Perfecting My Foot

Know What Can Increase Your Risk Of Complications Following Ankle Fracture Surgery

An ankle fracture is a common injury that can occur when you twist your ankle, fall, or are injured in an automobile accident or while playing a sport. If the injury is severe and your ankle is out of position and unstable, you may need surgical treatment (from a professional such as Rocky Mountain Foot & Ankle) to repair the broken bone. But like other types of surgeries, ankle fracture surgery comes with the risk of complications afterward. Your doctor can explain what conditions may increase your risk of post-surgery complications.  

Factors that put you at increased risk of complications following ankle surgery include:

  1. Diabetes. Damage to nerves in the feet or poor blood circulation in the feet – either of which is a possible side effect of diabetes – can lead to potential complications following surgery to repair an ankle fracture. High blood glucose levels can cause blood vessels in the feet and legs to become narrow and restrict blood flow – a condition that can slow or prevent wounds from healing. Because blood carries oxygen and other nutrients to a wound, an inadequate blood supply to the injury site can inhibit the healing process in both soft tissue and bone. Impaired blood flow can make you more prone to infection as well.

    While some bones have a more limited blood supply to begin with, even a bone that has a sufficient blood supply may have a problem. A serious injury that damages small tissues, such as muscle and skin that cover the bone, can restrict the flow of blood to the area.

  2. Cigarette smoking. If you smoke cigarettes or use other tobacco and nicotine products, you may be at higher risk of experiencing problems that interfere with wound and fracture healing following your surgery. Studies that compared the surgical outcomes of smokers with nonsmokers found that smoking increased the risk of a broken ankle bone failing to heal. Open fractures, in particular, often failed to heal. The studies showed that fractures that did heal took longer to heal for people who smoked than for nonsmokers. 

    Postoperative infections also were more common in smokers. Smoking decreases blood circulation by constricting blood vessels. Decreased blood flow means less oxygen and nutrients get to the damaged bone and tissue, which also increases the risk of infection.

    Another problem comes from the carbon monoxide in cigarette smoke. The carbon monoxide present in the tobacco smoke you inhale decreases the ability of red blood cells to carry oxygen throughout the body. Less oxygen and higher levels of carbon monoxide in the blood impair the ability of bone and tissue to heal and increases the risk of wound infections.

  3. Steroid medication use. If your doctor has prescribed high-dose steroids to treat a medical condition, glucocorticords (a class of corticosteroids) can increase blood sugar levels, make you more prone to infection, or impair surgical wound healing following ankle fracture surgery. The use of anti-inflammatory medications while a broken ankle is healing also may increase the chance that the bone won't heal. Although study data is conflicting, the results of animal studies suggest that the use of nonsteroidal anti-inflammatory drugs (NSAIDs) may be a risk factor that impairs bone healing.