoot (Lisfranc injuries)
- Injuries to the ligaments that hold the shin bones together (syndesmosis)
- Fractures that have not healed or have healed in a poor position
Is it right for you?
Treatment is tailored to your individual needs, symptoms and goals. Surgery is only recommended when it is likely to help, and non-surgical options are always discussed first.
Mr Jeyaseelan will talk you through the benefits, risks and alternatives for your situation at your consultation.
What does it involve?
- It's done under a general or regional anaesthetic, often after the swelling has settled.
- Some fractures need a short stay in hospital.
- Plates and screws are usually left in place unless they cause problems later.
Before your operation
- You'll have a pre-assessment check, usually a week or two before surgery, including blood tests if needed
- Stop smoking, ideally at least six weeks before, as it slows bone and wound healing
- Arrange help at home for the first couple of weeks, and someone to take you home
- Prepare your home: clear walkways, and put everyday things within easy reach
- If you'll use crutches or a knee scooter, practise beforehand
On the day
- You'll be asked not to eat or drink for a few hours beforehand
- The anaesthetist will discuss the anaesthetic with you, often a general anaesthetic with a nerve block to keep the foot numb for several hours afterwards
- Mr Jeyaseelan will see you before the operation to answer any questions and mark the leg
- Before you go home, you'll be shown how to use crutches and given pain relief and written instructions
Recovery
Most people are in a cast or boot for around six weeks, with weight bearing guided by the type of fracture. A return to normal activities typically takes three to six months, and swelling can last up to a year. More complex fractures take longer.
Foot raised most of the time, in a plaster or boot. Wound check at about two weeks.
In a boot, with weight bearing guided by the type of fracture.
X-rays check healing. Out of the boot and building up walking with physiotherapy.
Return to normal activities and sport. Swelling can last up to a year.
These times are typical only. You'll be given a personal recovery plan.
Getting back to normal
- Driving
- You can usually drive once you're out of a boot and can do an emergency stop safely. After right-foot surgery this is often six to eight weeks or more. Check with your insurer.
- Work
- Desk-based work is often possible after two to six weeks if you can keep the foot raised. Jobs that involve standing or walking take longer.
- Sport
- Low-impact exercise, such as cycling and swimming, usually comes first. Running and contact sport come later, once strength and movement have returned.
- Flying
- Long-haul flights are usually avoided for at least six weeks after foot and ankle surgery because of the risk of blood clots. Ask before booking travel.
Possible risks
As with any operation, there are risks. They include:
- Infection or wound problems, more likely in smokers and people with diabetes
- Nerve damage causing numbness
- Blood clots in the leg or lungs
- The bone healing slowly, in a poor position or not at all
- Arthritis in the injured joint in later years
- Irritation from plates or screws
Alternatives
Stable fractures are often treated without surgery in a cast or boot. Mr Jeyaseelan will explain whether surgery is likely to help your injury.
Conditions this may treat
Common questions
Where can I have foot and ankle fracture surgery in London?
Mr Lucky Jeyaseelan, a consultant orthopaedic surgeon who specialises only in the foot and ankle, sees private and insured patients with problems that may need foot and ankle fracture surgery at Align Orthopaedics on Harley Street, The London Clinic on Devonshire Place, HCA London Bridge Hospital, HCA UK at The Shard, HCA UK City of London on Old Broad Street and The Holly Hospital in Buckhurst Hill, Essex. See all clinic locations or request an appointment. If surgery is right for you, he will discuss which hospital suits you best.
How long is recovery after foot and ankle fracture surgery?
Most people are in a cast or boot for around six weeks, with weight bearing guided by the type of fracture. A return to normal activities typically takes three to six months, and swelling can last up to a year. More complex fractures take longer. Your own recovery plan will be tailored to you.
Is it covered by health insurance?
Mr Jeyaseelan is recognised by major insurers including Bupa, AXA Health, Aviva, Vitality and WPA. Cover depends on your policy, so please get an authorisation code from your insurer before your appointment.
Do I need a GP referral?
Self-funding patients can book directly, though a GP letter is helpful. Most insurers need a GP referral before they authorise your consultation, so check with yours first.
This information is general and is not a substitute for a medical consultation. Your diagnosis and treatment plan will be tailored to you.