Hello Everyone -- it is comforting to read everyone's own experiences and be able to relate to each other. I am glad I found this forum!! I wish I had found it while recovering from the initial injury which occurred on 11-8-08 as I was alone during recovery making it quite tough, depressed, and anxious; plus, since its my right foot I couldn't drive so I had extreme cabin fever. I actually looked forward to going to the doctors because it got me out of the house. Plus, I have 2 flights of stairs I had to overcome if I wanted to leave the house. I really feel for those of you who say you have 3 and 4 flights of steps; even one step is one to many. Luckily mine are inside and carpeted so not quite as cold on my bum, but I find it difficult to make it thru doorways and over thresholds but now that I have a walker, I think that may get easier as I will try that during my next outing.
I have some questions now that I have undergone surgery (see bottom), but thought I'd share my own experience with others -- moral of the story being, if it doesn't feel right, you have to be perserverent to seek proper treatment with your healthcare providers.

It started off 10.5 hours into my vacation, where steel bars around me fell, knocked me over, and crushed my ankle and foot. The ER doc in Jamaica said it wasn't that big of a deal, just a small bone chip but it needed a cast (triggering a signal to me: a cast doesn't mean unserious as I've never had one in my life). After nearly 6 weeks of being in a cast (1 of which was wheelchair as I couldn't stand on it, and I was out of the country on vacation where I didn't trust the healthcare, and the next 2 weeks on crutches, NWB, and then I moved into losing the crutches). Well after I lost the cast (which was a well supportive air boot with a steel sole), I had 2 months of physio which was slow progress but I did gain a lot of mobility back during the 2nd month. I didn't feel like I had correct mobility though, and was limping while walking with pain. My foot wouldn't go down when I stretched upwards on my toes. Plus, it was quite difficult to stand up from a sitting position on the floor. A follow-up with my orthopaedic surgeon, and much to my dismay, I didn't feel as if was listening to me so I sought another opinion from an ankle and foot specialist the vey same day as my ortho 'released me' for 4 months saying it was nerve damage and may take up to a year to heal, and that I didn't need surgery. Based upon my symptons, and reviewing my x-ray, the foot/ankle specialist suspected I may have OCD (osteochondritis dissecans) or osteochondritis of the talus due to the traumatic injury I suffered, but needed a CT or MRI for the diagnosis. We opted for the MRI as it was evident I had much soft tissue damage as well. The MRI confirmed the OCD. Based upon the location of the bone fracture being in the posterior region of the medial joint, and the fact that I'd already been immobilized, casted, and thru 2 mos of PT, he said he didn't believe it would heal on its own and would require surgery. He had to perform an osteotomy of the medial malleolus (cut the bone) to reach the OCD defect. During my pre-op consultation visit, he had a CT performed to gather measurements of the defect as it didn't show on the MRI, and this info was necessary to have better insight as to the size of the defect so he'd know whether he could drill the bone and have visibility into the joint or if he would have to cut the bone. It was determined that the bone would need cut to reach the defect. This area of the bone is highly likely to die from loss of blood supply, and potentially would need resurfacing or more likely a bone graft. Reviewing the CT images during the pre-op consult, they found yet another fracture, this one nearly the width of the talus bone. This fracture would require a screw and possibly a plate. It was already evident from the initial x-ray that the cartilage in the joint was damaged, but he was hopeful he might find the flap and be able to pin it back to the bone which would give me a better outcome in terms of more mobility and less arthritis in the future.

So I had surgery on 3-27-09, and am almost 2 weeks thru it (woo-hoo!!!). They cut the ankle bone, found the cartilage flap, and pinned it to the bone, drilled out the OCD defect, did a donor transplant bone graft into it, put a screw into the talus fracture, and then 2 long screws into the bone that was cut. I had a spinal epidural; thus, woke up from surgery virtually pain-free. Plus I had lots of (extra added) morphine because they ended up keeping me in the hospital overnight unexpectedly due to nearly doubled pulse rate. I am currently on extra strength vicodin. My first week at home of recovery, I didn't feel a lot of pain except when I used the bathroom as I could feel the blood pooling into my foot and that would usually relieve quickly once I resumed my normal elevation and icing. I didn't really move around much, and kept my foot elevated above heart level and rotated fresh ice packs every 30 mins behind my knee to reduce swelling. I returned one week post-op for consult. They decided to change my cast as it was thought it was too tight if I could feel it when it swelled up. Well the second cast was much looser except in one spot, and it felt like it was Jaws (without teeth) clenching my upper ankle and pressing down on the screws, with a huge burning sensation. So I went to the ER the next morning, and they cut the cast and wrapped with an ace bandage. It gave a bit of relief until they wrapped it. That night I rewrapped the ace bandage, and most of the pain went down within a few hours. But ever since, I still quite often feel a pinching or stabbing feeling, along with a burning sensation. I'm wondering for those that have had screws put in, did you feel them? I've heard that I shouldn't feel them. I'm wondering if the pinching/burning sensation is normal feeling while the bones healing.

I know this is quite lengthy but I have LOTS of time on my hands. Since I was down for about 6 weeks already and starting all over its quite tough. I hope my story will help others and I hope others would kindly provide me feedback as to the pain level and sensations they felt at different intervals of their healing process! :)

Here are some tips I learned the 2nd time around that really helped me. If you have know you are having surgery and have time to prepare beforehand I would personally recommend them. Others have inquired in the past about cast covers for bathing. My surgeon recommended them (showering only) and I have used them 2x now, with no problems. I tried it the first time just prior to my first appt that way if it got wet, I didn't have yet another emergency visit, as the wound could become infected if wet. He said garbage bags and rubberbands leak and its better to use duct tape but these work better. In my humble opinion, duct tape sounds painful to peel away from the skin. Since I'm in enough pain, I don't find the need to torture myself more. The toilet lid elevation is very helpful. Its nowhere as hard to get up from the toilet following surgery with it, in contrast to my first 4-6 weeks of the initial attempt at injury recovery without it. Also, the bath seat and walker help me to be able to get in / out of the shower easier. I use the walker for stability as I sit down onto the seat, and I don't have to worry about how I'm going to get in there without gripping bars across the shower threshold. Once I'm in there, I love to sit in there with the water running over me; it feels so goooooooooood. I sit with my covered cast extending out of the shower, and I try to keep it elevated on the walker to reduce the pain. Quite a puddle out of the shower when you get out so be careful and preferrably have a towel there to get some of it up before you try to get out.

Happy healing! :)

This site has been great!!! I broke my ankle last friday, went to urgent care, got a temporary cast, went to ortho two days ago permanent cast, back next Tuesday to decide if I need surgery. So my ankle is killing me - burning, throbbing, constant pain. Is this normal or is the swelling really bad and cast is too tight? No meds have helped this pain - ibuprofen, tylenol, oxycodone. Should I go back to the doctor?

having just broken my ankle, June 2, I certainly am no expert. I have had the same burning, throbbing and swelling issues and also wondered if the cast was too tight.
Oxycodene did NOT work for me. was prescribed vicadin and that is giving me some relief. I still have other issues I have posted and hope to get some results from others. If it is any consolation at all, you are not alone, and I would welcome any correspondance

I am 4 months post op and am walking unaided but my ankle still gets very stiff and aches at the end of the day. I can't bend my knees to touch wall either with bad ankle it really pulls round the back of the ankle is that what you r finding? Did you have a plate put in yours? if so r u having to have yours out? The reason I ask is cause I have to have mine taken out as one of the screws is pushing against the skin I feel nervous about having another op - can anyone tell me if they had to have their plate out and was it all ok?
Thanks Wendy.