Advice on recovery from ankle fracture

Discussion in 'Face Plant' started by PETDOC, Nov 18, 2011.

  1. doxiedog

    doxiedog Been here awhile

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    Go slow!
    My son started running around ,as soon as his cast stoped hurting.
    Resulted in a second surgery a year later.
    #21
  2. Sabre

    Sabre PrĂȘt? Allez!

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    Sorry to hear about the injury, and glad it wasn't worse.

    First things first: an ankle fracture that requires surgery is a big deal. Disregard anecdotal information ("I broke my leg once and...") because none of these folks have had fractures exactly like yours. It's a big deal.

    For the short term, get your foot up! I'm surprised to hear about you sleeping like that. To really reduce pain and swelling, your ankle should be elevated WELL above the level of your heart. Sleeping on a sofa with a massive pile of pillows is a good way to do it because the back of the sofa supports the pile from toppling over and you can prop your foot up there.

    Spend as much time as possible with your foot up during the day. It hurts so damned much when you're up and around because your leg is in a dependent position. Elevating it can dramatically reduce your need for pain meds.

    Some folks really like ice packs, and they are very effective at reducing swelling. Of course, with a fiberglas splint you're not really getting much cold into your tissues, but you might try it nevertheless.

    Don't be afraid of the hydrocodone, but beware the constipation! Lots of fluids are called for; it's virtually guaranteed that you're dehydrated because it's a pain to get up and pee all the time. Consider taking docusate sodium (Colace or Doss) once or twice a day along with a couple of senna tabs (Senokot). Eat fiber-rich foods, and use Metamucil or some other psyllium product if you need.

    Talk to your orthopedic surgeon before using NSAIDs (non-steroidal antiinflammatory drugs) such as ibuprofen, aspirin or naproxen. Such drugs tend to impede healing. Also, meds such as steroids, thyroid supplements and antiepileptic drugs can impair healing, and your surgeon should be told if you use any of these. Diabetes is a huge impediment to healing, as is smoking and excessive use of alcohol.

    How long will it hurt? The sad and realistic answer is, "a long time." It is not unusual for an ankle after ORIF (open reduction with internal fixation) to be swollen and painful for a year or more, depending upon the type of fracture(s) and the extent of repair needed. Many folks report a great result after 9 to 12 months, but it's also common to see swelling and pain persist for a couple of years. Fractures such as this are life-changing; the duration of that change is extremely variable. In some cases the person will want some hardware removed after a couple of years, but this isn't routinely the case. It is most definitely advised to return to your orthopod after a year or two if you're still experiencing pain.

    You're a long way off from physical therapy, but being dedicated to your PT when the time comes will give you the best chance at optimizing your recovery. Maintain good nutrition and the best physical conditioning that you can, as these also improve healing and help prevent compensatory injuries.

    Good luck!
    #22
  3. ruttingstag

    ruttingstag n00b

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    I was offroading and came off, the bike slid over my foot rotating my foot, had a dislocated ankle, broken fibia - plated and 5 screws next to the ankle also fractures in most of the metitarsal bones in my foot.

    I found the pain incredible for the first few weeks.
    No cast, I also had the big ski boot for 6 weeks with no weight bearing, crutches for 6 weeks.
    I found the swelling really bad.
    I kept it elevated all the time, pillows under it in bed so that my foot was allways higher than my head.
    For the first week I put a plastic bag over the dressings in the shower and sat on a plastic stool or later stood on one leg.
    Lots of ice on the ankle, but what gave me most relief was putting my foot in the shower with freezing cold water and spraying it for 10 mins every couple of hours when the swelling was really bad.
    I really had to push the hospital to get me physio on my ankle and that is really important almost right away.
    Try to get the ankle moving as quick as you can to stop you losing the range of movement as its hard to get it back as it feels really tight.
    I had 9 months of physio which helped a lot and after a year my ankle was at 80%.
    The metal work was causing me a lot of problems with swelling and sharp stabbing pain over the 18 months since the surgery and I pleeded with my doctor to get the metal work out.
    I went back into hospital in January this year and got the metal work out.
    Wow! a few hours after the surgery if felt great 90% back to normal and 3 weeks later 99%.
    No pain , no swelling and full movement back.
    First thing I done when I started off road riding again this year was buy the best motocross boots with the most protection I could get.
    #23
  4. Pantah

    Pantah PJ Fan from Boston

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    I was 51 when I broke my right ankle. I went for a Thanksgiving trailride with my son's and wore street boots. Snagged my toe on a rock climbing a powerline trail. Most debilitating injury I ever had! It was hard just getting me down to the truck!

    No surgery, but had the fiberglass cast to just below the knee and crutches for 8 weeks. Then a new cast so I could walk a little for another 8 weeks or so. I was riding again after that. I've had no problems since. I broke my shoulder in 1981 in MX. It still gives me problems, so I am glad my ankle came back 100%.

    Your pain should start to fade after about a week. Should be painless after another week. I took non-prescription pain killers for a few days.

    I got a kick out of your bath solution. I did exactly the same thing. :lol3

    If your pain persists you should press the Doc. Something must be wrong.

    Good Luck
    #24
  5. Fluffy Bunny Feet

    Fluffy Bunny Feet Adventurer

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    Sorry to hear about your ankle. Just as others on here are saying, each ankle injury is unique. In my opinion, ankle injuries just plain suck.

    Personally, I broke my left ankle back in 1998. To make a long story short, 4 surgeries, a sub-talar fusion and lots of PT later and life is good.

    Good news is that if you play your cards right, you’ll be able to walk again without pain. Bad news, if it was anything like mine, it’ll hurt a bit before you get there. When I say a bit, I mean a lot. It will get better, but it may take a while. You’re doing the right thing by finding others with similar injuries. It helped me out considerably once I found others that had gone through it before.

    Keep in mind that everyone has their own opinion. With that said, I can say:
    -Do what the doctors say. If they say stay off your feet, do it. They usually know what’s best.
    -Don’t push yourself too hard. I was really good at pushing myself way beyond what I should have and it usually hurt.
    -Pain management. You’re on the right track, in my book. The pain meds were a wonderful ride, but I pray that I never have to go on it again. I couldn’t wait to get off of them. Anymore I wont even use Ibuprofen. I had a tens unit for a time, it worked great.
    -Eat healthy, pretty much goes without saying.
    -Ice is your friend, heat is not. A bucket of ice water for the pain, stick it in and relax.
    -Physical Therapy/Exercises, sure it sucks short term but helps long term.
    -Everyday footwear is crucial. I found Rockport shoes to be my salvation.
    -Don’t be afraid to call it what it is, a lifestyle changing injury. There might be a blue placard available to you, don’t let pride get in the way. A gimp parking pass can be very useful. I don’t use mine often, but when I need it, I need it. Your physician should be able to supply the needed state paperwork if you need one.

    Hang in there, there is a light at the end of the tunnel, it will get better. Send me a PM if you need someone to rant at, I’ve been down the path you’re heading down.
    #25
  6. GaM

    GaM Long timer

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    This. I had a ligament come off in the ankle, the ligament didn't break, it just pulled a piece of bone off with it when it let go. I still can't balance on that single foot. You don't realize all of these continuous microadjustments your foot is making to keep balance. I didn't do any PT and the range of motion sucks in it now.
    #26
  7. scooteraug02

    scooteraug02 Dog Rancher

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    Isn't is just a mental challenge at this point? Your doctor gave you a time line but right now you probably can't imagine the pain ever going away. Hang in there, think positive and it will heal.

    I got into bicycles and they are talking about recovery socks like diabetic socks. When you can wear them they should improve circulation and help expedite recovery a little.

    [​IMG]

    More info.
    #27
  8. PETDOC

    PETDOC Long timer

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    Thanks to all for their input.
    I saw the orthopedic surgeon today; 9 days post-op. Her assistant took me to an exam room and removed my bandaging, splint and skin sutures. She was oohing and awing at every new view. Last time I saw my ankle was the day following the surgical repair during a bandage change in Spartanburg, SC. It was swollen, but not too badly. Today what I saw was hideous. Incredibly swollen (i.e., couldn't get much worse before exploding), and black and blue. I then had radiographs taken. The surgeon came in with copies of the radiographs, showed them to me remarking the repair was well done, and then after examining my foot said "Looks pretty good". I'm not sure of my exact words, but they were pretty close to "You've got to be kidding me." She said "What were you expecting after dropping a 500 lb motorcycle on your ankle? Looks pretty good to me." Point taken.
    I'm now sporting a blue cast. I had a choice of a dozen colors, but I selected one that would most closely match the color of my calves. Before the cast was applied I had to stretch my Achilles tendon. They brought in this rather simple contraption, I'm sure dates back to medieval times, on which I had to place the ball of my foot and press down until getting the foot to the correct angle, then hold it. It hurt like hell! I was repeatedly assured if I didn't achieve the optimal angle they had a guy who would come in and assist by rolling me on my stomach and flexing my foot. My bet is they keep him in a closet til needed and he looks like a Hun. While uttering many 4 letter words I got it done. Two weeks and I go back for more.
    The pain seemed to reach a crescendo 5 days after the surgery. I'm now coping well with 2-500 mg hydrocone tablets spaced throughout the night. I was told to keep my ankle above my heart to reduce the swelling. This was already recommended by a response in this thread. I told the surgeon despite being advised not to take a shower or bath I had done both. She said she didn't care what I did as long as I didn't get my cast wet.

    Dave
    #28
  9. scooteraug02

    scooteraug02 Dog Rancher

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    Dave,

    Out of concern I tell you about a guy on the Yahoo XR605R forum. I was looking at the pictures he posted on the forum. He shows his swollen ankle and his wounds, Then I see a nub at the knee....I read more and find out he crashed, smacked his leg pretty good then 2 months later the doctor said he wasn't getting circulation due to nerve damage and they amputated his leg at the knee.

    When you mentioned it looked bad it reminded me of the XR650R guy. Keep an eye on it and heal quickly.
    #29
  10. Guano11

    Guano11 Behind Bars....

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    Seems to me somebody would've invented a breathable (dryable) cast material by now. Just sayin'....
    #30
  11. gofast1320

    gofast1320 Been here awhile

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    Broke my right ankle in 98. No surgery or pins required. Did have the the cast & crutches 4 weeks, no weight on it, then the boot. Hurt like the dickens seemed like forever then it didn't.
    I did do everything the Dr said as far as no weight for so long, minimum activity, keep it propped etc, etc, etc. etc
    Every once in a while when its cold or wet I might get a twinge or two.
    #31
  12. PETDOC

    PETDOC Long timer

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    I have had a few animals with limb fractures that also sustained permenant nerve damage. The loss of limb function and tactile sensation caused them to drag the leg, eventually necessitating an amputation even though the fracture was repaired.
    I suspect the guy's problem that led to an amputation was either damaged vasculature or the development of a subsequent thrombus. Thus far my existing vasculature seems adequate, but I'm certainly at risk for both local clot formation and subsequent thromboembolic disease; same thing that happens to a few people who fly long distances, but with different predisposing factors.
    #32
  13. PETDOC

    PETDOC Long timer

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    I believe all the cast padding and bandages under the fiberglass shell is the issue and not the casting material itself.
    #33
  14. PETDOC

    PETDOC Long timer

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    Sleeping in a cast vs. a splint was wonderful. For the first time I was able to roll over to either side and onto my stomach without eliciting severe pain. Because of the foot elevation issue I still spend the vast majority of my time on my back, but it is relaxing to be able to periodically roll over onto one's side.
    My wife has been great researching all the ways to adjust and use crutches correctly, and miscellaneous other things that might benefit my comfort/healing. One thing she found that is fantastic is a Cast Cozy http://castcozy.com/Castcozy/Home.html I give this my 5 star ranking. Anyone who is sporting a cast with exposed toes will be forever grateful if you send them one of these. I could attach all my MOA rally pins to the toe if desired.
    I found a good inclusive article on the nutritional aspects related to bone fracture repair http://www.betterbones.com/bonefracture/speedhealing.pdf Many of the items discussed have been mentioned in contributions to this thread.
    #34
  15. craigv

    craigv Adventurer

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    Hi,
    Sorry to hear about your accident.
    Being a skydiver for the last 20 yrs, I've had a cpl lower leg breaks.
    I use a cast cover for showering, it has a huge opening with a very soft & pliable rubber seal that you pull up over the cast to bare skin, then push back down a little to form a nice seal to your skin. Mine is very similar to this one:

    http://compare.ebay.com/like/200296436256?var=lv&ltyp=AllFixedPriceItemTypes&var=sbar

    Also, I make sure not to rush recovery & to optimize my rehab.
    Stay off foot as long & as much as possible until told to use it.
    I've had friends thru the years give lots of advice for healing as well (although I've never investigated these, I've broken both lower legs twice & have a little hardware with about 95% recovery, now it's been so long I don't even remember what the last 5% felt like)

    Fresh pineapple (especially the core)
    Good Yougurt, with fresh fruits & almonds
    Berry Greens (product I mix with water or apple juice, ph balances the blood & promotes healing?)
    No alcohol
    No smoking of anything

    As soon as the cast comes off, & with doc's permission I go straight to daily Epsom salt soaks. My technique is to use a kitchen type garbage pail (new) and to make the bath using a physical therapist receipe:
    Boil a large pot of distilled water
    add epsom until completely saturated, as in the salt crystals no longer break down & get absorbed, you'll be amazed at how much salt the water will take in.
    Cool, fill pail with cold solution with foot inside to avoid overfilling, add Ice
    Soak as long as possible every day
    Solution can be reused multiple times, you'll know when to make more

    Good luck, & +1 on GOOD BOOTS
    #35
  16. PETDOC

    PETDOC Long timer

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    My accident and multiple posts to this thread have given me a lot to think about regarding suitable boots for my future on-road riding. I had finally graduated to a pair of Daytona Road Star GTX boots and have really liked them, but realize they would do nothing to stop a similar accident from occurring. A couple persons have posted they wear MX boots for on-road riding. Virtually all of my riding consists of long cross country solo road trips, mostly on back roads vs highways, and I don't want another ankle fracture. I'll start looking at some MX boots.
    #36
  17. Guano11

    Guano11 Behind Bars....

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    Well then somebody oughta provide dryable or disposable padding & bandages in a repackable cast.
    It seems like a common, yet solvable, problem. Kinda like the cast cozy, it ain't rocket science. Just sayin'
    #37
  18. PeterW

    PeterW Long timer

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    I havn't broken bones, but I managed to turn a foot round 180 degrees one day. If I'd had decent boots I'd have dislocated a knee as well ;), so I'm not sure "great boots" is the whole answer here.

    Riding the bike wasn't a problem, but I learned pretty quickly to give table tennis a miss for a year or so.

    Three years later and consistent and progressive exercise and the ankle was 100% - but it did take time. My experience suggests that the trick is - don't injure it again, how you achieve that - your call.

    Pete
    #38
  19. B1

    B1 Carbon-based bipedal

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    i think good mx boots reduce your chances of fractures a lot, but not completely. i must admit even the heavy duty oxtars didnt prevent four fractured metatarsals in my foot a while back when the DR slammed down on my foot. but i figure the foot could have been completely crushed in a cheaper set of boots...

    on the whole ATGATT theme, our mob have been pushing knee guards too when dirt noobs join us. had a guy show up the other day for an gentle beginner's ride in jeans and a pair of work boots and i suggested he should have at least a pair of cheap mx boots and set of knee guards for trail riding. said he'd get some in the next few months.

    thirty seconds into the ride he dropped the bike and had a badly scraped shin from knee to ankle. then some riders have been wearing gear like that for 30 years and never had a scratch on their lower legs. guess it's luck of the draw...

    hope you are back into things again soon, petdoc.
    #39
  20. scooteraug02

    scooteraug02 Dog Rancher

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    Here's a good thread to look at: I Want A Pair Of Boots That Do It All !!!

    [​IMG]
    Alpinestar Tech 7 about $300

    [​IMG]

    Sidi Discovery Rain about $300 too.

    I had the Tech 7s for dirt biking then got the Discovery's for riding the GSA on the street. You can smack some tree stumps and downed logs pretty hard in the Tech 7s and not get injured. My friend with bad knees thinks a strong boot will transfer the damage up to his knee so he prefers wimpy boots.

    Look at some trials riding boots too.

    This place http://trialstrainingcenter.com/ is about 150 miles away. Trials 101 is good cross training. It is motorcycle physics.
    #40