Foot and Ankle Surgery at OSI
The foot and ankle is a region where honest scope matters. OSI performs fracture fixation of the foot and ankle: ankle fracture fixation, Jones fracture fixation, heel bone fracture fixation, ankle-bone (talus) fixation, pilon (lower tibia) fracture fixation, and Lisfranc (midfoot) fixation. These are fracture operations that fall within our general orthopedic and trauma training.
Non-fracture foot and ankle surgery is a different matter. Bunion correction, Achilles tendon repair, lateral ankle ligament reconstruction, peroneal or posterior tibial tendon reconstruction, flatfoot correction, and ankle replacement all require fellowship-trained foot and ankle surgical expertise and specialized instrumentation. Because these operations call for foot-and-ankle subspecialty training that a general orthopedic residency does not provide, we make sure these cases reach a fellowship-trained foot and ankle specialist. This is not a gap in our care. It is making sure the right surgeon performs each operation.
Fracture operations are performed at our partner hospitals across the region, with follow-up at any of our six clinic locations. For information on foot and ankle conditions, evaluation, and non-operative treatment, see Foot & Ankle Care at OSI, or browse the full list of foot and ankle conditions.
Foot and Ankle Fracture Surgery
Fractures of the foot and ankle are among the most common orthopedic injuries. The fracture pattern and degree of displacement determine whether surgery is needed.
Ankle fractures
Ankle fractures can involve one, two, or all three of the bony bumps around the ankle, and some also tear the ligaments that hold the two leg bones together. Stable fractures that are still in good position can be treated in a boot or cast. Fractures that are out of position or unstable need surgery to put the bones back in place and hold them there (open reduction and internal fixation, or ORIF) so the ankle heals in the correct position. Plates and screws hold the bones, and if the ligaments between the two leg bones are torn, those are stabilized as well.
Jones fracture
A Jones fracture is a break at the base of the fifth metatarsal, the long bone behind the small toe, in an area with a limited blood supply. Because that area heals slowly, many Jones fractures (particularly in active patients) do better with screw fixation than with a long stretch of staying off the foot in a cast. A single screw is placed through a small incision to hold the break together and help it heal.
Lisfranc injury
Lisfranc injuries involve the joints and ligaments in the middle of the foot. They range from a subtle ligament sprain to a more serious injury where the bones shift out of place. When the bones are out of position, surgery is needed to line up the midfoot and hold it with screws or a plate while the ligaments heal.
Calcaneus fracture
Calcaneus (heel bone) fractures usually result from a fall from height. When the break is out of position and runs into the joint, it may need surgical fixation to rebuild the shape of the heel and the joint surface. The choice between surgery and non-surgical treatment depends on the fracture, the condition of the skin and soft tissue, and the patient.
Talus fracture
Talus fractures are serious injuries because the ankle bone has a tenuous blood supply and bears the full weight of the body. Displaced talus fractures require surgical fixation to restore the anatomy and minimize the risk of avascular necrosis (loss of blood supply to the bone). These are time-sensitive injuries.
Pilon fracture
Pilon fractures break the lower end of the tibia where it meets the ankle joint. These are high-energy injuries that often need treatment in two stages: a first surgery to restore the length and alignment of the leg while the swelling and skin recover, then a second surgery with a plate once the soft tissues have settled. Pilon fractures take longer to recover from than a standard ankle fracture because the break runs into the joint and the surrounding tissue is badly injured.
For the full picture on fracture care across all regions, see Fracture & Trauma Care at OSI.
When We Refer
Non-fracture foot and ankle surgery requires fellowship training beyond what general orthopedic residency provides. The procedures are technically demanding, the instrumentation is specialized, and outcomes are best when the surgeon performs these operations regularly. The conditions we refer include:
- Bunion correction
- Achilles tendon repair and reconstruction
- Outer ankle ligament reconstruction for chronic instability
- Peroneal tendon repair and reconstruction (the tendons along the outer ankle)
- Posterior tibial tendon reconstruction and flatfoot correction
- Ankle replacement
- Ankle fusion
- Hindfoot fusion
- Hammer toe and claw toe correction
- Morton's neuroma removal
When one of these operations is the right answer, we coordinate the referral. We send your imaging and records, communicate with the receiving surgeon about the diagnosis and treatment plan, and continue to see you for any other orthopedic needs. The referral is a handoff for one specific operation, not a transfer of all your care.
Foot and Ankle Procedures We Perform
Fracture fixation
What Surgery Day Looks Like
Most foot and ankle surgery is outpatient: you come in, have the procedure, and go home the same day in a splint or boot. The anesthesiologist places a regional nerve block that usually keeps the foot numb into the night, so start the pain medicine before it wears off. Elevation is your main job the first two weeks: it controls swelling, and swelling controls pain. You leave with written instructions, weight-bearing rules, and a plan for the first follow-up visit. Someone needs to drive you home.
Recovery and What to Expect
Recovery timelines for foot and ankle fracture surgery depend on the fracture and the fixation. A straightforward ankle fracture plate-fixation patient is typically non-weight-bearing or toe-touch weight-bearing for six weeks, then transitions to a walking boot and begins physical therapy. Most patients are back in a regular shoe by ten to twelve weeks and at full activity by four to six months.
Jones fracture fixation allows earlier weight-bearing than cast treatment (often by six weeks), with a return to sport by three to four months in most cases. Calcaneus and pilon fractures have longer recoveries because of the severity of the initial injury and the articular involvement. Non-weight-bearing for eight to twelve weeks is common, and full recovery can take six months to a year.
Ankle stiffness and calf weakness are the most common issues after foot and ankle fracture surgery, and both respond well to structured rehabilitation. Your surgeon will give you specific milestones and restrictions for each phase.
Who You Will See Here
All three of our board-certified orthopedic surgeons perform foot and ankle fracture fixation. Non-fracture foot and ankle conditions (sprains, tendinopathy, plantar fasciitis, arthritis) are evaluated and managed non-operatively by our full provider team. When surgery for a non-fracture condition is indicated, we coordinate the referral to a fellowship-trained foot and ankle surgeon. Meet our providers.
