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Old 02-09-2012, 02:28 AM   #113
Beastly Adventurer
Joined: Mar 2008
Location: USA
Oddometer: 1,948
Originally Posted by PETDOC
[...]My left ankle when measured around the malleoli is 2 centimeters larger in circumference than the right ankle. It looks like a small tree trunk. The orthopedic surgeon said it will be a year before the swelling is gone and she suspects the swelling is the biggest impediment to me regaining normal range of motion
I had a very similar injury in spring of 2008: spiral fracture of distal fib, with some crushing at the end of the bone where it helps form the ankle joint. And a distal tibia break, cleaner than the fibula. I have a plate 6-8 inches long, carefull custom-shaped down by the ankle, and 8 rather long screws at various angles to hold it all together. I thought a long-term report might be of interest to you, now that you are concluding phase 1 recovery. The ankle size slowly settled at about 1.5" larger in circumference than the other one. No swelling is evident on most days. I'm not sure why it is larger, but it is, and I expect it to remain so.

Originally Posted by PETDOC
I asked about hardware removal. She said to wait for a minimum of 6 months. Based on research I discovered that with a plate removal the risk of re-fracture is 2% and virtually all occur within 90 days of the surgery. I didn't ask, but suspect at the very least after plate removal I'll be back in the boot for some time. My current plan is to schedule plate removal for November[...]
The plate and 8 screws are still in. I see no reason to have more surgery to have them removed, unless / until other work needs to be done. Occasionally it is an inconvenience when fitting boots or when a screw tip close to the surface catches or rubs on something. But mostly I have no issues with the plate and screws staying in there.

Originally Posted by PETDOC
I want to sincerely thank everyone who shared their experiences/advice regarding ankle fractures on this thread. When I sat up in the dirt after the crash and saw my foot flopped over at a right angle I didn't know if I would ever walk again normally. It was a very scary moment for me. I am ecstatic at how much I have recovered to date and now expect to eventually return to normal.
You might consider establishing a new normal. It may never be as strong or stable as it was. The bones may heal and approach former strengh, and with luck stay in good alignment to fit in with the matching bones at the joint, causing no further problems. The soft tissue damage may be a different issue. I have much less stability in the ankle now, and I attribute that to soft tissue damage. Along with the reduced stability, I get pain on the medial side of the foot, below the ankle, and pain in the arch area below. I think this is because the remaining soft tissue is insufficient to hold the ankle / lower leg in the joint properly, and it wants to slide to the inside.

Between the reduced stability and the extra give toward the instep, I need to wear boots, not shoes, with firm soles and footbeds with arch support that fits my feet. I wear Asolo leather hiking boots, after trying many makes, and they do very well. I wish they were 1-2" taller, since it would help to have support up as high as the damage goes. I also wear Sidi leather OnRoad touring boots a few days a week, The ankle box on these is roomier, so I use a neoprene compression sleeve around the ankle to fill the gap in a comfortable way so the boot supports the ankle better.

I limp on bad days, and occasionally need to take hydrocodone to dull the pain enough so I can sleep.

A few months ago, I was doing some heavy manual labor (moving a wheelbarrow full of dirt), and the ankle suddenly complained. For the next week I had a rectangular bruise outlining the plate and some blood pooling on the other side below the ankle. I think maybe the screws (or bone) gave somewhat and the plate moved, and the lower leg put unusual pressure on the inside of the ankle joint. It has slowly improved, but I may go back to the ortho guy and take a look at what has changed.

My suggesion, again, is to forget about "back to normal" and find a new normal; consider it as permanently weaker than before and act accordingly. And keep up the exercises long-term, to strengthen whatever ligament and tendon structural support remains.If that works, you should be in pretty good shape, and the new normal may approach the old normal. If not, welcome to the club; life goes on.

Ask questions if you have some specific area of curiosity. Best wishes.

derangedhermit screwed with this post 02-09-2012 at 11:29 AM
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