trimalleolar fracture Rehab questions

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Hi all,

I fell at the end of June and broke my ankle in two places, dislocated it, and broke my fibua/tibia.

I had a 6 hr operation to improve things and had a lower leg nerve block. I was told by my surgeon that I had a very severe injury and should expect a 1-2 yr recovery.

I am in week 11 and can 'stand' without a boot, but I am very crooked.

My ankle rotation is poor but mainly because my foot swells up when its vertical. I wonder if I am doing too much as I loll around the house without my sticks or boot.

I saw my surgeon 4 weeks ago and he said I should try to transition from the boot, but didn't necessarily say walk about.

I have a question about my foot though.

My little toe and the toe next to it are numb, really numb. Alien. They feel like I have just trapped them in a door. There is a spot under the ball of my little toe that when it is on a flat surface and I catch it, sends searing pain through my body. It feels like a bone touching directly to the floor. My question is that after 11 weeks my little toe has not improved at all. Not a bit whilst my big toe and the next two have, fully.

Is this normal, and what might be causing me such pain? I'm not due to see my surgeon for another 8 weeks.

In terms of physio I have some basic rotations of the foot to do but I have only seen my physio once 8 weeks ago and its his first job and I am his first patient.

All comments and thoughts appreciated

Sam

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3 Replies

  • Posted

    just bumping to see if I can get any advice...爛 sorry

  • Edited

    Hi Sam,

    I'm sorry your injury was so severe. It sounds like you have a long road ahead of you, as far as healing. Sometimes, it is a good thing if you are your PT's first patient. He will probably be hyper focused on your needs and will do lots of research on your particular surgery. I would try and do as much PT as you can fit into your schedule. And I would start sooner than later. Did your surgeon give you the green light for PT?

    I also had a 6 hour surgery for the following (to remove a bone cyst/tumor inside my talus):

    Left Ankle Scope, Debridement; Left Medial Malleolus Osteotomy; Resection Talus Bone Cyst; Open Repair Talus; Osteochondral Dissecans; Left iliac Crest Autograft Harvest.

    I am about 6 months post-op. I also had a nerve blocker to help with the pain for the first 24 hours. I had a large portion of the top of my left foot that was completely numb for almost 4 1/2 months. I slowly started regaining feeling and now it is completely back to normal. The pins and needles, when my foot touched the ground, were unbearable in the first few weeks of weight bearing. I was given the green light for FWB around 8 weeks. However, I wasn't able to start taking steps until week 11 or 12; even then it was very painful. I am doing PT 3x/week. I still have limited range of motion but hope to regain enough to allow me to go for short runs (or maybe even get back to my long runs). I was very active prior to surgery. I have 3 screws that may need to be removed, as they continue to cause sharp pain in my medial malleolus (tibia); and my surgeon also thinks the scar tissue is limiting my range of motion, so I may need surgery to remove that, as well.

    Getting back to your pain when weight bearing -- the only thing I can say, from experience, is that you will have a lot of painful sensations that come and go. It's the ones that don't "go" are the ones you should be concerned about. Most of what we feel are nerves trying to repair themselves and it goes through all sorts of levels of pain, from numbness, burning, tingling, lightning bolts, and back to normal.

    Be patient with yourself and your ankle. This is definitely a LONG and SLOW process. You will go through times where you'll notice big changes and other times where you plateau and feel frustrated and sad. After 6 months, I still have so much soreness and stiffness in my ankle, it takes me almost an hour each morning to get my ankle stretched and ready for the day. I still have to ice my foot if I do too much daily activity.

    I hope this was somewhat helpful.

    Take care! 😃 Rhonda

  • Posted

    That dead feeling is a nerve thing that could heal in a couple of years. I had that with a wrist surgery years ago. I think you need another follow up visit to check the little toe pain and a better physio program.

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