Broken Ankle in several places - Recovery Questions and Tips
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9th Apr '09, 5:03pm
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! :)
3 weeks since plaster off!
28th Apr '09, 7:38pm
Hi everyone its been 3 and half weeks since i had my plaster of and I am pleased to say it is all going better than i expected. Have had 3 physio sessions and am able to get around with out crutches but do still need them for walking out and about especialy on the school run - can move a little quicker with the crutches. Am getting some pain but its not as bad as i thought it would be it tends to ache at the end of the day. can feel the plate through my skin which is weired! Reading about others broken bones I feel very lucky i only had one break and not both ankles.
Good luck everyone keep positive it does get better it now seems ages ago that i was sitting around doing nothing so enjoy it while u can!
Wendy.
Somewhat disheartend
10th Jun '09, 4:39pm
hi there, i can truelly understand suzq, in may 09 i broke my ankle in three places, into my 4th week with a cast on, getting it off in another 2 weeks. I have a plate and five screws on my left side of my left ankle and a longer screw and a wire on the right side of my ankle. For the last 2 weeks i have been relativly painless wich is a pluc, but the hours and hours of sitting around make up for the lack of pain!!! although mine is a sevre fracture in the doctors terminology, I have asked them if i will be ok to run for my Pre fitness assesment on the 12th of august, approximatly 7 weeks after the cast is off, ad surpirsingly both the physio and the surgeon said i should be fine with strict training. I find that hard to believe now as everyone i have read about with broken ankles have taken months to heal enough to walk alone let alone run!!! It has dampened my spirits as i am actually going in tomorow to the Defence Force recruiting to hand in forms and it seems to me that it would be easier ust to ask them to push me back and save the humiliation of turning up and failing. What do you rekon in your experience. I am 20 years old, before the break i was very active and very fit, gyming 5 days a week, obviously now one leg is surpirsingly skinner then the other lol I mean is it possible with strict rest, nutrition, and proper excercises i could reach this point or am i biting off more than i can chew?
thanks very much...its surprising how many ppl break their ankles honestly, im glad in a way makes me feel not so alone in the matter!
lloyd
Lloyd
12th Jun '09, 3:40pm
Hi Llloyd,
Just from my experience it's not impossible!! Similar to you I broke my ankle in 3 places and had 2 screws and a pin put in (no plate but thats a long story). This happened on 24th March, it's now 12th June and I am walking with 1 crutch and hope to be crutch free in a few days. I have only had 2 lots of physio so far but have been doing exercises they showed me at home so by 24th June it will be 3 months and hope to be walking around fine if not jogging. I have been told it takes a year for the bone to heal completely but theres no reason why you cant aim to be running but you gotta be 100% before doing it, a doctor will let you know nearer the time.
Dont give up mate, believe in yourself, keep your foot elevated as much as possible and you'll get there.
Hello Lloyd, Wendy and Suzq
20th Mar '10, 9:39am
Hello Lloyd, Wendy and Suzq
Reading what all of you have been through with your injuries is really helping me grasp reality. I broke my ankle in two places, (both outer bones) and the doctors call it a bimalleolar fracture only two weeks ago yesterday. I am 8 days into recovery from surgery today. They put two plates in each side of my ankle as well as screws. This has been the most difficult experience I have ever been through as I have been going to school full time and had two jobs for the past five years of my life. I thank God that this is the hardest I have ever had it, however that only makes things a little better. Before this incident, I had never broken a bone or had surgery before, luckily. Although I am experiencing a lot of pain, and can only cringe when I see my deflated, deformed uneven calf the biggest challenge I am having trouble overcoming is asking others for help. I also don't want to be crippled and have tried to do things I used to do, like go up stairs. As the university I attend isn't really crutch friendly I tried to conquer some stairs and was painfully unsuccessful. Were any of you able to gain some sort of in dependence while still on crutches? Did yall figure out how to carry food or drink around your house to your place of elevation while in the first stages of recovery where you aren't able to put any pressure on your ankle? Are there vitamins or a calcium rich drink I should be taking in order to speed up recovery? When does reality set in that this isn't the end of the world and you shouldn't be so upset because accidents happen? Are there exercises routines you did like leg lifts, push ups or bicycle kicks to help you stay in shape while disabled?
Please let me know if you have any comments or answers, I deel like I need some reassurance that it will be ok and that this really isn't that bad.
Thanks, Megann
ankle
22nd Mar '10, 7:31pm
Hi, interesting to read about your injuries guys and best of luck for good healing. Megan has anyone showed you how to use crutches and stairs? I apologise if i'm repeating them if they have but have got a couple of suggestions of things i've taught guys in the past who are on in patients and for one reason or another are using crutches. The first involves using a hand rail.. ideally on the same side as your injured leg but as we don't live in an ideal world works nearly as well if its the opposite side. Basically at the bottom of the stairs pass the crutch that would be on the same side of the rail to the other hand and hold it about half way down the shaft with the same hand that's gripping the hand grip.. the two crutches will make a cross shape. Then grasp the rail with your good hand and place your good foot on the step, Now .. this bit is important leave the crutch resting on the floor.. Don't place it onto the step. Then use the good leg, the arm holding the crutch and the arm holding the rail to help you step onto the 1st step. Once securley on it with both feet lift the crutch off the ground and place it beside you on the step, repeat as required till you get to the top. The reason for leaving the crutch on the step below is you want to push down through it.. not (as you have to if you place it on the step you're going to step on) pull on it. On the way down bearing in mind you want to push down through it place the crutch on the step you are going to step onto to allow you to use that arm to help lower you. Also reverse the stepping order of your legs, eg injured leg steps down first to allow the stronger good leg to lower it.
Two crutches: Use as the one crutch was used, ie on the way up; leave both on the step you are stepping off to allow you to push through them, bring them up to the step you are stepping onto only when both feet are firmly on the step you are stepping onto. Going down: place both crutches down onto the step you are stepping onto...This is pretty scarey but much more stable than leaving them on the step above you.. not to mention avoids twisting your shoulders behind you. The foot order is the same as for the rail ie on the way up good leg(so it can do all the pushing up) then injured, reverse it on the way down.
It will mean only going up one step at a time and its slow but you will get there.
I'd recommend finding a short set of shallow steps to practice it on first of all before you have to plough through the throngs at college. Heres a link to a leaflet I've just found which says what I just said only more simpily (should have googled first) good luck! http://www.pat.nhs.uk/uploads/20090212_0488-PI(DS)ClimbingUp&DownCrutches.pdf
Jenny
(In case you're worried if I'm talking out of my arse I work as a physio assistant and am training as a physio.. still talking out my arse mind..nah;0) done this and its worked with people.. so far every time.
Ankle
23rd Mar '10, 8:40am
Hello and welcome to the Peak Performance forum. It's great to hear so much good advice - thanks for taking the time to post your thoughts.
There's another topic that you may be interested in here:
http://www.pponline.co.uk/forum/talk-injury/broken-ankle-injury
It's a long topic all about broken ankle injuries and it's one of the most popular discussions on the site.
My sympathies to you all
23rd Mar '10, 9:11am
My sympathies to you all with injuries at the moment, I broke my ankle in two places in 2003 and was on non weight bearing crutches for 4 months - HELL! I have a nice metal rod keeping it in place now !
Best wishes to you all for a speedy recovery.
Am I done after six weeks?
6th Apr '10, 4:37pm
Hi, I broke my ankle in three places five weeks ago, I've had surgery which resulted in eight screws, a pin and a plate. My big question is after six weeks (for the total of which I will have been non weight bearing) what happens? Am I done? Will I still have to wear the boot? Can I just go on about my life? Six more days of non weight bearing and I am going beyond crazy here! Thanks to anyone who read, hope all are doing well!
primadonajo
9th Apr '10, 11:10pm
Loads of people on the other forum were sent out to weight bear at six weeks - It depends on the break. I did my tibia and fibula and had plates and lots of screws last November and was allowed to touch weight bear (20kg) at 8 weeks and to start moving towards fully weight bearing at 14 weeks with full weight bearing at 18 weeks. (Driving at 14 weeks - what a relief!) I'm now at 22 weeks and can walk to the pub, wear normal shoes and walk most of the time without a stick. (handy to keep the stick for when the ankle says that enough is enough!) Planning to go for my first walk at the weekend.
So keep positive - when I realised that I wasn't going to be bounding around at 8 weeks as I'd hoped I got really quite down, discovered these forums, realised that everybody else was suffering the same nightmare and was much cheered. Now three months on I can look back on those darker times as you will be able to. Bloody hell that sounds depressing!
You'll get there - just takes time.
Chin up
Steve
for MegannL- coping with crutches
21st Apr '10, 10:20pm
I empathise totally. I had my Mum stay for a week when i came out of hospital but still had to get myself up and down the stairs and around the house. Stair rails are great help and some great advice for stairs and crutches above (I did this when outside).
The pvc leg covers are fantastic - allowing me to sit in a shallow bath and to shower when I needed to wash my hair.
When alone I tended to hop with one crutch around the kitchen, preparing food whilst seated. I also used very large mugs half filled and hopped without spilling. Somebody suggested making a flask of boiling water, and taking jug of milk, teabags etc in lounge.
A small rucksack is very useful if you do want to go out anywhere as my handbag kept falling off my shoulder and hooping down and around my crutch!!
As for exercises whilst in plaster - I have a body bar and a flexi bar and some free weights etc which i used for upper body. An exersoft ball is great for easy exercises for the foot and ankle in and out of plaster.
PS I think we would be able to form a brilliant hopping team for the Olympics. My balance through the uninjured leg is fantastic!! As for the other.....