I am in week 4. and my doc says i have to start wb!

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I had my ankle surgery 4 weeks ago and i have the following questions

1) my doc says that i should start Weight bearing and no one online agrees that patient should start WB before week 6, what do u think?

2) anybody have experience to read the x ray in week3

3) when usually Ankle surgery patient go back to normal walking as before the surgery?

4) when should I start PT

 

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  • Posted

    Hi

    I am waiting for surgery in July.  Having tendon repair, ligament repair, broken fib repair and a brace fitted inside ankle. 

    I have been told 2 weeks in plaster and 3 weeks in a walking boot.  Seems a bit too soon to me as when I had a lesser surgery done 9 years ago that was 8 weeks in plaster no weight baring.

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  • Posted

    Can you tell us exactly what you had done and something about you so that we have a chance of giving you some worth while help.

    Cheers Richard

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    • Posted

      I am very concerned about my surgeon, his instructions is always against what the rest of the world recommend, addtional to asking me to weight bearing in week 4, he's asking me to remove the 2 screws in 2 weeks (6weeks post the surgery). my surgery is ORIF after i had ankle displaced as you can see in the attachment

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    • Posted

      Thanks for that. The X ray is so overexposed that the important detail is lost unfortunately.

      Due to having had total ankle replacement and a subsequent revision my ankle knowledge is limited to these procedures and problems but I would not expect to be weight bearing in just four weeks and given that taking the support screws out at six weeks seems rather early.

      Can you cause a delay by being on 'holiday' or something? As an alternative how about writing to him expressing your concern and asking him to confirm in writing to you that this is a recognised and a safe thing to do, it flags up the possibility and should make him take stock then if things go wrong he will be in a very difficult position.

      Hope this helps. Richard

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    • Posted

      I have decided to take another X-Ray on week 6 until then no weight and this is a personal decision . and then ask for a second opinion. so when usually the screws are removed? week 10? 

      Thank you for sharing thoughts. 

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    • Posted

      hello. i cannot see your xray but do the two screws go across your ankle? if they are then yes, surgeons usually remove them at an early stage 6-8 weeks from ORIF (syndesmotic fixation/ syndesmotic screws).

      about the weight bearing, it depends on your case some surgeons let you weight bear as tolerated if he believes your bones are going to heal well. the plates and screws are there to support fracture. normal cases are non weight bearing for 6 weeks (thats what my surgeon told me and most of the literature online) however in my case when the surgeon saw my xray at 6 weeks i was asked to stay non weight bearing for another 3 weeks. so i was non weight bearing for 9 weeks total. ive seen 4 surgeons in total and they all have different opinions. i am now 14 weeks post surgery now full weight bearing but im still walking with 2 crutches. i can move easily with one crutch but slow. and i also started walking, just a few steps without crutches everytime im at the physio. i have been going everyday from week 13 but i started doing exercises one my own since the day after the surgery just calf pumps which was what my operating surgeon told me. some surgeons are conservative and some are aggressive. my advice is to do what you feel but also listen to the experts and listen to your body. you will walk before you know it smile

       

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    • Posted

      Thank you Anne, very helpful. May I ask how old are you? and what you had exactly? you can see my 2 weeks post surgery xray... 
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    • Posted

      I just turned 33 few days ago.  Broke my ankle (trimalleolar fracture) 3 months ago skydiving. The person who saw me said i flared too low. so yea as i was landing i felt a wind gust from behind me and my foot just hit the ground hard then bam! Its been tough.. i dont know when i can jump again. or if i will have the same passion for it once im back on my feet. 

      What happened to you?

      i can see your xray and it looks good in my opinion smile  also your surgeon is correct, those two long screws need to be removed. its normal to remove them. you can read about it online. Trust him he knows what hes doing. 

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    • Posted

      I slipped and fell on my ankle, im too scared of the idea that I might limp for a long time or won't heal or require correction! i am struggling already staying home until i start walking and back to real life. 

      so you think it's good but you're not a bone specialist :P i need a more rational opinion lol.. 

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    • Posted

      It is a long process but you will get there smile  i cried everyday the first two weeks and now i dont cry anymore.  its nice to have a good support system. just keep busy and eat well always. and make sure you get a really good physical therapist when you are ready
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  • Posted

    Hi Kilany. I'll try to answer your questions if I can. 1. I am ten weeks post surgery. Bimolleur fracture of left ankle plate and 6 screws. Had boot on 24/7 including sleep until March 26. Just started weight bearing. 2. My x-ray showed full placement of bone correctly on 3/26. 4. Started PT the week of 3/26 go twice a week. Don't have a answer for three yet. I'll keep you posted. Take your time. Better safe than sorry. Take care.

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  • Posted

    Hi Kilany,

    Yes, I believe the norm is for an ankle fracture patient to start partial weight bearing (in the moon boot) at around 6 weeks or so. That was true in my case.

    We are hearing more stories about practitioners pushing their patients into weight bearing as soon as possible, even before 6 weeks (assuming patient x-rays validate bone mending).

    I have not heard of any clinical studies that support or disprove the early weight bearing theory. I do not know what to believe.

    What is important is your individual case. If your doctor does not give you explicit instructions otherwise you would be advised to bear only partial weight as tolerated at first (don't get greedy and try to make it a marathon sport at first-- patients who do this usually suffer the consequences).

    Remember, nice and easy at first does it right.

    You will need crutches or a walker (frame) as tools to properly manage your percentage of partial weight bearing.

    Normal walking (in regular shoes, without boot) can happen around week 8, more or less. That doesn't mean however that walking will feel normal. Many patients deal with a limp and pain for some time after they throw the boot away. Limping should subside fairly quickly (there are exceptions of course) but pain and swelling can persist far longer than you can imagine for some patients.

    You should have started physiotherapy as soon as you had permission to wiggle your toes with boot off. Now you should be actively engaged in progressive ankle rehab exercises to: strengthen and stabilize your ankle soft tissue, improve balance and gait, and good joint alignment in preparation for returning successfully to normal life.

    Ankle rehab, in my opinion, is not a one-time thing but should be a regular, ongoing practice to ensure any gains you get will stick-- that you will not slip back to an unstable ankle (which can lead to chronic, progressive ankle dysfunction leading to arthritis).

    Best wishes.

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    • Posted

      I have started to be concerned about my surgeon, he's pushing for 4 weeks weight bearing! and he's asking me to remove the screws in week 6 post the surgery! this makes me wonder and ask for a second opinion about my 2weeks post the surgery's xray as attached! what do u think?

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  • Posted

    I had a ORIF after I broke my ankle. but I want to make sure that the bone has been fixed correctly, because I have only two screws without any plate. do you have experience of reading my xray?
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