MEDICAL ANIMATION TRANSCRIPT: If a person breaks their ankle and the bones no longer line up with each other, a doctor may need to perform a surgical procedure to reposition and secure the bones. The ankle is the joint that connects the leg and the foot. The ankle joint includes the two lower leg bones, called the tibia and the fibula, and the ankle bone, called the talus. Together, the ends of the tibia and fibula create a mortise, or slot, for the talus, which forms the bottom of the ankle joint. Tissues called ligaments and tendons support the ankle bones. Ligaments attach bones to bones, and tendons attach muscles to bones. The ankle joint allows the foot to move up and down. Ankle injuries usually happen during athletic activities, falls, or car accidents. The most common type of ankle fracture occurs when the foot turns inward and the ankle rotates outward. If the fracture is stable the pieces of bone still line up in their normal position. In any type of fracture, more than one bone may break. In a displaced fracture, the pieces of bone no longer line up. If bone breaks through the skin it's known as a compound, or open, fracture. In addition to broken bones, the ankle may be sprained. This means the ligaments have been stretched or torn. If the ankle is very swollen the surgeon may delay a surgical procedure to allow the swelling to go down. During this time the surgeon may put the ankle in a splint to provide support. In addition, the surgeon may recommend elevating the ankle above the level of the heart and applying ice to it. To treat a stable ankle fracture, the health care provider may put the leg in a cast or boot to keep the ankle from moving so that the bones can heal together. Displaced and compound fractures with multiple broken bones and torn ligaments may require a surgical procedure. The most common surgical procedure to repair a displaced ankle fracture is called an open reduction with internal fixation. To begin, the surgeon will make an incision over the area of the fracture. The surgeon will open up the ankle to view the pieces of bone, and line them back up with each other. A plate and screws will be used to keep them aligned. Additional screws may be inserted through another incision to hold other fracture fragments in place. If the ligaments holding the tibia and fibula together are severely damaged, the surgeon will place a screw through both bones, or a suture device may be placed through both bones. Either of these devices will help hold the bones together while the ligaments heal. At the end of the procedure, the surgeon will close any skin incisions with stitches.