1-Week Post-Ankle Surgery: When will I be able to lower my leg without massive swelling and pain??

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I (34 yrs old) am now 9 days post-ORIF surgery on my left ankle (plate/screws for spiral fracture and repair of torn ligaments) for a Weber C fracture/dislocation (surgery was one week post-injury). I now have a splint-type cast and go back to the surgeon for my first follow up next week (2 weeks post-op) and will be in a removable cast for 4 weeks, and then in a boot. I am non-weight bearing until I am in the boot.

I have been off pain meds for several days now and have minimal pain when my leg is elevated. When I put my leg down to get up to use the bathroom and shower, etc, my leg and ankle immediately swell from what seems like blood/fluid going down there by gravity. Putting my leg down results in almost unbearable pain within seconds, and is only relieved by elevating the leg again.

My question for those who have gone through similar ankle procedures is: how long should I expect until I will be able to be upright without this massive pain from lowering my leg?

I am not able to use my knee scooter yet and am now in bed with leg elevated 99% of the time because of this. I know that once this stops (or at least the pain is reduced) I can be more mobile and upright, which will certainly lift my spirits. Any advice folks can give based on similar experiences would be most appreciated.

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  • Posted

    Hi Andrew, I meant to say in my earlier post - when I queried that sensation with the doctor, he said that the pain was due to damaged blood vessels and it is, as you quite rightly say, blood rushing down to the foot.
  • Posted

    You're very early in your recovery. I suggest inclined rest of the foot as often as possible!!! My injury was 07Feb & surgery 16Feb, if I was not inclined my ankle was swollen and painful- it was the main treatment I used. 2 weeks after surgery I was no longer using pain med's & at 9 weeks I was released to walk unaided. I had fibula break with a ligament damage.... I am doing better than I ever imagined 4 months later. I don't think I would do a long walk or run yet but I'm not hurting too bad either!! I do think everyone is different based on each individual's break and damage. Good luck!!
  • Posted

    Sorry to hear of your accident.On January 30th I had an accident which resulted in an injury called a Maisonnueve Fracture.Something similar to the Webber C with syndesmotic injury and interessous muscle tearing and a high fibula spiral break. I was in a non weight bearing cast for 7 weeks before being able to partial weight bear for the next 3 weeks and then full weight bearing as pain allowed.At present my foot stills turns purple if I am sitting,the consultant said this is due to the massive trauma caused when the ankle came out of the mortise and the energy transferred up through the ligaments and up through the muscle and out through the break.He said it could take up to 2 years for that to settle.At present I am still walking with the aid of crutches for stability as the ankle is very weak and catching my bone.He said I maybe looking at another operation to clear that up.I am 54 years old and my job as a postman involved walking 12/14 miles a day,now I have gone to limping about on crutches with still a good bit of swelling whilst on my feet.I am still attending Physio and trying to use the wobble board but I feel it is aggravating the joint and I am in pain for a good few hours after it.My days as a postman are numbered as my work want to get rid of me on ill health retirement as it's taken to long to recovery from the injury which happened in the course of me doing there job.Buts that's loyalty for you.Like yourself my leg /ankle causes no pain when elevated but you can't be sitting all the time.Its frustrating when you have been on the go all the time and then this happens.You need the calf muscle to get moving as it pumps the blood back to the heart.Even when resting keep wiggling the toes as this helps to get the blood moving.I had to self inject blood thinners for 5 weeks due to the inactivity with the cast, boy was I glad to get shot of those.At present I am wearing a home made modified trainer to let the swelling disperse as normal trainers keep the fluid gathered round the ankle making it stiff and tight.I still think my ankle will improve given time but it will never be the same as before.Wishing you a speedy recovery,but these sort of injuries are slow the consultant said.My screws will be staying in as he doesn't believe in taking them out.

        Regards Chris From the UK

  • Posted

    Similar injury for me. 8 months so far for me.4 months non union, over 4 months ago I had bonegeaft, plates and surgery.

    Yours sounds worse. Getting over surgery will take several weeks to start with. Yes its a very slow process. Sift tissue injury swelling can take months.

    There is light at the end of the tunnel. I can verify that with Drs care and up and coming Physio, you will improve.

    Don't be a hero and go off meds. Use them as directed . I stopped codeine but kept on anti inflammatories and panadol.and vitamin C.

    I got very down about my swollen sore foot . purpley red blotchl mess.

    Stayed in bed for 2 weeks. Hated shower. I have a shower slide. More stable than a stool. Your knee scooter may come in handy soon. Short bursts with pain medication on board. Take it easy. I drove mine out of hospital. Slow speed at your stage. From memory every thing was a pain in but. I ate lying down. Couldn't sit or stand easily, but you have to make regular efforts to prevent blood clots. Try to lightly wiggle toes. Ask Dr about that.

    Get a hobby. Ps4, books, movies?

    Hard I know. But very very gently do a bit more each day under medical advice.

    This forum gave me sanity.

    Good luck!

    ©{°$°}©

    • Posted

      Good advice from everyone as always. What is a shower slide? 
    • Posted

      Hi Patti, shower slide is a long bench with a back and suction adjustable legs. Most of bench goes in shower, , part with 2 legs goes outside shower. Have at good height. Get on seat outside shower and sorta slide yourself along bench to water, then exit same way. I couldn't do without it. I kept falling off shows stool. This is a very handy gadget.I'm big on getting right took for job!

      ®{°÷`}®

    • Posted

      Wow! It is so nice products like these have been developed to help people! I found a picture online. Never heard of this one before you mentioned it. So glad you found this to help you!
    • Posted

      We should start a thread with useful devices tried and tested lol.@(*+")#
  • Posted

    Hey Andrew, I had RT lateral malleolus ORIF & ligament repair one week after my accident as well, plate 10 small screws, 1 large syndesmotic screw.  In splint like you for 2 weeks, then he skipped the removable cast and put me in boot (all doctors different).  Then had to wait 7 weeks from that point till 2nd surgery to remove synde screw before I could even PWB.  The boot was NOT for walking, only stabalization at this point in my case.

    Not sure why your not in knee scooter yet, I was using from day 2.  Your surgery worse then mine or doctor's order?  When using my knee scooter, leg responded as when elevated.   

    Swelling = inflammation = pain.  My swelling improved significantly at 2 weeks by keeping foot elevated and icing, anti-inflam meds like you.  Doc gave me prescription anti-inflam as well as pain meds.  Are you taking anti-inflammatory? Help tremendously!!  After two weeks, only took pain meds when needed (like 1X daily when getting in shower vs the 8 daily preseribed), but I continued with anti-inflam. pretty much daily, elevation (mainly for discoloration), but need for icing reduced. 

    Although swelling became a non-issue for me soon after 2 week mark (maybe anti-inflams?) and almost literally no pain when foot elevated, ONCE FOOT DOWN still had bad achy pain within seconds due to those blood flow issues you mentioned. in addition I had much annoying pins & neeedles, burning and red, blue, even purple discoloration. So foot up 100% except when bathing, dressing, bathroom and some unavoidable situations. 

    I was so frustrated not to be able to sit at my desk or the dinner table.  I used walker with a seat as a knee scooter, not as good as the real thing but I coped.  So by week 3, couldn't stay in bed or the recliner anymore all day, was going crazy.  Reading books & watching TV just not my thing.  So started to literally lift my leg up on my desk to work on computer (working on computer helped keep me keep sane). At dinner time I rested leg on the seat of walker.  Had to twist back and forth to take bites but liked being able to sit with family. 

    These sensations most probably will continue till you start weight bearing, then will slowly decline.  Can scare the @*#$ out of you at times - after bathing with chair in shower it was almost black when I came out.  But it's all normal. 

    I finally started to walk in book at week 10 from accident and significant improvement on the lowering of the leg issues, still happens but way less.  However, WARNING, once weight bearing, your swelling and pain will increase significantely again, and a whole new phase of questions.  So be sure to get pain med refills when they put you in boot!!  I'm at week 12 and just walked unassisted today.  Remember I'm behind due to my 2nd surgery so you may be up and about sooner. You have your youth on your side ;-)  I'm 56, was not in good shape and had many other health issues working against me.  

    It takes hard work and much paitence is needed to get through all this. Never imagined the recovery process would be so tough.  Keep your mind busy, get adult coloring book if have to :-), read book, get a tablet, keep in touch with friends and family frequently, have visitors if you can to sit with you for a while, don't be afraid to call doc or his nurse with ques, take one day at a time and don't hesitate to ask for help from friends and family.  

    This is a great site for support.  If you have Facebook, another good support is the page that will show up when you search for "Broken / Ankle / Foot / Leg Recovery - On a Quest for Normal."  Join, it's a closed group but another great resource while you recover, you will have many more questions.  Just a caution on comparing you healing time to others with same surgery.  Some take 8 weeks, some 16 weeks, some lot's longer.  So many factors come in to play regarding when.  We are each unique and will heal based on our individual situation. Best of luck to you!! 

  • Posted

    I've had my knee scooter 36 weeks. I've thrashed it. Have an all terrain walker with seat. Great for when you finally can get up. I want a fancy cane now. Hard to use 1 crutch. 2_crutches are not my style either. Have fallen off them countless times! Want sand pan attachment on bottom too. Damned if I'm going down this path again.

    Because if my bakers cyst I can't get up off ground. Annoys me. Feel helpless like a chicken in a tree.

    Have been stuck on groubdcfor an hour once. A husband with a slow healing broken hand not always that helpful.

    @(+&+)@

    • Posted

      I got Ergobaum forearm crutches - ( YouTube) they offer great support from regular crutches. They also make canes ( walking aides) they are cooler looking than most.....keep on your doing great! 👣

       

  • Edited

    Andrew, how are you doing now? I had ORIF for bimalleolar fraction yesterday. I was 11 days post injury at time of surgery and I'm a 35 y/o healthy female. My ankle was dislocated and fractured in three places. My pain had finally abated somewhat from the initial injury, so it's been hard to start back at square one with new symptoms like incision pain and the lovely swelling that everyone describes. I'm really interested to see when people felt comfortable driving or going to work.

    • Edited

      I am now 9 weeks post ORIF and doing very well.  I am in a walking boot / aircast and am largely able to walk without crutches.  4 more weeks in the boot.  I was not prepared for how long of a process it was until I would be self-sufficient and able to drive and go to work.

      The first few weeks afer surgery were the worst.  The swelling issues I noted in my original post were pretty bad for the first 3 weeks after surgery.  I was effectively inactive other than to get up to the bathroom, which was all I could handle.  Being effectively on bed rest really got to me, and I know that I suffered some depression during those weeks.  Those first 3 weeks were tough, and if you experience the same, know that you will get through it.

      Right around 3 weeks post-op I started sitting in a chair with the foot down, and those issues seemed to start going away slowly.  My surgeon said that this was all normal, and he agreed that starting to sit in the chair with the foot down and get the foot to start getting acclimated to the circulation pressure again couldn't hurt. So I started sitting up more with the foot down until it got fairly uncomfortable (this was the first step to being more comfortable standing up/on the knee scooter), and after a few days I got to the point where I could drive and work half days in an office.  I do wonder if I would have started putting my foot down earlier to get it acclimated (at least until the point where it really started to hurt) would have allowed me to become more active earlier.  At about week 4 I was able to drive, because having my foot down was bearable - the swelling finally started to not be so painful when my foot was down.

      During weeks 4-6 (in a cast then and using a knee scooter to get around) it still swelled and was uncomfortable if it was down for an hour or two without putting the foot up, but it was improving. I found that icing several times a day to get the swelling down helped a lot.  By week 6, I was able to work in the office close to normal days. 

      At week 6, I went in and had an X-ray and was placed into the walking boot/aircast, and was then permitted to put weight on the foot while it was in the cast, or in the shower.  It took about a week on crutches slowly adding more weight as I walked until I was down to one crutch, and then at about week 8 I was largely able to go without the crutches.  The first week or so in the boot was tough, as the swelling issues come back in full force because of adding the weight to the ankle joint.  But once I was able to go on just one crutch and then without the crutches, I felt like I really got my life back.  I was able to get my own glass of water (gasp!), cook, and just be self-sufficient again.

      Once I was in the walking boot at week 6, I started physical therapy.  The first two weeks were just exercises to start regaining range of motion (e.g., "drawing' the alphabet with your foot) and massage/soft-tissue work to get the swelling down, and now I am starting on a stationary bike.  The big thing, I am told, is to try to get the range of motion back while you are in the walking boot, so that you are ready to walk when you can drop the boot.

      When the cast came off at week 6, the dr. said that I could start to stand on the foot without the boot while showering, but that took about a week before I was comfortable standing on it in the shower without the boot.  But now, I can put most of my weight on it in the shower without any issue, and can see that with the range of motion coming back I should be in a good position to walk when I can drop the boot at week 13.

      My advice would be not to let the horror stories get you down in the first few weeks.  It is a slow process, but it does improve day by day.  I hope that my story helps give you a sense of how at least one other person of the same age and otherwise healthy got through it.

    • Posted

      Thank you, Andrew! I really appreciate the clear and detailed description of your healing process. I keep telling myself that this is temporary, but it helps so much to see that there are small improvements on the horizon. I go back one week post op and they say they'll put me in a cast at that time. Right now I'm in a splint. They told me I'd be in the cast for two weeks and then move to the boot. I have been using the knee scooter since the third day after my injury. One positive is that the swelling doesn't happen every single time I get on my scooter or lower my foot. Maybe all the scooter time before surgery helped. I am still laying down the vast majority of the time with only short trips to the bathroom or kitchen. I'm also still on pain meds as my incision sites are stinging a bit and there's an overall ache throughout my foot. I'm trying really hard to stay positive, but the mental side of this is as tough as the physical effects. It helps so much to see that I'm not alone, so thanks for responding!

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