5 weeks after ORIF

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Hi everyone

dislocated & fractured left ankle 5 weeks ago. Underwent 4 manipulations over 9 hrs after foot was pushed back into place.

ORIF followed the day after. Have 2screws on one side with plate and 6 screws on the other side.

Very painful for 1st week and haven't taken any painkillers in the last 4 weeks although I stumbled and fell in the bank a couple of weeks ago but managed to protect the foot!

luckily managed to work from home since 2nd jan - plaster comes off 5th Feb. Looking forward to this but also slightly worried about vulnerable foot!

what happens at this stage? How do you protect the foot or am I worrying unnecessarily?

any tips re physio? 

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25 Replies

  • Posted

    Hi Tosh, I can't say too much about your specific surgeries and such but I'd be interested in hearing how it goes when the cast comes off. I fell too after getting my cast off but wasn't as successful in protecting my foot. Thankfully I didn't break it again, but I did tweak it. I see skateboarders and ice skaters and it amazes me what our ankles can do. Anyhow, I do wish you only the best...

    By the way, how did you initially break your ankle?


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  • Posted

    Hi Teri

    Did you get your ankle checked out with your doctor as I called the fracture clinic and arranged an appointment just to be sure that there wasn't any damage?

    I broke mine playing badminton - just landed wrongly after playing a shot and knew it was bad as I heard a crack and saw my foot lying a weird angle.

    I asked the doctor what protection I could use from air cast boots to ankle braces after the plaster comes off but was informed that nothing was needed - is this the same advice for anybody else out there?

    will keep you posted of events when the plaster does come off?


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    • Posted

      Hi Tosh,

      I did have an Xray taken on Monday, but I didn't after I fell. I just didn't leave the house for 7 days (no joke, I barely walked on it at all). But then last Friday, I hurt it again getting in/out of the darn shower. It hurt the entire weekend but I knew I was scheduled for the xray already, so again babied it. But the doctor says I didn't mess it up. And now that I have 19 days to go, I am totally babying it. I just don't want to gain too much weight, one of other big concerns...............AGH!!

      Badmition??? wow....That must have been some shot you were going for. ha And yes, do keep us posted!


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    • Posted

      You need to eat biscuits and cake to keep your energy levels up Teri!

      Noreens comments below are very useful & also comforting although I appreciate each case is individual.

      hope you don't have any further accidents.

      dont seem to have come across anyone else who has suffered fractures and dislocation......hopefully that won't affect my recovery.

      stay happy 

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    • Posted

      You're funny....I'd eat biscuits and gravy every day if it wasn't so fattening. I mainly munch on mixed nuts and M&M's and just keep them nearby so that I don't have to get up often.

      Mine is considered fractured, but not dislocated. Just curious though, what is the real difference between a "break" and a "fracture" ? The doctors use the term "break" but that paperwork defines it as a fracture. Just wondering if they're one and the same.

      Do you think you'll play badmition again, or are you done with that as a sport? As I watch skateboarders jump onto their boards, I cringe. The same for ballet dancers. We really do take our bodies for granted.


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  • Posted

    Hi Tosh,

    I broke all 3 malleolar 8 weeks ago and had a plate and 8 screws put in. (hill walking)

    Had a plaster cast for 6 weeks and was non weight bearing. I was given full crutches and a zimmer frame in hospital before I came home and found using the frame around the house was much easier than the crutches. Also had a wheelchair for outside.

    Had the cast off 2 weeks ago, was given elbow crutches and told that full weight bearing was fine.  (no boot or aircast needed) I used both of them for the first 2 days and on the 3 rd day managed to walk about a mile round town with both crutches...very slowly. I started work (only work 2 days a week) 3 days after the cast was off and have just started to drive yesterday. Saw the physio the day the cast came off and again a week later. I have been given loads of excercises to do 4 times a day and from next week will be going to the local pool to swim and doing cycling in the gymn for 3 days a week.

    I have been lucky in that I haven't had much pain at all and haven't taken pain killers since I came out of hospital 7 weeks ago but my ankle and leg up to my calf swell alot especially after a day at work. Iceing doesn't seem to help much but rest overnight in bed reduces the swelling alot.

    Now 2 weeks after the cast came off I am now able to walk without crutches but I do limp a bit.

    My advice is that if the surgeon says it's OK to full weight bear then try to get back to normal living as quickly as possible and be religious about the excercises the physio gives you. I felt that my foot, ankle and leg had lost alot of strength over the 6 weeks in plaster so I wanted to push things as much as possible to get back to normal but be sensible and take the advice of the physio. When I had my second physio appontment I went with a load of questions written down to ask her which helped me to know how far I could push my ankle. Expect all sorts of aches and pains in the whole of your leg with the break as all the muscles get used to walking again but they do go after a day or two as your leg and ankle readjusts.

    Good luck over the next few weeks...I know exactly what you have and will go through. It's tough but a positive mind really is essential.


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    • Posted

      Thanks Noreen

      Did you need any brace on the ankle when sleeping or is this unneccessary? Just thinking of getting foot caught in the blanket, particularly as I also disclocated the foot.

      Thanks for the feedback re physio, rest, ice, elevation and I intend to take this seriously, just as I did approx 4 years ago when I ruptured my achilles tendon on the same leg.

      Re driving, did you have to gai approval from your car insurer to be able to drive again?

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    • Posted

       Hi Noreen 

       Congratulations on recovering so well. 

      I had a fracture in three places in my tibia and Fibula.  Like you I had plates inside one with eight screws and one with four.  

      I was non-weightbearing in cast & boot for six weeks but now have been weight-bearing for six weeks and I have been free of boot for 6 weeks, free of crutches for 2/3 weeks. 

      Whilst I can weight bear fully on  the foot of my damaged ankle I cannot yet stand on my toes to weight bear fully on the ball of my foot.  That is slowly improving. 

       What is slow for me is being able to bend my ankle forwards at 45° angle.

      For example if I'm coming downstairs and my mended broken ankle is behind me I cannot bend it  forward enough to support me as I bring my good foot down.

       I understand that this can sometimes take a while to repair but my consultant was really vague when I asked him if there may be a permanent restriction and didn't seem able to tell me. 

       My physio has told me just keep working at it and that it will come.  

      What's your experience of this?  I am quite mature as I am in my late 50s. 

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    • Posted

      Hi Leah,

      It's 8 months after my procedure (two plates and 6 screws) and the worst were the first 6 non-weight bearing weeks. Since then, doing the physio exercises has helped enormously and now my bend-ankle-forwards angle is as good with the injured foot as the uninjured. The trick, for me, was to stand 2 inches away from a wall and bend my leg forward till my knee touched the wall while keeping the heel on the ground. 3 sets of 10. Then, after a week or so when I could manage that, place the foot 2 and a half inches away... 3 inches... etc. Of all the physio exercises I have had, this has been the hardest but the most worthwhile.

      Hang in there! PS I'm 70, so you'll manage, I'm sure!


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  • Posted

    HI Tosh,

    No I haven't needed a brace and have had no problem sleeping.

    I checked with my car insurer and they said it was OK as long as my surgeon said it was OK. I left it a week after he said OK just because of the snow we have had. I think by law you need to be able to do an emergency stop. My fracture was the left ankle( my car isn't an automatic).

    Best of luck on the 5th.


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  • Posted

    Plaster came off earlier today! Serious muscle wastage on leg but I'm sure this will build up over the coming year(s).....

    Leg/foot felt very strange, expossed vulnerable.

    Doc asked me to stand and bear weight but as the ankle hadn't moved in 6 weeks this proved to be difficult and I managed minor movement. He then proceeded to push my foot and this moved slightly without pain.

    SInce coming come, I have continued to flex foot and also stand and earlier managed to stand on both feet without crutches gradually shifting more weight to the left leg - feels good.

    Waiting for physiotherapy appt to come through but in the meantime I have just ordered some therabands (and a wobble board for later) which should arive tomorrow.

    I intend to push through with as much movement as I can on a daily basis.


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  • Posted

    A week after plaster came off:

    Flexibility in the ankle joint about a 1/3rd of right foot but improving daily with exercises and walking still with both crutches although I sometime push it by using only one. Tried walking without any but still too painful.

    I wasn't given any data on exercises when I left the hospital and I guess like most people, I hit the net and found the following to be the simplest and most useful:


    Have 1st physio appt next week and intend to start driving after this weekend.

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  • Posted

    Hi Tosh,

    Good to hear that your cast is off and that you are now on the move.

    Thought I would give you an update on my situation as it may give you an idea of how things progress although I know everyone is different. Now just over 4 weeks after cast has been off and I am walking without any aides but limping a little still. Went into Aberdeen shopping yesterday and ended up walking around town for a couple of hours. Started off OK walking at a reasonable speed (no crutches) and a bit of a limp and ended up with a big limp and very sore ankle for the last 30 mins! At least I know what my limit is at present.

    I have been going to the pool and gym 3 times a week for the past 3 weeks and have found it really helpful. I'm not much of a swimmer but have been kicking in the pool and doing my 'land' excercises also running in the pool. It feels really good and my ankle swelling is well down the day after. I have also been on the stationary bike (no resistance) and the rowing machine for a total of 40 mins each time. Again my ankle seems to really 'like' it and swelling is slight the next day. Im finding that moving the ankle reduces the swelling alot (although walking for too long in counter productive but you don't know how much too long is until you've done it). Also been having hot baths the days I am not at the pool with 'Dead Sea ' salts in them and just kicking and doing rotation excersises in the water which also is good. I have been rubbing in Bio Oil on the scars twice a day and the scars have almost totally faded. 

    I am still getting a swollen ankle at the end of a working day and when it's swollen my ankle feels stiff but the swelling has reduced by about 70% since the cast came off. I have a bit of pain sometimes but it's when I have pushed the ankle too far. 

    I feel the excercises I have been given by the physio are now too 'easy' and I have an appoinment today and want to try to extend the mobility side of things more now. I have bought a wobble board and tried it last week (just both feet on board and going side to side and front to back and also moving the board round ina circular motion) but my ankle was really painful after a few minutes of this so stopped and will speak to the physio today about it.

    I think where I am at now is to push the ankle but I am wary of going too far and injuring a tendan or ligament. The physio should be able to reassure me on than today.

    My calf muscle is back up to the same size as the other and although the swelling is well down my ankle is about twice the size of the uninjured one. 

    Any way how some of this helps.

    Keep going and good luck.


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    • Posted

      Hi Norren

      thats great news - your rapid recovery makes for wonderful reading.

      just read one of your earlier posts and I wish that I had been referred to a physiotherapist after the cast came off. Got my first appointment next Tuesday, a week and ahalf after cast removal which isn't great. 

      Dont know if I'm doing my exercises properly which is very frustrating.

      im thinking of seeing a private physiotherapist in addition to NHS as I'm struggling to walk with one crutch.

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    • Posted

      Thanks Noreen for your update...I really could use the tips you gave on swimming and using a bike. Do you remember how soon you started using the bike? I'm only on my 2nd day of cast removal and need to lose the weight I gained so I'm desperate for which exercises I can start doing....

      Good luck to you as well...!


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