BIMALLEOLAR ANKLE FRACTURE- How long for weight bearing after surgery

I am on day 7 after getting the go to walk. I was able to wean from the boot and crutches as tolerated by pain so I wore the boot with the even up shoe for 2 days, dropping the crutches immediately. Since the bone was healed I really didn't have that to worry about. I've been walking in tennis shoes and once in flats (that was not as comfortable). I first walked half a mile, then 1, etc., and my last one was 2.5 and my foot swelled up quite a bit and the gastrocnemius hurts mostly. Get some PT and do move it often for best results!

I had my fall July 7th and surgery July 8th. 2 weeks later I had my staples removed and cast taken off and in a boot since but non weight bearing. I go this Friday the 18th to check and see progress and see if I can start weight bearing. I've also been in physio since week 3 and my range of motion is about 95% of my good ankle now. Hoping to start walking this Friday!!!

Greetings Susan,

We share one thing in common-- a bimalleolar ankle fracture. Mine was displaced but I managed to dodge the knife-- thank goodness. Surgery is sometimes necessary but surgery of the foot is not something I'd personally care to contemplate. Nonetheless, judging from this forum respondents' stories it seems most patients do alright.

It sounds like your post-surgery healing journey is going swimmingly. You got some really good advice somewhere, and I bet some of it came from this forum  :-)

In reply to your question about time progression to walking status: I'll report my experience. I was 4 weeks NWB (non-weight-bearing) in CAM (aka moon- or airboot), then, based on x-ray evidence of bone mending doctor put me on PWB (partial-weight-bearing-- 50%) while still in boot for 2 more weeks. PWB 50% means to put only 50% of total body weight on injured foot (when standing evenly on both feet each is 50% weight bearing). I started walking at 50% WB with crutches (walkers are good for this too if you are afraid of crutches). It's more of an art than exact science to figure out what is close to 50% WB when using crutches-- but you figure it out quickly.

My orthopedist was probably conservative in his approach to weight-bearing progression. Other physicians may accelerate the time line (and really evidence on x-rays should be the determining factor). Each patient case is unique and different, so don't be excessively concerned if some people jumped to walking much sooner than others.

Note: as you may have learned from other patient's experiences here, it's important to make sure your good foot shoe is as high as the moonboot-- they make 'even-up' shoe levelers just for this purpose. Walking with feet at uneven heights can lead to pain in other joints like hips and knees. In fact, some patients have other joint pains even with 'even-ups' because of long weeks of skeletal/muscular atrophy from enforced inactivity.

It's important to walk thus as much as you can tolerate without too much pain to prepare ankles, calves, and all the other assorted soft tissue (that have been inactive and atrophied during the long NWB convalescence) for stress of walking.

So at 6 weeks my doctor said go FWB, but stay in boot for 2 more weeks. In my case, I did fine with little  pain or swelling. I transitioned to regular shoes at 8 week mark. It was a little touch and go for a while (I used a cane for a few days and had a slight limp for a few more days) but I was soon in the swing of things with a normal gait.

I wear a good ankle brace (only when I know I will be standing/walking for extremely long periods) and a shoe orthotic because I suffered PTTD (a tendon dysfunction) as a result of my severe ankle sprain with fracture. I believe the biggest impediment to many patients' full and lasting recovery from sprains/fractures is soft tissue damage that can go undiagnosed and untreated. Bones are usually good to go from the day your doctor says you can go FWB, unless you have a complication.

It's important to begin ankle rehab just as soon as doctor gives go-ahead. Physiotherapy (either professional or self-taught) is fundamental to getting normal mobility back and staving off chronic ankle problems in future.

Good luck to you.

Really good to hear the experiences of others and know that it has been just as frustrating for other people!! I dislocated and broke my ankle on holiday in Portugal on 15th Sept. I had surgery to repair trimalloelar fracture on 17th Sept. I had a nightmare time in Portugeuse NHS equivalent hospital where I had no pain meds for hours and a member of staff walked into my dislocated ankle (I am tall and my feet hung over the end of the trolley)! I then had my ankle manipulated twice without any drugs - worst experience of my life!! Luckily friends took me to a private hospital after this and this is where I had the surgery and was very well looked after. I had staples out 12 days later back home in UK and another 3 days later went for orthopaedic clinic appt. They put a cast on and I have appt to remove it after 4 weeks. It's been 2 weeks now and I am desperate to get it off as I am so fed up not being able to walk or do things for myself. I know it all takes time to heal but I am so worried that I will not be allowed to walk after they take the cast off. The recovery timescales seem to be different for everyone. I suppose I just have to be patient and hope for the best. I totally understand your frustration and emotional state as I frequently end up in tears at the moment and I had a spinal anaesthetic not a general. I feel like I am constantly asking people to do things for me and apologising for doing so, I hate being this reliant on others even though my husband and mum have been amazing.

Hi there,

Two weeks ago I rolled my ankle at home and went to the ER to discover that I have broken my ankle and will need a BIMALLEOLAR ANKLE FRACTURE surgery. I had to wait one and a half weeks before I was able to be operated on as the ankle was still so swollen. It's been a bit of an ordeal, and I am now 4 days post surgery. 

I was given Lovenox injections to do myself for the next two weeks to avoid any potential blood clots. However over the past 2 days I have felt a weird throbbing going up and down my leg that was operated on. 

Is this normal? I have also been on Oxy pain killers this week which hasn't been handled well in my body as i am always nauseous and feel super dizzy.

I have a follow up appointment in 2 weeks where I think I will be fitted my boot and the stitches to get taken out. However I feel this might be too soon?

Just wondering when I will be able to walk normal again on my own?

You asked about determining how to bear weight at 50%. You were told  to determine what 50% by getting on the scale, finding your weight and then pushing down until you get half your weight registered on the scale. I understand that might seem confusing. I think they want you to see how much pressure sensation you feel on your foot (on scale) when you push down with 50% of your total weight-- it gives you and an idea for what it should feel like when you are walking at 50%.

I simply noticed what it felt like when I was standing evenly on both feet-- each foot is bearing 50% of your total body weight.

 On June 10 I had a bad landing while skydiving. I have bimalleolar ankle fractures on both ankles with broken tibia's as well.   I had surgery June 11 and was put into half cast on both legs. Two weeks later the surgeon took out the stitches and put me in air boots.  I am nonweightbearing totally. It's very limiting and frustrating.    But, I guess I can say I'm happy to be alive. I go back on July 20 for my six week check up. I'm hoping to hear that I can start bearing some weight. What I see in this forum is that people start by only bearing partial weight.  I wonder how that will work for me being that I have both ankles affected. My right ankle is much better than my left. My left ankle had a lot more displacement. I am able to take my air boots off of the day if I am sitting with my feet elevated.  I have also begun to sleep without the boots on. That took me three weeks before I was comfortable enough to do so. I have more range of motion in my right than I do my left ankle but they are both still a bit stiff.   I just want this to hurry up so that I can get back to my normal life. I have a feeling it's going to be longer than I think. But I don't feel so alone knowing that I'm not the only one going through all this frustration.