Maisonneuve Ankle Fracture with ORIF My story at 4 weeks

Since fracturing my ankle in a fall, I've found it helpful to read other people's accounts of recovery as it gives me a sense of  what to expect and how I am doing overall.  Clearly, people heal and recover at different rates which expands the definition of normal.  

         I am 52 years old and and now I am now 4 weeks post fracture and 3 weeks and 4 days post open reduction and internal fixation surgery to repair my ankle.  I broke it coming down my stairs (in socks) and pitched forward with my hands out to prevent braining myself on our slate floor.  After recovering a moment at the bottom ( fell on the last three steps) I noticed my ankle was uncomfortable and sort of numb.  I went to get up on it and quickly decided that wasn't a good idea.  I figured I had a sprain and called out to my husband (a physican).  He examined it and thought it should be xrayed.  Xrays showed I had broken off the tip of the medial malleolus which is the end point of the tibia the bone that is towards the inside of the foot.  I had also snapped the fibula (the outside bone of the lower leg) almost 2/3 of the way up towards the knee.  Xrays also showed significant widening of the syndesmosis which is the area where the two lower legs bones come together. This is apparently the classic presentation of a maisonneuve fracture and requires surgery. The injury happened on Sunday and I had surgery by an orthopedic surgeon who specializes in ankle fracures the next Thursday.  I had an incision on the medial aspect of my ankle where two screws were inserted into the medial malleolus.  On the lateral aspecit of my ankle another incision was made and a plate and 4 screws were placed to bring the two bones back together.  Also I had torn some ligaments which were repaired.  Nothing was really done about the higher up fracture because it was in line and there isn't a lot you can do except rest it and let it heal. 

           From the beginning, the pain wasn't really all that bad, mostly numb then a kind of aching.  I was placed in a split cast to stabilize it  for the first two weeks.  Initially I showered by covering the leg with a trash bag and tying it closed then using a shower hose attachment while I sat on the floor of the shower with my foot hanging out the door.  I prefer baths though so within a week of surgery I was climbing in and out of the bath, covering the cast with the bag and propping it up on the side of the bath.  

          There were no specific instructions about dressing changes but knowing there were bloody pads on my legs bothered me so after a couple of days I went ahead and put clean dressings on with 4x4's and  wrapped up with long cotton bandage.  I then covered this with an additional dressing of self-adhering tape.  I massaged my lower leg and the incision with coconut oil.  

      I tried to elevate my leg as much as possible though that's hard when you've got a lot to do and are used to being busy.  I bought a cushion meant to elevate the leg.  My husband also bought a machine that circulates cold water through a pad he would wrap around my legs and I used this most evenings for an hour or so.  I used a wheeled leg cart for most of the first 2-3 weeks.  I found this incredibly painful over time.  I have always had some problems with sacroilitis but this raised the pain in my hip to andexcruciating level.  However I couldn't maneuver at all with two crutches.  As I said previously, I never had much ankle pain but I did consistently take pain medication for the hip and lower back pain.  The other major difficulty is that we live in a two story house and every time I needed something, it seemed to be on a different floor than I was.  Going up and down stairs was intensely frustrating.  I ended up having a large beach bag that I would load up and tote from place to place

           My stitches were taken out at two weeks and I was placed in a CAM boot.  The the wound has healed well.  I wasn't supposed to be weight bearing  until 4 weeks post op but I've been cheating mostly to avoid the pain the scooter produces in my hip and have been partial weight bearing for almost a week now and it gets better every day.  I saw the doctor today for followup and the xrays looked good with the joint spaces all looking as they should.  The bone in my fibula still shows the fracture but so far so good.  I was given a lace up boot and was told to progress from the CAM boot I've been wearing to the lace up boot as tolerated with followup in 4 weeks.  I'm also supposed to begin physical therapy in two weeks.

           I had already looked up some physical therapy exercises and been doing them at home so my range of motion is returning but not all the way there yet.  I also began driving a few days ago.  I had one doctors appointment where I took an Uber back and forth (the drivers were fantastic in helping me in and out with my scooter) but had an appointment last week and couldn;t get one so drove myself as it was only 10 minutes away.  

           I've never broken a bone or had surgery previously and don't like asking for help so this has been frustrating but overall seems to be turning out OK.  We;re supposed to be going to Europe in two months and I'm very determined to be up to the trip.

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