Recovery from ankle surgery

[Humpy D]

Can anyone give any tips to someone just discharged from hospital following a compound fracture of the ankle?

It's my OH that is the patient and is living downstairs as it was quickly obvious that stairs were a no-no. Thankfully we have a downstairs loo (posh).

I am aware that she can't put any weight on the ankle for at least a month (and probably longer) so all household tasks are falling to me. Thankfully I work from home so am on hand whenever she needs as she is understandably a little nervous using a frame to get around

Thanks

[K77 CTR]

Elevate, analgesia and follow any instructions given by physio. Is she is plaster or a boot?

[Humpy D]

She is in a boot. She had the ankle pinned on the 16 December after which she had a cast on which we understood was to remain on for 2 weeks. But a doctor saw her after about 5 days and said that the cast could be removed and a boot fitted. She is being seen next at the end of January.

She is sitting in a padded garden recliner with her boot on a footstool. The sofa would be more comfortable but is a little lower plus the recliner has arms that help her get up.

[Bill]

K77 CTR said:

Elevate, analgesia and follow any instructions given by physio. Is she is plaster or a boot?

This. Has she been referred to physio? Or had any instructions from the surgical team about whether/how much weight to put on it? They may well be waiting until after her next appointment - I would guess this is the case if she's been given a frame.

[Humpy D]

No physio until she can put some weight on it. I guess we are very much at the healing stage where the bones are starting to repair themselves.

[itcaptainslow]

Having almost completely recovered from a broken ankle and lower fibular which occurred in May (only thing I haven’t done since is play football, which is how I did it!), I’d highly recommend getting hold of some resistance bands and some sessions with a physio to guide how to use them.

Then the key thing-stick to the rehab exercise program and be consistent-it’ll be worth it in the long run for how quickly strength and mobility is regained and maintained.

[Cpt Stirling]

I broke mine late September. Metalwork removed last week and in transition to full weight bearing now. Physio booked for new year. The treatment depends on the damage and the individual so just listen and be lead by the advice given by the pros. One thing I wasn’t prepared for was the length of time it has/is taking to heal. Rehab is a long haul (predicted 12/18 months for me) so be patient with her.

[Humpy D]

Cpt Stirling said:

I broke mine late September. Metalwork removed last week and in transition to full weight bearing now. Physio booked for new year. The treatment depends on the damage and the individual so just listen and be lead by the advice given by the pros. One thing I wasn’t prepared for was the length of time it has/is taking to heal. Rehab is a long haul (predicted 12/18 months for me) so be patient with her.

That seems quite a time between when the break happened and physio to start. Any reason for that?

My OH had a call from the NHS physio team yesterday keen to get started but as soon as she told them she wasn't weight bearing they said they would contact her again in about a month.

[Cpt Stirling]

The reasoning was the physio wouldn’t start until the screws where removed. I had ORIF (Open Reduction Internal Fixation) surgery which stabilises the joint by connecting the tibia and fibula via screws. One week after removal now and I can put weight through the ankle whilst in the boot but there’s no way I can do that without. Hoping physio with strengthen everything up. Hope that helps. If you have any questions I’d be happy to answer them if I can.

[Humpy D]

Don't know what type of surgery she had and whether she is going to have to screws/pins removed at all. She had it all done at the Royal London hospital which I understand to be specialists in this type of thing.

How were you 'living' whilst in recovery? My OH is sitting in a plastic garden recliner padded out with loads of pillows. And this is where she sleeps too. I'd rather she was on the sofa for comfort as much as anything but the recliner is slightly higher and having arms and being plastic means there is no give and she can get herself up easier. And she has her legs on a foot rest.

[Cpt Stirling]

I left hospital in a cast and on crutches so could get upstairs to bed. 8 weeks in cast with leg elevated where possible I.e most of the time. The most comfortable for me was to lie flat with leg on pillows. Cast and sutures removed at 8 week point and into the boot and crutches but still non weight bearing up until last week. That period was frustrating and horrible. I must admit I had a couple of ‘moments’. All the general day to day tasks fell to my wife and to see her doing everything and putting up with my uselessness was humbling. She was and is brilliant and I’m conscious to try and keep the demands to a minimum but life as we knew it is basically on hold. I can move about now in the boot with no crutches. No way I could do so without the boot. I have no strength in my affected leg and the ankle still feels ‘vulnerable’. I’m sure physio will fix that. A big part of it is attitude so stay positive and be patient with yourself and your wife.

[Humpy D]

The length of time being immobile is a worry although I am going into this very much with my eyes open and know there is no quick fix. It's interesting what you say about being able to go upstairs as the physio at the hospital said that this was not possible at the moment although I suspect this is largely because my OH is using a frame rather than crutches. But even going upstairs on crutches must be an accident waiting to happen.

Glad you are on the mend.

[Bill]

It depends on the physical capabilities of the person, some people don't have the upper body strength to manage crutches full stop, some are fit enough just to hop.

[Cpt Stirling]

Humpy D said:

The length of time being immobile is a worry although I am going into this very much with my eyes open and know there is no quick fix. It's interesting what you say about being able to go upstairs as the physio at the hospital said that this was not possible at the moment although I suspect this is largely because my OH is using a frame rather than crutches. But even going upstairs on crutches must be an accident waiting to happen.

Glad you are on the mend.

Thank you for those kind words. Best wishes to you and your wife. Here’s to a speedy recovery. Happy New Year.

[numtumfutunch]

Humpy D said:

The length of time being immobile is a worry although I am going into this very much with my eyes open and know there is no quick fix. It's interesting what you say about being able to go upstairs as the physio at the hospital said that this was not possible at the moment although I suspect this is largely because my OH is using a frame rather than crutches. But even going upstairs on crutches must be an accident waiting to happen.

Glad you are on the mend.

I had much more extensive surgery and was initially non weight bearing too

Physio got me up with a frame on day 2 then up and down the stairs on crutches before discharge from hospital on day 8

Outpatient physio was shamefully resourced so I paid for one appt to keep me from seizing up completely. It was basically just stretching and some easy resistance stuff

I'd find out more about what your wife's allowed to do, her rehab sounds tough

And good luck

[Humpy D]

OH had an appointment yesterday at the fracture clinic and saw the surgeon. His advice was to start putting weight on the ankle although still to use the frame. This all seems very quick to me although it goes without saying that the surgeon clearly knows more than me about these things. Our fear is doing too much too soon and causing more damage.

Our plan is to arrange some sessions with a physio so at least they can advise exactly what can and can't be done.

[itcaptainslow]

I was told strictly non-weight bearing for six weeks post surgery, that was in a full cast.

Once it was removed (no boot, straight back on my feet, thank goodness), I could weight bear and start strengthening and training.

[Humpy D]

I suspect my OH's break was not as severe as yours. She was in a cast for less than a week after the op which pinned the ankle. That was then removed and she has an ortho boot.

I'm certainly not complaining about what the surgeon has said but it's just so different to what we have been told by others who've suffered seemingly similar injuries.

[drmike37]

There are so many variables that the only good information you'll get will come from fracture clinic. Anything else is just guessing. Bones take at least 6 weeks to heal as a rough guide. Open fractures (you said compound which is an outdated word meaning the bones were sticking out of the skin, we now say open) take longer generally. The fixation/fracture pattern may or may not be able to take weight during this period. Again, the only person who really knows is the one looking at the X-rays in fracture clinic.

Don't take this the wrong way, but is there a good reason why she's not hopping round on crutches? I'd expect anyone below retirement age with functioning arms to be getting on with it - crutches, upstairs on bum etc. I'm always keen on encouraging people to carry on with their lives as much as possible.

[Humpy D]

drmike37 said:

There are so many variables that the only good information you'll get will come from fracture clinic. Anything else is just guessing. Bones take at least 6 weeks to heal as a rough guide. Open fractures (you said compound which is an outdated word meaning the bones were sticking out of the skin, we now say open) take longer generally. The fixation/fracture pattern may or may not be able to take weight during this period. Again, the only person who really knows is the one looking at the X-rays in fracture clinic.

Don't take this the wrong way, but is there a good reason why she's not hopping round on crutches? I'd expect anyone below retirement age with functioning arms to be getting on with it - crutches, upstairs on bum etc. I'm always keen on encouraging people to carry on with their lives as much as possible.

Sorry completely missed this post.

She went to the fracture clinic yesterday and was told she needed to stay in the boot for another 6 weeks as an area isn't healing as much as they'd hoped as there is a piece of bone missing. (That would be the sliver I found in the towel I was using to stem the flow of blood immediately after the break!)

But they said that she should remove the boot as much as possible and even try to walk without it whilst using the frame.

As for crutches, I have asked the same question and was told by my OH that she doesn't feel safe using crutches although I would like her to persevere.

We are certainly going to get her upstairs in the next couple of days by whatever means possible!