Ankle Recovery from Bimalleolar Fracture

[Sprill]

Hello everyone.

I am a 28 year old woman, living in Australia.

On Sunday the 19th of February, I fell badly while trying out roller skating for the first time, and sustained a bimalleolar fracture in the right ankle. The experience was quite frightening (though everyone around me was very helpful, and the ambulance got to me pretty quickly) and I'd never broken any bone before.

I was told that I would need an internal reduction and fixation in the coming days. They put a boot on my ankle and sent me home very late that night.

The next morning, I was struggling with the crutches, and nearly fell. Instinctually, I put my bad foot down (not hard). My husband was behind me, and caught me, and I quickly asked for a chair, but my ears were ringing. According to him, I passed out and convulsed, and he got me on to the floor and protected my head, but apparently I hit my bad leg on the floor several times during the fit. I am prone to convulsing when I have passed out in the past, but it was still frightening (especially for him!).

That night, I was told to expect surgery the next morning. I will admit, I was quite scared. I've never had surgery before, not even stitches.

The surgery went well, but I requested to stay overnight, as I wanted to see a physiotherapist or occupational therapist, because I was extremely anxious about using the crutches following the incident at home. I was told that there had also been ligament damage, and therefore some kind of band or tubing or something had also been used in the fixation. I am unclear on all of the specific details, perhaps I'll learn more later?

I learned some mobility tips from the physio, and spoke briefly with an OT about home aids. My mother is actually a retired OT, though she doesn't live nearby, so I spoke to her later about options. Then I was given an appointment... of some kind (the card doesn't say who with, just that I have one at the hospital, and when) for the 8th of March, and some prescriptions. And then I was sent home.

I've been at home since. They prescribed oxycodone to me, and I had my husband fill it just in case, but I have learned from a previous prescription for codeine years ago that I do not like the way that opioids make me feel, and I haven't touched it. I've been managing fairly well with paracetemol, and taking aspirin once a day.

I joined this forum as a way to possibly just share all of these things with people who have been through similar, and like a diary. I admit I feel quite scared of this whole process, and it is feels almost like my whole life has come crashing down, and the lack of concrete information from the hospital has added to my uncertainty. I am trying hard to keep my spirits up.

I have some questions for all of you lovely folks;

- They told me that it would be about 3 months until I am "back to normal". I play soccer casually, like to hike, and work a physical job (housekeeping). Is that a realistic expectation for those kinds of activities?

- What kind of activities can I expect from a physiotherapist later along the line? Will it be painful?

- Is this always going to be my "bad leg"?

- Can I take the boot off at all within this first 2 weeks to resettle it? It feels almost like my foot has shifted within the boot (the heel shifting backwards) and isn't sitting flush against the sole of the boot and I am worried that this will somehow affect my healing.

Thank you all for reading my tale! It will be nice just to talk to some people who know what I'm going through.

 

[Jaycey]

@Sprill Welcome to BoneSmart! So sorry you had to deal with all this trauma!

- They told me that it would be about 3 months until I am "back to normal". I play soccer casually, like to hike, and work a physical job (housekeeping). Is that a realistic expectation for those kinds of activities?

Doesn't sound realistic to me. But we are all different. It takes about 6 weeks for bones to heal. You will be closely monitored to insure the ankle is stable. Then you will need to work with a physio to gain strength.

- What kind of activities can I expect from a physiotherapist later along the line? Will it be painful?

Physio should be gentle stretches and movement to regain any range of motion. It should not be painful and if it is please tell anyone you are working with to stop.

- Is this always going to be my "bad leg"?

Too early to say. Do bring up this concern with your physio.

- Can I take the boot off at all within this first 2 weeks to resettle it?

I would call your surgeon's office and ask about this. They may want you to come into the office to get help with the boot.

 

[Sprill]

Thank you for the welcome, and your response.

I will definitely ask for help with the boot on Wednesday when I go in for my appointment. I assume that they will be taking it off briefly to check the healing process. Perhaps I shall just leave it alone until then!

I am trying to come to terms with the fact that the 3 month estimate from the doctor at the ER may be a little bit eager. Perhaps not soccer in 3 months... But I am considering some gentle swimming perhaps, given doctor's permission, later on. Just something, anything, to exercise!

I lost close to 30kg several years ago, and I fear greatly that I will put a lot of it back on while I am effectively bedbound. I am trying to eat healthily, but it is extra difficult, given that I cannot cook for myself anymore, and my poor husband is struggling to find time to cook healthy meals for us around his work. He has to cover all of our expenses, currently, as I do not get leave from my work, and government payments are very slow to go through.

I'll also admit that the boredom of sitting around at home, and feeling sorry for myself, has made me prone to eating poorly to cheer myself up!

I really am trying not to get down about it all, but it is such a frustrating experience, as I'm sure many here can attest to.

 

[Jaycey]

Yes, boredom is all part of this recovery. The mind wants to race but the body isn't ready. What is the weather like where you are? Can you get outdoors and sit in the sun?

Or maybe find a TV series that sounds interesting. Books or puzzles. Or call a friend/relative.

Please let us know how your appointment goes on Wednesday.

 

[Sprill]

Thankfully, the weather is quite lovely right now, aside from being very hot (30+C most days)! My (wonderful) husband borrowed a wheelchair and has taken me outside several times (I was getting very keen on the gardening before this happened). It is a bit difficult to manage alone, however, as there is gravel and uneven surfaces that stump the wheelchair. I hope to get out there more!

He has also taken me out to several social outings (we went to a stand up comedy show the other night) with wheelchair access, which I thoroughly enjoyed. Particularly as the comedian did a bit of audience interaction directed at me and my obvious wheelchair-boot combo! My answer that it had been a roller derby accident got quite a lot of laughter from the crowd.

I selected a cross stitch pattern and ordered some supplies last week. Thank god for click and collect; I was almost about to send my poor husband down to select nearly 30 different skeins of embroidery floss in very slightly different shades! This way I was able to select them all online and have him pick up the parcel. At the very least it should keep me occupied for some time.

I am also currently studying part time at university online, so at least I can direct my free time toward that.

 

[Sprill]

Update following my first appointment two weeks after surgery.

I was pretty nervous going into the appointment, because I didn't really know what to expect. Thankfully, my husband was able to attend, which helped a lot with the anxiety.

The doctor had my post-operation (taken during the surgery, I think) xrays up for me to see, which was the first time I'd been told how many screws/plates/what had been done specifically for my ankle. He pointed out the tether, as well, and explained how it worked to hold the bones together since I'd had some ligament damage.

It was a relief to actually know fully what had been done. And the doctor seemed quite pleased with the fix (he said he had not been in that day, it had been done by a colleague), which was a reassuring feeling!

He took off the boot to examine the ankle, which also involved removing the bandages and dressing. I had 9 stitches in total. It all looked very neat! He tested my ability to note sensations on various parts of the foot, then tested my range of motion by pushing my toes back gently towards my shin. It wasn't painful, but was uncomfortable.

After making sure it was all healing nicely, he called in a nurse to take out the stitches. She was very understanding of my anxiety about it, as I told her I'd never had stitches before. She even lowered the top half of the bed for me, because I will admit that all the movement of my ankle had made me feel a bit faint and gross.

I have another appointment booked for 4 weeks from now. I was told that they will take an xray and determine whether I will be ready for partial weight bearing at that stage.

In the meantime, I am now allowed to remove the boot briefly for showering, and if I want to do some very gentle range of movement exercises, which I have been researching. I need to try to keep my heel down on the base of the boot as much as I can to keep my ankle as flexible as possible.

I am mostly posting as a way to journal my experience, and work through it. I have found it reassuring in some ways to see the other journeys here, and I hope this can help others in the future.

I will update following any other news, or otherwise after my 6 week appointment.

 

[Jaycey]

@Sprill Thanks for the update! Sounds like you are on track with this recovery. Fingers crossed you can transition to partial weight bearing after your next followup.

Thanks for sharing your experience. I am certain your input will help others who might be considering ankle procedures.

 

[FCBayern]

Sounds like you are making good progress @Sprill. The range of motion they had me start with after my ankle replacement and 6 weeks in a boot was to try and write the alphabet with your toes. That did seem like it worked on every direction your ankle should move.

 

[Sprill]

Sounds like you are making good progress @Sprill. The range of motion they had me start with after my ankle replacement and 6 weeks in a boot was to try and write the alphabet with your toes. That did seem like it worked on every direction your ankle should move.

That sounds like a good exercise to try once I'm more regularly out of my boot.

I'm not brave enough yet (2 and a bit weeks out from surgery) to take the boot off for exercises, but I am currently wriggling my toes regularly, and making sure my heel stays planted in the boot so I can hopefully keep my ankle from stiffening up too much.

I am also trying to exercise my good leg a bit, as I have heard that, due to the nervous system mirroring itself, it can help keep my nerves "awake" on the other side, despite not moving.

 

[Stephplum]

Hi @Sprill. Like you I had an ankle fracture with surgery to repair. My story is here.
Thread 'Ankle Injury Recovery encouragement'
https://bonesmart.org/forum/threads/ankle-injury-recovery-encouragement.70675/

I don’t want to scare you but 3 months would be very optimistic for being “normal”. My PT and Dr both warned that my ankle would swell for up to a year. I’m much older at 57. I do believe that contributed to taking longer to get back to normal. so I hope you’ll be quicker than I was.

Don’t be worried if things get better and then are not as good. I had plenty of days where I would back slide slightly. I love the recovery picture that is curvy and wavy and not a straight line because it exactly describes the journey. My ankle is much, much better now 10 months later.

ROM - yes try to write the alphabet. At first I could not do that and my PT had me do circles until I could do that. I worried my Ankle would be stuck but with time and practice, full range returned.

your calf will shrink. That was so surprising to see at the end of the non weight bearing phase. Again don’t worry with time and exercise, it will return strength. I still have less strength in one leg and less balance but continue to work on it.

Glad you found a craft to keep you busy. I watched a lot of TV, read books and crocheted.

This forum is great. It really helped keep my spirits up.

 

[Sprill]

Hi @Sprill. Like you I had an ankle fracture with surgery to repair. My story is here.
Thread 'Ankle Injury Recovery encouragement'
https://bonesmart.org/forum/threads/ankle-injury-recovery-encouragement.70675/

I don’t want to scare you but 3 months would be very optimistic for being “normal”. My PT and Dr both warned that my ankle would swell for up to a year. I’m much older at 57. I do believe that contributed to taking longer to get back to normal. so I hope you’ll be quicker than I was.

Don’t be worried if things get better and then are not as good. I had plenty of days where I would back slide slightly. I love the recovery picture that is curvy and wavy and not a straight line because it exactly describes the journey. My ankle is much, much better now 10 months later.

ROM - yes try to write the alphabet. At first I could not do that and my PT had me do circles until I could do that. I worried my Ankle would be stuck but with time and practice, full range returned.

your calf will shrink. That was so surprising to see at the end of the non weight bearing phase. Again don’t worry with time and exercise, it will return strength. I still have less strength in one leg and less balance but continue to work on it.

Glad you found a craft to keep you busy. I watched a lot of TV, read books and crocheted.

This forum is great. It really helped keep my spirits up.

Hi! I read your journey when I first discovered this forum. It was your story that helped me figure out more of what to expect from my healing process, since I hadn't gotten much information from the hospital at the time, so thank you!

I'll admit, I was quite upset when it truly dawned on me that I wouldn't be back to complete recovery as quickly as I'd anticipated. After losing a lot of weight several years ago, I'd really come to enjoy being able to move around freely, and I hadn't realised how important it really was until I couldn't do it anymore.

But I've decided just to keep pushing forward and focusing on the small victories. Like wiggling my toes, or flexing the ankle slightly within the boot. I might start working on my "fitness" with the crutches, soon. Nothing big, but just small, measurable, progress!

I am currently going back and forth between three different craft projects; a crocheted cushion cover, a cross stitch, and I just finished off a knitted dress for my niece that I'd abandoned a few months ago with only 10 rows to go, for some reason !

 

[Jaycey]

I'll admit, I was quite upset when it truly dawned on me that I wouldn't be back to complete recovery as quickly as I'd anticipated.

Many of our members have this experience. But you definitely have the right attitude. Slow and steady steps forward. Small victories celebrated!

 

[CricketHip]

@Sprill

I just read through your recovery thread. What a nasty fall! But you actually sound like you are doing very well and that's a big positive. Thank you for sharing your story with the BoneSmart forum.
Looking forward to following your progress!

 

[Sprill]

Hi everyone!

During the last couple of weeks, I've been taking my foot out of the boot while my husband and I watch the evening news. He has been encouraging me to rest my foot in his lap while we watch and he has been gently massaging my toes and foot to help with the sensitivity I have developed on the top and heel of my foot. He even started using lotion to help with the really dry skin (I wasn't prepared for how flaky and dry it would get!)! It has been a great help getting me more used to having the ankle manipulated and I feel like my circulation is improving thanks to his hard work!

Last week, I had my 6 week follow-up appointment. I was quite excited to attend this appointment, as I understood that it was the one where I would be told whether I could partially weight-bear or not. I've experienced next to no pain lately, so I was hopeful!

I attended some xrays. The poor xray tech seemed to be in a world of pain of his own. He apologised and told me he had done something to his back earlier; I almost felt grateful for my broken ankle!

The appointment itself was incredibly quick. At first, the doctor had mistaken it for my 2 week appointment, and when I asked about weight bearing she told me it would be another 4 weeks! I was so shocked (and devastated)! Thankfully, I realised pretty quickly that she was mistaken and we cleared it up. She had me attempt to stand, and when I had no issues standing with the boot, she gave me the all clear to weight bear, guided by my level of comfort.

That was basically it. I asked some brief questions, such as whether it was normal to have numbness on the top of my foot, and sharp heel pain on the inside heel when pressed. She said that both were normal with the boot, which was a relief to hear.

I am booked in for another appointment in 6 weeks time to "hopefully throw that boot away" according to the doctor. Fingers crossed!

I have been practicing with weight bearing in the boot and the crutches at home. At first, I was a bit unsure, and I kept waiting for it to hurt. But other than some sensitivity in the heel and the sole of the foot (particularly when I've been sitting for a while), and just a little soreness in the ankle when I push it a bit, I have been doing great!

The doctor didn't really mention physio at all during the appointment, though, and my range of movement in the ankle is pretty limited (I suffer a fair bit of pain in plantarflexion, particularly as I try to bend my big toe down, and also inversion and eversion). Is 6 weeks too early? Should I be perhaps seeking physiotherapy on my own? I am a bit afraid that if I leave it too long under the impression that the outpatient clinic at the hospital intend to do it after my 12 week followup, then I may be inviting these to become long term issues, but private physiotherapy is so very expensive, and we are on an especially limited income currently due to me being out of work.

Anyway, just thought I would give an update as to my current stage of progress. I hope everyone else is also doing well!

 

[Jaycey]

I would definitely ask your OS about physio. They may want to wait until after your next appointment. But it can't hurt to ask.

 

[benne68]

The doctor didn't really mention physio at all during the appointment, though, and my range of movement in the ankle is pretty limited (I suffer a fair bit of pain in plantarflexion, particularly as I try to bend my big toe down, and also inversion and eversion). Is 6 weeks too early?

For what it's worth, my doctor didn't order physical therapy for my ankle until I was three months post-op. Although, I had a trimalleolar break, I don't know that that made a difference. He just wanted me to gain some stability walking before I started exercising it.

But I agree with Jaycey; it's worth a call to his office to ask!

Good luck!

 

[Stephplum]

Hi @Sprill,

That is great news that you can now put some weight on your foot. Glad to hear you aren’t in much pain.

So much dry skin! It is amazing how long that lasts. Every shower it seemed like my skin just flaked off. It does end.

My big toe took a really long time to be able to bend fully, like months. I actually googled some toe stretches and moved it around manually. Like you, I was surprised the top of my foot hurt And I had the heel pain as well. That eventually went away.

On physio, I’d ask the DR. Mine sent me when him allowed my to put weight on it. But I got the impression that he usually waited. I was very stiff and had very little range of motion. The first exercises I did were scrunching a towel on the floor with my toes and writing the alphabet with my foot. I guess what I want to say is not to be too worried. It took me a long time to get the full range of motion back but it came back. You won’t be stuck in one position forever!

Happy walking!

 

[benne68]

Hi @Sprill

Checking in to see how you are doing. I just noticed that you passed the two-month mark in your recovery last week.

Hope all is well. Give us an update when you have a chance!