Trimalleolar Ankle Fracture (w/ dislocation) - Progress Update
Posted , 9 users are following.
Hi everyone!
Firstly, Thank you for everyone that has posted about their experiences regarding ankle ORIF surgeries! The unknown is not a comfortable place and everything has been put into greater perspective with so many experiences shared here.
I have read many posts here, and while helpful, often do not continue along the road of recovery and that is what my intent is with this thread. I will catch you up with where I am now and I plan to check in on a regular basis to hopefully help provide the injured with a timeline/expectation. Just keep in mind that everyone is different and nobody's healing path will be the same - never be disappointed if someone is doing better because there is also someone doing worse.
I am a 36 year old, healthy, athletic male. I suffered a trimalleolar ankle break on July 9, 2022 during a cycling race. I felt my right ankle twist on the way down and when I took a look, my foot was pointed at 2 o'clock when my leg was straight - not ideal. Amazingly, I was in very little pain. I thought it was the adrenaline but it turns out that I was just lucky (or tough as nails 😉) as it did not hurt until after my Surgery 5 days later. The surgeon wanted to wait that many days because when I saw him on July 11, I had severe swelling and my foot was covered in fracture blisters. Also not ideal.
I had my surgery on July 14. My fracture blisters were still there but the surgeon was able to work around it. I am thankful for that as I hated the fact that I was wasting days waiting as opposed to healing. I have seen many posts of folks having to wait longer so I am lucky in this regard. I have attached my operation report written by my surgeon so you can read to see what went down. There is also a before/after XRAY picture of my ankle.
I was sent home that same day and went right to bed to rest. The nerve block was in effect so I did not feel much pain. The next day, it was manageable as well. Actually, for the most part, when lying down with my foot elevated above my heart, I was fairly comfy. But for the first 1-1.5 weeks, when I would stand up, the blood would rush to my foot and the pain was wicked. I dreaded getting out of bed to do something as quick as taking a pee. TMI - I peed in bottles and my wife would empty them. It really was that bad.
At week 2 I had a follow up appointment. They were to take me from a backslab to a hard cast for another 4 weeks. I convinced my surgeon to allow me to have a removable boot instead. I figured that if I can use the 4 weeks to work on my mobility, it would only help speed up my recovery. Cycling is my life and I just want to do everything I can to help myself heal ASAP and get back to doing what I love. He was reluctant because I think many people take advantage of this, remove their boot often and become prone to reinjury. I assured him that I would only take it off for my mobility work, will stay 100% NWB and will wear the boot always (except during mobility). I highly recommend this to everyone that is able to be disciplined and not put them in a position to reinjure.
I am now almost at week 5 and things are better. I am not really in pain anymore. When my leg is down I do pressure/discomfort but am able to work at my office for the day. I still try to elevate and lay down as much as possible. My mobility is increased but would likely be better if I started to see a physio. I was hesitant just because my doctor didn't tell me to see one and I also thought it would be better to start once I can bear weight - in hindsight, I do with that I started then. Moving my ankle up and down has progressed a lot but the lateral work or spinning my ankle in circles is just so hard to get going.
Next up is my 6 week appointment on August 24. If all is well, I can start to put weight on my foot. I have my first physio appointment booked for August 25 so I can begin my journey to independence. I will keep you all posted and I hope this thread can serve some sort of purpose for someone out there.
Words of wisdom: Good luck. It's s**t but keep reminding yourself that this is temporary. I found that focusing on each day as opposed to looking ahead truly helped me keep myself sane. As an example: don't think about how it will be 10-12 weeks until you walk or drive again when you're in your first week of recovery, as that wont do you any good... so just focus on getting past the day.
0 likes, 34 replies
je34918 DannyLev
Edited
thanks for this! im three weeks post injury, 1.5 weeks post surgery.
I'm trying to be optimistic, but some days its hard. its good to hear how recovery is going .
look forward yo see your future updates.
I also found the most painful thing that first week would be standing up with all
the blood rushing and swelling
pennie12643 je34918
Posted
looks like we got injured near the same time .
pennie12643 DannyLev
Edited
You are just ahead of me . i fell off a ladder 7-30 and have a bimalleolar fracture of the left ankle.
Luckily they took me to surgery the next day and i have a plate and 9 screws. i went back last Monday (2 weeks post op) to surgeon who offered me the choice of hard cast or boot he said if i was "younger and stupid" he would have insisted on cast. The boot is awful tho. its heavy and presses on my ankle bones . He said i could take it off when im in bed and to shower and even when im resting so now i hate to put it on. this all just sucks so bad. i go back in 4 weeks and he said maybe could progress to light weight bearing and PT At that time. Its so hard not to get down!
jacqueline07362 DannyLev
Posted
I've just discovered this site and wow it's helpful. There's so much doctors don't tell you- this is a steep learning curve. I'm a 58 yr old woman, broke my ankle (trimalleolar and dislocation) while hiking on August 8 2022. What a nightmare! They decided to keep me in hospital and do surgery the next morning as the ER dr couldn't get the bones aligned to my ortho's. satisfaction. Then they kept me a 2nd night because the surgery was so late in the day. So I'm nearly 3 weeks post break and surgery.
I experienced pretty much the same pain journey as DannyLev. Not a lot at first but boy did it kick in around Day 3 and 4. Now it's much better although the skin on my foot, ankle and incisions is incredibly dry and painful - it feels like my skin is about to crack open. i asked if I could put some kind of surgical barrier cream on the area but they said only around the foot, not on the incisions. I had my stitches out a week ago.
I have a boot and initially it was killing me. It's slightly better now. Mainly makes my toes and ball of foot turn numb with stabbing pain. One of the on-call doctors suggested I created a small heel wedge with either cotton or paper towels and that seemed to help. I started removing my boot when not moving around and also at night - letting my foot/leg just rest in it while sleeping, but with extremely loose straps. But today my dr's assistant said to try to keep it on 24/7. Ugh.
I have my first PT appointment tomorrow and I've been doing the point/flex plus rotation exercises 3xs per day the past week, plus stretching my Achilles with a yoga belt a few times per day. I'm sore at the end of the day but I am seeing a small improvement in ROM. I live in the Pacific Northwest and can't imagine my life without getting into the mountains a few times per week so, like you, am determined to heal thoroughly.
So far I've managed to stay positive and focus on "this too shall pass" though it's a tough one when you feel so helpless and dependent on others. I'm using a knee scooter. It's done wonders for making me feel a little more independent. At least I can get up and get my own cup of coffee or a snack!
DannyLev
Edited
Hi all!
Thanks for you comments 😃 It's great to follow along and hear everyone's experiences.
So I had my 6 week appointment and the surgeon was happy with my healing to that point. As I hoped, he gave me the green light to start putting weight on my foot while letting pain be my guide. He will see me in 6 weeks so the 12 week post surgery mark.
I had a PT appointment scheduled for the day after my 6 week appointment with the surgeon. The PT appointment highlighted my swelling, which is very apparent, and the goal of reducing it to help me increase my ROM. He manually manipulated my foot to increase my dorsi/plantar flexion. He said that it typically takes 8 weeks for the bones to heal so he doesn't want to be too aggressive in the early going but has no issues with being aggressive after 8 weeks which is my wish. He gave me exercises similar to what I was already doing.
The day I went to my PT, I was already walking smoothly with 2 crutches. He didn't think that I would be able to go down to 1 crutch for my appointment today (based on how recently I've been allowed to bear weight) but welcomed the chance to be pleasantly surprised. It's been wild what progress is made daily. Yesterday, I was using 1 crutch but could not do a full walking stride and it was not smooth. Today, I can use 1 crutch smoothly... and not just that but I can hobble around with no crutches and feel no pain. I predict that I will be walking with no crutches in the boot within 2 days (if he allows me as I do not want to risk reinjury). Would not have imagined this less than a week ago.
pennie12643 DannyLev
Posted
wow!! yay!! i have 20 days until my appt to go back to surgeon but who's counting? that was awesome for you!!
jacqueline07362 DannyLev
Posted
Danny Congratulations and what great news! This is inspiring and very hopeful!
I had my first PT appointment on Saturday. She was thrilled with my ROM and said it was most likely because I'd started my exercises the moment I got my cast taken off. My doc had said it was ok to do circles, point and flex plus achilles stretches 20-30 at a time, 2-3 times per day, so that's what I've been doing. So glad I started as PT said ROM was much more than she'd expected!
I've also been trying to eat and supplement with bone building things: Vit D3, extra protein, calcium and mag.
I've still got 22 days until my 6 week check up. Your post has definitely brightened my day!
DannyLev
Edited
Ha! Pennie, you probably aren't counting the days... but hours, minutes & seconds. Very relatable. Always remind yourself that this is temporary because it is.
Jacqueline, that's great to hear re your ROM. One regret that I had was not asking if I could start physio at the 2 week appointment which is when I got put into the removable boot. I was doing the prescribed exercises until week 6 but am sure things would only be better if I'd started PT earlier. Regarding supplements, I'm taking my multivitamin, collagen as well as a D3+K2. I have also been making sure my protein (and calcium for that matter) intake is high.
I had a physio appointment yesterday, this one was a shorter visit, he basically just did more manual manipulation to help increase my rom by stretching the ligaments and whatever else keeps it tight. He also bent my foot in all kinds of directions, trying to open up the bones for the purpose of getting the fluid that is normally keeping things oiled back. He also pressed hard on the bottom of my foot where the arch, pressing from heel to toes. That really hurt but I'll take any pain as long as it is doing something beneficial lol He liked my stride/progress to one crutch. He told me that I can start attempting to walk without crutches this weekend. Not bad for 5 days after the 6 week appointment! (The weekend will be 10 days after the 6 week appt)
Today I went for an appointment for Bioflex laser therapy. This therapy's efficiency will be harder to gauge than PT but some of my friends had amazing results and I'm willing to give it a shot - it certainly won't hurt.
You are both halfway there! Let's gooo!
jacqueline07362 DannyLev
Posted
Danny I have to look into Bioflex laser. I've not heard of that. Interesting...
Your physio sounds a lot more intense than mine but then I guess I'm not as far along on the healing as you are. She does very gentle massage with me and only super simple ROM exercises.
Incredible that you are so close to walking without crutches!! Once again, your post is very inspiring.
I am trying to decide whether or not I should attempt a 5 day business trip to San Francisco this week. I'm feeling a lot of pressure to be there, in-person but am of course quite anxious about it. I did manage to find a flight where I can book a whole row for myself (and using miles!). I think I'm most concerned about working 8 hour days while there plus getting to and from an office using Uber. I wanted to do one 2 weeks ago but my dr. said, "I'm not saying no but I am saying you'll be miserable the whole time and I wouldn't do it if I were you" so I canceled that one. But I'm definitely feeling much stronger than I was 2 weeks ago. So...I don't know. Still on the fence about it. I am self-employed so that makes it even tougher.
Hope everyone is having a good weekend!
DannyLev jacqueline07362
Posted
That's a tough decision to make. Did you end up going?
jacqueline07362 DannyLev
Posted
I did! And while I'm glad I did it, I will say it's not for the faint of heart. Traveling solo with a broken ankle is HARD. Should anyone read this post in the future: consider carefully before doing it. I'm exhausted and so happy to be home!!
Happy to hear your transition to walking is going so well. Sounds like you're riding a bike with a boot on? Wow, that's hard to imagine how you're managing that. I am encouraged that you got the green light to walk after only 7 weeks as my surgeon initially told me 9 weeks. I have my 6 week check-in on the 20th and am hoping I don't have to wait an additional 3 weeks after that before I can walk.
DannyLev jacqueline07362
Posted
WOW! You definitely are brave. Kudos to you for doing it. I'm sure time passed faster doing all of the travelling and work related stuff.
Yeah, I am riding with my boot on. I did a couple outdoor slow rides and am now riding on my indoor bike so I can put in a bit more effort. I managed 45 minutes on constant pedalling yesterday which was great. Cycling is non weight bearing so it's great for recovery - the only downside is the boot as I don't really love the idea of getting it sweaty.
I booked a physio appointment the day after my 6 week check-in and I would suggest to do the same. My doctor gave me timelines as well but those timelines are usually very conservative and based on the general population. So now I go by the timelines my physio provides which is based on my progress as well as my age and athletic background. For example, my doctor said I would be able to drive when I feel that I can slam on the brakes which he estimated would be the 8 week mark. I went over to a parking lot, practiced going from gas to brake and pressing hard on the pedals for a few days and was driving 5 days later (6 weeks, 5 days).
Have you began to think about walking with the support of 2 crutches? I remember in the days leading up to my 6 week appt, I was starting to put my foot down as if I were walking on it but without actually putting weight on it.
jacqueline07362 DannyLev
Edited
Oh just saw this one about driving. That's so great you're able to do it! Next week will be my 8-week mark so I am hoping I can try it then. My dr said to "practice around the neighborhood" but we live on a small farm with only steep dirt roads around us and then the next road is a busy highway. Ha! I'll have to see if my husband can get me to a parking lot to give it a try.
Funny you asked about me trying to walk prior to my 6-week check-in. When I went in for that, my dr's assistant asked me if I'd tried putting weight on it yet. She said a lot of people get brave and try before their appt but nope, I didn't.
Even though it hurts, I can definitely see progress each day. I'm walking further and longer. My home office is about a 3 minute walk from our house - down a forested path. The terrain is pretty uneven so I don't do it without my husband with me and it takes me a long time to make it but I've been making it down there nearly every day.
Hope you're doing great and healing is going smoothly!
DannyLev
Edited
I had a physio appointment today and I got the green light to start walking with no crutches (boot on of course)!!! I'm at 7 weeks post surgery.
pennie12643 DannyLev
Posted
wow!!! how does it feel? 16 days left to sit here!
DannyLev pennie12643
Posted
10 days now! You are pretty much there. I'm excited for you!
jacqueline07362 DannyLev
Edited
Hi Danny
Congrats on walking without crutches! I wonder how it's going for you now?
I am coming to the end of my 7th week. I am still walking in the boot with both crutches. It's pretty painful but, as you said, manageable. It's mainly on the inside of my ankle, up through the calf. My PT has me in a shoe but only for a couple of exercises: standing with hands on counter or using crutches and shifting my weight front/back then side to side. She thinks next week I should be able to start walking in a shoe, with crutches. She thinks the pain is mainly from tight scar tissue and muscles that haven't been used in several weeks. She does a lot of massage in our sessions and encourages me to do the same. I find the pain is worse at night but icing and ibuprofen seem to help. Oh and she also has me doing some resistance exercises - flex/point and side to side using my hand for light resistance.
Have you started driving yet? That's what I'm most excited about at this point. I'm hoping I can try it next week, along with the shoe walking.
Onward to a speedy healing for all of us!
Jacqueline