Ankle fracture surgery is performed when the injury is complex and cannot be treated with conservative methods such as casts or splints. The procedure involves making an incision in the skin to expose the fractured bones. The surgeon then realigns the bone fragments and stabilizes them using metal plates, screws, or pins. These implants help keep the bones in their correct position while bone healing occurs. The choice of fixation type will depend on the severity and location of the fracture.