Why these fractures differ
Peripheral neuropathy means the injury may not be felt; union is slower; and wound complications and infection are more frequent. A systematic review I co-authored (Nash, Hester & Ha, Journal of Clinical Orthopaedics and Trauma, 2021) reported poor outcomes with cast treatment alone in this group, and found that more robust fixation was not associated with an increase in complications.
Fixation
Longer plates with additional screws, supplementary fixation across the syndesmosis, and in selected cases a retrograde hindfoot nail — followed by an extended period of protected weight-bearing, often in a total-contact cast.
Additional considerations
Glycaemic control, vascular assessment before surgery, careful soft-tissue handling and close follow-up. A neglected fracture in a neuropathic ankle may progress to Charcot collapse. I work within the King's Diabetic Foot multidisciplinary team.
First two weeks after surgery
Items patients often find useful in the first two weeks. Always follow your surgical team's instructions; these are general suggestions, not medical advice. As an Amazon Associate I earn from qualifying purchases.
Recovery and after your operation: helpful products
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Arranging an appointment. Private patients are seen at King Edward VII's Hospital, The London Clinic, Cromwell Hospital and HCA Healthcare at The Shard.
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Radiographs are from my own practice, reproduced uncropped with identifying details removed. This page provides general information and is not a substitute for individual assessment.