Surgical management of fractures in the distal tibia, ankle and foot can be performed by two methods:
Internal Fixation: consist of realigning the fracture site and inserting metallic screws and plates for proper compression. This method requires non-weight bearing status for 6-8 weeks followed by physical therapy.
External Fixation: consist of realigning the fracture site by means of inserting wires through the skin and bone (transosseous) and attaching them to a circular or monolateral frame. The External fixator serves as a cast, but with the advantage of also applying internal compression. This technique allows the patients almost immediate ambulation and early range of motion.
Improper footwear and/or a tendency toward over-pronation.