Fibula ORIF 3/15/16 & still can't walk

Hello All,

Any advice on my situation?  Seems so long and truly starting to think I am never going to walk again. 

Broke my right fibula on 3/8. Rolled my ankle off my shoe getting out of my car and fell.  I am 56 years old.  Extreme swelling and pain upon movement next 24 hrs, unable to place full weight, I was basically hopping on one foot.  Went to walk in clinic on 3/9.  Did plain xray and said ankle was broken.  Put in splint, given NORCO for pain and crutches to walk NWB until I could be seen by see orthopedic surgeon. 

Went to ortho on 3/10/16, he confirmed break and said needed surgery.  When I looked at xray seemed pretty simple fracture of fibular a couple inches above ankle joint (imagine peeling a banana upside down, the fracture looked like one of the peels were lifted upward 1 to 2 incles).  No other alternatives given except surgery.  Said surgery needed to clean out and fix tendons etc and he probably would put in plate with ONE OR TWO SCREWS for fracture stabilization. 

I woke up from surgery on 3/15 (they scheduled quickly and did not wait till swelling was gone as many of you have stated??) and was placed in hospital overnight.  When I asked the nurse to point where the two screws, she said two?  You had a plate with 10 screws put in and one large screw across the ankle.  "WHAT" I said.  Needless to say, doctor never came to visit before I was discharged the next day, his PA came to look at incision, confirmed the hardware was in fact what the nurse said and discharged me w/2 week f/u.  I also had a 13 1/2 inch incision with 21 staples.  They gave me entire leg nerve block prior to surgery so I was numb without pain at this point.  That was the beginning of my nightmare.  I was in a splint from toes to bottom of know and a wrap.  I was told to NWB, use cruthes to walk (argg) and elevate and ice until my 2 week f/u. 

At 2 week f/u, staples removed, incision healing nicely.  NO CAST.  At that point he gave me a walking boot BUT said ONLY WEAR IT FOR SUPPORT AND COULD NOT BEAR ANY WEIGHT FOR ANOTHER 7 WEEKS.  I literally thought he was joking but not, I think I was in shock.  Within 3 days I called and said that was impossible for me, weight of boot was making difficult to hold up leg while walking on crutches never mind seemingly to put me off balance.  Could not sleep in it as pressure of the boot caused ache and pain in my ankle, especially at the incision site.  They told me it was ok to take off when elevating, sleeping and bathing.  Well, since this was bascially was all I was doing at that point at NWB, I only wore the full boot when I went outside to doc appts or to pharmacy with the help of friends driving me.  I used knee scooter to get around house, using just the inside soft wrap of the boot for support (yes, the frankenstein boot actually comes apart). The full boot .. was too painful, caused swelling, pins and needles, discororation (red and purple) and spasms and electrical type sensations that concerned me that the boot was causing more harm then good.  Even the PT could not understand giving me a walking boot when NWB instructions.  He called doc and he okayed the use of the wrap from inside of boot only since I was NWB.     

He also told me at that appointment that after 7 weeks of NWB I needed a 2nd surgery to remove the big screw and that should relieve some of my discomfort, and then we would re-evaluate for WB.  WHAT, again?  I was terrified to move with that big screw in, he said if I bear weight could cause it to break.

F/U four weeks later, doc said bone healed and could start moving ankle during my physical therapy for ROM but still foot off ground.  Surgery was scheduled 3 weeks from that date.  I was doing PT and my ROM was good and hardly any swelling but I was doing all the PT with my foot off ground or in the air.  My calf muscles, significant atrophy since 2 weeks post op.  Excercises 'off' the floor helped ROM but not the muscle atrophy in calf.  

Just had 2nd surgery on 5/16.  Outpatient.  Large screw removed with two regular stitches.  No nerve block this time.  Actually felt some relief that that screw was gone.  Was off the pain meds for two weeks but started again but only do once a day cause they make me sweat, sick to stomach and itch. 

He told me at that time that I could start "WB as tolerated" with PT and boot.  I was so excited, thought I'd be walking in two weeks or less.  And I was scheduled for a F/U 5/28/16.  PT didn't come for 4 days and only came twice, started me ROM and some weight bearing but it has been sooooo painful to bear weight, again, especially in the boot.  I do them every day but extremely difficult, I still think I'm hurting something due to pain.  Not just an ache, sharp shooting pain.  I am very weak, lost weight, sweat a tremendous amount when doing PT and get so exhaused easily sometimes I feel I am going to pass out.        

Two weeks post op appt. doctor said bone healed nicely.  I told him I was having a lot of trouble weight bearing.  Bearing 'partial' weight causes pain in entire leg, a lot in knee, EXTREME SWELLING in ankle and foot and toes after walking on crutches with boot ...  I can do it but only with a lot of pain, still pins and needles and discoloration and aching when foot down or showing with foot just slightly touching ground.  When doing the PT march, I have to still hold my weight with my arms on counter to put weight on right injured leg.  Am I being too agressive thinkng I should be able to stand on one leg, my injured leg, at this point after 11 weeks?  He didn't answer.  Can anyone out there answer?

He gave me a shot of cortizone in knee thinking some inflamation from the knee walker or a meniscus tear and said that should help with WB. 

It's only been 5 days since that appointment and I am working so hard each day to walk in boot, do excercises, massage, everything, etc, etc.  The shot did not help.  The pain and swelling has gotton worse and is today causing me to back off on the WB.  I should be hearing from PT today to schedule an outside appointment.  (How I'm gonna get there since I'm not cleared for driving is another story ...).  I actually feels as though the ankle is broken again, but now having more nerve pain in entire leg.  Even when I take a deep breath, cough or sneeze I feel an electrical shock in my foot.  Weird.   

My questions:  

1.  Have you all had cat scans and or MRI's prior to 1st surgery or was a plain xray good enough?  It seems to me that more investigation should have been done and something could have easily been missed.  Anyone have advice? 

2.  Should I request scan now and if so, what is best; Cat scan or MRI?

3.  At 11 weeks today and I am going crazy, depressed and overthinking every little twinge of pain.  Need some encouragement.  

4.  If I think I have nerve problems, what type of doctor should I see and what type of tests will they do?  

5.  OR is this just normal and just keep following this doctor's instructions.  

6.  I think I should be walking by now.  So many of you are walking at 8 - 10 weeks (again today 11 weeks since 1st surgery, 12 weeks since accident).  I know I'm 56, and that will take more time, but I think I should be full weight bearing.  Am I not being patient enough?

Surgerys:

3/15/16 lateral malleolus ORIF (think that just means fibular ORIF).

5/16/16 removal on long screw. 

Any advice is appreciated.  Seems so many of you have had worse situations/breaks and are recovering earlier.  Mostly concerned about future complications and causing more injury when WB since so much ache, shart shotting and nerve pain, swelling and other weird sensations. 

Thanks.  Sorry so long. 

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