ROLE OF PHYSIOTHERAPY IN BROKEN ANKLE RECOVERY

Physical therapy helps us in improving ankle mobility, regains its strength and helps performing normal activities and function. This article will provide you a number of important easy to follow broken ankle exercises which you can perform at home.

Caring your injured ankle matters a lot. So do pay attention to how your ankle is during healing. Physical therapy is most helpful during middle and later stage of recovery. In early stages, when the plaster is on, keep moving your knees and toes to prevent the stiffness..

When your plaster cast is removed, start moving your ankle. You will feel uncomfortable, this is normal as it was not moved for a long time. You may be advised to avoid certain activities initially by your surgeon. If no restrictions are advised, use your ankle as pain allows.

After plaster cast removal, your surgeon will explain you all about Pain, Swelling, Stiffness and Strength which is very very important for you to know.

PAIN:  Yes you will have pain and discomfort. With the help of homeopathic medicines which I have suggested in my previous posts, you will be able to manage the pain and will be able to do exercises.

SWELLING:  Your ankle may swell on and off up to one year following ankle fracture. This is normal. There is nothing wrong with your ankle. If the pain and swelling becomes severe or if it remains continuous then visit your doctor.

Use Ice Pack to reduce swelling and Elevate Your Foot while sitting also and at night rest your foot on the pillows (above heart level).

STIFFNESS:  There are two reasons why stiffness seems to last a long time post surgical.

1. There is the joint itself. After injury, the repair process can be damaged and slow to return to normal.

2. Muscles shorten up and the cartilage in and around the joint becomes unable to slide and glide.

To reduce stiffness, move your ankle as much as possible after plaster cast removal. Give yourself 4 to 6 weeks to regain your full range of motion. With walking and exercises, stiffness will be reduced.

Strength (power):  Ankle may feel weak, as it has been not used while you have been in plaster. To get the power, gradually increase the use of ankle and walking as per your pain.

EXERCISES

Exercises during the healing process and after the bone heals are essential to help restore normal muscle strength, joint motion and flexibility.

Early Exercises –

Start these exercises as soon as your plaster is removed. Carry out 3 to 4 times per day.

    1. Lie down on your back or sit. Bend and straighten your ankles. Hold for 10 seconds in each position.  Keep your knees straight. Repeat 10 times.

     

   2.  In sitting or lying position, move your ankle slowly in large circles. Repeat in opposite directions. Repeat 10 times.

   3. Sit on a chair. Raise your toes and heels alternatively. Repeat 10 times.

  4. Sit on a chair with one leg out straight in front of you. Put a rubber exercise band or towel around your foot. Use the band/ towel to gently pull your foot up towards your body. You will feel a stretch in your calf. Hold for 10 seconds.  Repeat 10 times.

Intermediate Exercises –

These exercises are to be done only after you are advised TO PUT FULL WEIGHT on your foot.

1. Sit on a chair. Put the outer edges of your little toes together. Press the outer edges of your little toes together. Hold for 5 seconds. Repeat 10 times. Alternatively, sit on the floor or on a chair. Put rubber exercise band around your foot around your foot. Turn your foot outwards against the resistance of the band as if to look at the sole of your foot. Hold for 10 seconds. Repeat 10 times.       

2.  Put the inner edges of your big toes together. Press the inner edges of your big toes together. Hold for 5 seconds. Repeat 10 times. Alternatively, sit on the floor or on a chair. Put a rubber exercise band around your ankle. Turn your foot inwards against the resistance of the band as if to look at the sole of your foot. Hold for 10 seconds. Repeat 10 times.

3. Stand holding on to a support. Transfer your weight onto your bad leg, lifting the good leg off the floor. Repeat 10 times.  

4. Stand holding on to a support. Push up onto your toes. Repeat 10 times. 

5. Sit on a chair with one leg out straight in front of you. Tie a rubber exercise band to something secure and put the same around your foot. (Make sure there is some tension on the band to pull against.) Pull your foot up towards your body against the resistance of the band. Hold for 10 seconds. Repeat 10 times. 

6. Practice standing on one leg, you may initially need some support. As your balance improves, repeat this without support. Hold for 10 seconds. Repeat 10 times.

Keep in mind that during the above exercises you will not be comfortable but that is okay. You should not push yourself into pain. Exercise like medication, requires a specific dose: not enough will be of no benefit, too much may do harm.

With any new exercise, your muscles may ache and you may have new aches and pains for a few days, these should settle. If they do not, consult your physiotherapist.

Hope this helps you; wish you a safe and comfortable speedy recovery.                                                                                                                      

                                                                                                          Your well wisher and friend -   DIMPLE

Role Of Homeopathic Medicines In Healing Fractures

Most people think that homeopathy is only for chronic diseases. What many people do not know about homeopathy is that it is also used in cases of injuries and accidents. The treatment of acute and chronic cases requires individualization of patient’s physical and mental makeup. But for the treatment of accidents and injuries it does not require such individualized prescription. The reason is that the patients with injuries tend to experience very similar signs and symptoms, usually needing a similar metabolic stimulus to heal their complaints.

The following medicines which I have used for myself are usually very effective for reducing pain and speeding the healing process. Let’s see one by one:  

1. ARNICA : This is the chief remedy for bruising and soft tissue damage for blows and falls. Its great action is on blood and blood vessels.  In case of fractures, it not only reduces the pain and swelling but also controls the bleeding, promotes healing and lessens the risk of infection. Arnica speeds up the healing of damaged tissue. It is invaluable for combating the effects of physical and mental shock and jar, beside those of overexertion and strains and sprains. 

It is not to be used when the patient is unconscious.

2. SYMPHYTUM: It is used to ease the pain of broken bone and speed up their repair. Symphytum is the great homeopathy remedy for fractures and of that fractures that fail to unite. It has a special mission in regard to periosteum and bone. In case of fractures, ensure positions and immobility and symphytum will take charge.

It will heal your fracture within one to two thirds of the time normally expected.

3. CALCAREA PHOS (Calcarea Phosphorica): It is the tonic for bone. It gives the bone its strength and flexibility. It is thought to be beneficial in healing bone fractures and bone misalignments, as it can provide balance and reformation of deformed bone structure. 

It aids to the formation of callus in fractures.

So this is it for today. My next post will be about physical therapy in detail and how important it is, for getting back your healthy ankle. It will be all about right exercises which made me recover so soon. Stay tuned.

I will be very happy if  this page helps you for your ongoing recovery.......

                                                                                                                      - Dimple                                  

Facts about Broken Ankle Recovery

You are here that means either you have recently met with an ankle injury- have undergone ankle surgery or you are in your recovery phase. I can relate how distressing unstable ankle fractures are. We all have faced the same problems, had surgery, metal work,passed through emotional ups and downs...etc.More than coping physically, it is tougher coping psychologically. 

Broken ankle recovery takes time and patience. No matter how you plan to get back your healthy ankle, your foot will take all the time it needs to get itself back on track.The bigger the damage is, the longer the broken ankle recovery takes.It requires an ample time to heal up. Soft tissue damage causes long term discomfort.

If your ankle fracture is a simple break, it will take minimum 3 months to heal. Smokers with broken ankle will take more time to heal (add one month more). If your fracture is complicated with dislocation and several breaks, it will take 6 months to one year to heal completely.

It is not life threatening injury, but the pain can be excruciating and troublesome. Lessening pain is the sign, that the broken ankle recovery  process  is taking place. .

Highlights Of My Recovery Along With Useful Tips 

1. Bought wheel walker and a wheelchair the very next day of my fall. I have not used crutches at all. My surgeon told me to focus on balance, I should not fall again. And with crutches, there are great chances that you might fall. (Either avoid it or take precautions. I have read so many blogs sharing the bad experiences with crutches).

2. Being a homeopath I was aware of the very important homeopathy medicines which can help me to get over with the post surgical pain and to heal the fracture fast. I started with the following homeopathy medicines along with other medications.

    Arnica mother tincture and Symphytum mother tincture 15 drops each mix with half cup of water (normal temperature ) at every 6 hrs And Calcarea phos 6x at every 6 hrs

Above 3 medicines have really helped me a lot for my speedy recovery. I did continue till I started to walk on my own without any support at 8 weeks. Hope these medicines help you also.

      

3. Post ORIF, I was only in heavy splint with soft cast, never had plaster cast. It was so comfortable. My surgeon did not advise it because there was no point in giving me tight plaster as I was not supposed to put any weight strictly for 6 weeks on the fractured ankle. So I didn't suffer from blisters, severe itching, etc......as side effects of plaster cast.

4. Elevate your foot as often as possible, at-least for 2-3 weeks. Keeping the ankle raised will reduce the swelling, which in turn improves  healing.

5. It is important to follow your surgeon's instructions carefully in terms of rest and movement. When he warns you to stay NWB (non bearing weight), he really means it. Do not pressure your ankle to start carrying its weight before it is ready. Your injury is going to take its sweet time recovering. It is very risky if you do not listen, your fractured fragments may move, surgery may fail and you may have to start all over again.

6. Suture removal done after 15 days of surgery (17^th Feb.). It was not painful. But by that time I had already developed numbness and burning in all toes (nearly half foot). And it was increasing gradually. My doctor advised tab Pregabid- ME 75mg for the same. (1 tab. at night). It worked. 

7. It takes about 6 - 8 weeks, for a broken ankle to heal but longer to regain full movement and return to all of our normal activities. We focus on the fracture but forget the damage happened to the surrounding soft tissues. Swelling may take some more time to improve.You will, however be able to move around with the help of walker/crutches and manage stairs.

8. On 17^th march, that is 6 weeks post ORIF; my x-ray confirmed that my bones were healed up nicely. I was advised PWB (partial weight bearing) for one week then 100% weight bearing with PT thereafter.

9. After your bone heals, you will be advised physical therapy (P.T) as you need to loosen up stiff muscles and ligaments of broken ankle. Exercises improve the flexibility and strength. Total recovery time varies depending upon the severity of injury and the physical demanding of our lifestyle.

10. Once I started my range of motion exercises with PT and on  my own, things started falling back to normal in 8-10 days.  Within 2-3 weeks, there was a remarkable improvement in my  ankle movements, in terms of range of motions and flexibility.

11. I resumed my clinic in the mid of 8th week. I was on my feet, walking without any support but limping and swelling continued for another one month.

12. Start with bone supplement – Calcium with magnesium and Vitamin D3. Avoid alcohol and sugar.

Although I am not 100% after 20 weeks of post ORIF surgery, but I am much much better. There is occasional pain and mild swelling in injured ankle when I stand too long plus muscle  stiffness (not much) and some partial numbness as a result of nerve  damage, that’s all. I do not limp at all. These entire things are not affecting my normal active life.

When your broken ankle returns to a normal functioning without any pain, then this will be your ideal recovery. This may be very difficult in some complicated cases, but you can do your part to get there.

So anyone starting this journey, please know that you are not alone.keep going, do not give up. GOOD LUCK to everyone and I hope you will recover very soon like I have. Hope this  helps you............                                                                                                                                                                                                                                            
                                                                                                                                                  Dimple 

An Unexpected Trauma 

 

It was 30th January 2015, Friday evening, I and my hubby had gone to attend my son's annual function at his school. He had taken part in drama. We both were very excited to see our beloved son's performance.

The function started on time, at 6.30 p.m, and all the parents were enjoying. His drama got over at 8 p.m. As the function was in open ground; all the lights were off except the stage light. So basically it was pitch dark and there was a band performance going on, which was really loud.

IT HAPPENED when they announced A BREAK for 15 minutes. I wanted to meet my son, only to tell him how wonderful his act was....So I went on backstage, appreciated him. I wanted him to join us for the rest of the program but he told me that he will take time to wind up everything and join us.

WHILE RETURNING TO MY SEAT , I was walking normally , I really don't understand how I stumbled across an uneven area of ground , my left ankle got twisted as it did not make a sure connection with that uneven patch ( it was too late to realize it). Everything happened in a fraction of second. I LOST MY BALANCE as my left foot bent sideways at the ankle and my full body weight slammed onto it.

AS I WAS FALLING DOWN, I COULD HEAR A CRACK, (YES IT WAS AUDIBLE.) and I was on the ground with terrible, excruciating pain. I was stunned for a while........waiting for my pain to decrease ...so that I can get up. But how I was going to get up????? I was too sure as I heard a crack from my left leg. I told myself, “ Oh! no.... Dimple, It 's a FRACTURE ."

My husband was far from me. He had no idea what was happening to me. The pain started giving me giddiness. Suddenly I became very thirsty. I knew it was a pain reflex. I was in shock and was praying to God continuously to keep me conscious and alert. I did not want to pass out as I was the only person to help myself (being a doctor, I was aware of what next step has to be taken , one by one).

For a moment I felt it was a nightmare, not a reality. In those 10 mins lots of negative thoughts ran across my mind. But I did not allow any bad thoughts to win over me. I gathered myself; I had faith in God that he will look after me.

I wanted to call my hubby first.

4-5 parents came immediately to help me. The school ground is very huge. The function was going on at its pace with Loud music and Colorful lights. One lady gave me water, God bless her. She told me it might be just a sprain, try to get up, apply ice immediately, you will be fine. But I told her I am not able to get up on my own. I feel the injury is much more than we think.......

They lifted me and made me sit on the chair. But while getting up, I could not put any weight on my left foot without tremendous pain. I CRIED OUT LOUDLY.......

I sat on a chair, the pain was intolerable, I was holding my left leg, and made it rest on my right knee. Then I called up my husband, but.....He didn't hear the ring because of music. I had to take a help of a lady and showed her where he was sitting. These people were not known to me. Again I tried to call him, but it was in vain. Now I was restless, the pain was getting more intense, my ankle had swollen. It was bad, very bad. Again I called up for the 3rd time, thank god, this time he picked up. I told him to get the car. I wanted my son to be with me. Tried to call him, but he was not reachable. With the support of my husband and my son's friend, I hopped on my right leg all the way to the car. Each hop was giving immense pain to my injured leg.........

The PAIN took away my tears. I can't describe the level of pain. It was unimaginative; I have never ever experienced such type of pain before. Right now while writing, I am feeling that trauma again...IT HURTS.........

OK... let’s go further,

I did not panic. My brain was working fast, even in that terrifying pain. I knew few orthopedic surgeons in my area. So went to the closest orthopedic doctor, he took my history, examined me and carried out ankle joint x-rays.

I could not believe that I had not only fractured my leg at 3 places but also it had got dislocated. I fractured my tibia, fibula and talus. Doctor told me my talus had separated out and I might have damaged my ligaments and tissue also. (Diagnosis done by doctor - Circular fracture)

My lower jaw dropped.

HERE IS MY X-RAY

Dr. told me my pain is more because of dislocation and so without wasting much time, he located it. Before doing so, he warned me that it will pain me more. I was like, still more pain??Asked God," IS THIS NOT ENOUGH??? ' I had hold my hubby tightly , a loud animal noise came out from my mouth , THAT HORRIBLE PAIN STILL HAUNTS ME , THAT FLASHBACK MAKES ME CRY.(I wish if I had known it will pain so much then I would have requested Dr. to give me some kind of nerve block, sedation or anesthesia. But I am grateful to him for treating me rightly on time. Things could have been a lot worse) I will never ever forget these TWO moments, when I fell down with that audible awful snap and the moment Dr. located my bone. It was very sad and frightening too. I mean, I feel, I have experienced the height of pain, and pray to God that no one, NO ONE should undergo such type of painful situation. I was relaxed when my bone got relocated. Half of my pain disappeared. Now I was able to communicate with my husband and my doctor. He suggested me to undergo surgery as soon as possible. (I wanted the other surgeon). He put a splint to my left foot and advised analgesics and sent me home. He also suggested MRI to find out injuries to soft tissues. Here is the x-ray after reduction (locating the bone into its place) Dr. told me my pain is more because of dislocation and so without wasting much time, he located it. Before doing so, he warned me that it will pain me more. I was like, still more pain??Asked God," IS THIS NOT ENOUGH??? ' I had hold my hubby tightly , a loud animal noise came out from my mouth , THAT HORRIBLE PAIN STILL HAUNTS ME , THAT FLASHBACK MAKES ME CRY.(I wish if I had known it will pain so much then I would have requested Dr. to give me some kind of nerve block, sedation or anesthesia. But I am grateful to him for treating me rightly on time. Things could have been a lot worse)

I thanked him for everything he did for me and went home.

I unfortunately had to wait for 2 days to get  my damage repaired as my orthopedic surgeon was unavailable. But I talked to him on the phone and I was  updating my status in those 2 days. I had sent my x-ray pics and he assured me everything will be fine although I had DIFFICULT fracture. After seeing x-ray, he told me that MRI is not needed. He planned my surgery on 2nd February, 2015. 

I was glad I waited for him. He is an amazing Doc. I was very lucky to receive the right treatment at right time from right doctors.

With medication I was better, pain was tolerable. But in those 2 days, (Saturday and Sunday) I understood how badly it had impacted my day to day life. Normally I am very active and independent lady. I felt like my whole life had been turned upside down. I had to depend on my family to do every small thing for me. Negative thoughts as what if I will not be able to walk again?? This damage will be permanent?? Will I ever be normal again??? .....(These types of thoughts are bound to come, let them pass, one should fight the situation and try to overcome it)

Underwent ORIF (outward rotation internal fixation) surgery on Monday under epidural anesthesia. Doctor told me that when he removed my splint, there was a huge hematoma as a result of internal bleeding. So he had to put a drainage tube for 2 days (Thank god it was not an open fracture, the complications would have been more serious). As my fracture was unstable one, he had to put one long metal plate and 9 screws to hold the broken bones together so that it can heal naturally and quickly. It was 2 hours surgery.

 POST SURGICAL X-RAY

Surgeon's job was done. Now it was a physical as well as mental challenge for me to overcome this situation.

Being a homeopath I was aware of the very important homeopathy medicines which can help me to get over with the post surgical pain and to heal the fracture fast. I discussed with my friend and started with the following homeopathy medicines the very next day of my fall along with other medications.

- Arnica mother tincture and Symphytum mother tincture 15 drops each mix with half cup of water (normal temperature ) at every 6hrs

And

- Calcarea phos 6x at every 6hrs

Above 3 medicines have really helped me a lot for my speedy recovery. I did continue till I started to walk on my own without any support at 8 weeks.  Hope these medicines help you also, to heal your fracture fast without much complication.(At present I am only on calcium tablets , nothing else.)

If u are active , you can break your bones, can hurt yourself in a lot many unexpected ways. It is okay, don't feel bad and don't get depressed. There is light at the end of the dark Tunnel. Get up, get going. Get back to normal using the right methods. Change your doctor if you have to. You will heal perfectly in your own time at your own pace in response to your body and injury. Do not get upset, impatient, frustrated, do not lose hope, be positive, soon it will be a bad memory (get that).

Although I am not 100% after 20 weeks, but I am much much better. There is occasional pain and mild swelling in injured ankle when I stand too long plus muscle stiffness not much and some partial numbness as a result of nerve damage, that’s all. I do not limp at all. These entire things are not affecting my normal active life.

JUST HANG ON. Do not give up. My next post will be about highlights of my recovery along with useful tips. Thanks for reading my blog. See you soon; wish you a safe and speedy recovery. Hope this helps you................

                                                                    your friend & well wisher - Dimple

          

P.S: If you are sailing in the same boat, share your stories, it may help someone. I will be more happy if some of the things I have shared here is useful for your ongoing recovery. I am here for you not only as a doctor but also as a friend. I will do my best to respond you all. Thanks again for taking out your precious time.

INTRODUCTION

I am Dimple Parekh, if you are seeking solutions of your problems related to Ankle fracture, then this blog is for you. It contains all the information you need to know. Start your speedy recovery confidently. I am sharing few tips and important stuff I learned during my recovery phase.

Ankle fractures are very common injuries among people of all ages, interests and lifestyles. Athletes are more prone to such injuries because of the physical demand placed on their ankles. In order to know more about the ankle fracture related problems, and to prevent its complications, we must understand the anatomy of an ankle and what exactly the ankle fracture is.

ANKLE 

Ankle joint is made up of 3 bones. It is very complex joint.

Tibia - Shinbone, larger of the 2 bones of lower leg - bears 90% of your body weight.

Fibula - thinner bone of a lower leg - bears only 10% of your body weight.

And                               

Talus - a small bone that is placed between the heel bone and the ends of tibia and fibula. It is wedge shaped. It supports the lower ends of tibia and fibula and it forms a solid base of the normal range of ankle movements.

These ankle fractures are either stable (no change in talus movement) or unstable (talus does not move in a normal way). This means that the joint is not in a symmetrical position. In case of unstable fracture, more invasive treatment is advised.

Other parts of Ankle - Inside part of the tibia is called medial malleolus

                               - Back part of the tibia is called posterior malleolus

                               - End of the fibula is called lateral malleolus

WHAT IS ANKLE FRACTURE or BROKEN ANKLE ?

It means one or more bones of ankle joint are broken. If the end of fibula breaks, it is called Lateral malleolus #. When both, tibia and fibula break, it is called Bimalleolar #.And if all the 3 malleoli are broken then it is called Trimalleolar #.This fracture can be associated with dislocation.

If there is open fracture ( bones poking through skin ) , then there is severe risk of getting infection as this open wound will attract bacteria which will contaminate the broken bone. And I tell you THIS IS DANGEROUS.

There are 2 joints involved in an ankle fracture.

1. Ankle Joint - here tibia, fibula and talus meet.

2. Syndesmosis Joint - this is between tibia and fibula, held together by ligament. 

There can be damage to the ligaments which hold the ankle joint and bones in position.

If you have only one break in ankle, it does not prevent you from walking, but if it is more than one then definitely you require immobilization for few weeks.

CAUSES :  An ankle fracture can occur when the joint is forced beyond its normal range of motion. It can be caused by a direct blow to the bone itself.

Other causes include,

1. Twitching of ankle

2. Falls

3. A sporting accident or an impact during a car accident

4. Rolling of ankle

HOW YOU WILL FIND OUT YOUR ANKLE IS BROKEN ?

1. Tremendous throbbing pain immediately

2. Swelling

3. Significant Bruising

4. Tender to touch especially bone area around the ankle 

5. Difficulty in walking and inability to put weight on the injured foot

6. Dislocation may happen

7. Due to terrible pain and shock, you feel dizzy and you may faint.

8. A crack sound during injury ( in some cases )

9. Severe ankle deformity in case of open fracture.

WHAT YOU SHOULD DO ?

- Seek Help first

- Rush to the nearest, preferably orthopedic center, as soon as possible

- Do not put any kind of weight on the injured leg (it will give so much pain, you never had imagined)

- Apply ice pack if possible while going to the hospital. It will reduce your pain and    swelling.( do not apply ice directly).cold packs are effective for 24 - 48 hours.
-keep your leg elevated to help to decrease pain and swelling
-take ibuprofen tablet immediately.It reduces pain as well as inflammation.

- Call the ambulance if your fracture is open

PHYSICIANS ROLE

After taking your medical history carefully and examining you physically, he may advise for one or more additional tests to provide more information about the injury.

X -RAYS - confirms the fractures or any dislocation. It can also show if one or more bone pieces are broken. Stress fractures can be missed by x-rays until the break actually starts healing.

C.T.Scan (Computerized Tomography) - It is the cross section image of ankle, gives the minute information which can be missed on x-rays. It reveals all about the bones in detail and soft tissues surrounds it .This helps your doctor to ascertain the best treatment for you.

MRI (Magnetic Resonance Imaging) - This provides high resolution detailed images of both bones and soft tissues (like ligaments). This can identify fractures which are not seen on x-rays. Mostly used for athletes and for the people whose occupation demands them to be active on their feet. This test is very important to evaluate the condition of ankle ligaments.

TREATMENT PART 

There are many types of ankle fractures. Treatments vary significantly depending on the location, type of bone broken and severity of the injury. Stable fractures are treated similar to ankle sprains. All other types require surgery, ORIF (open reduction and internal fixation) It is usually carried out with implanted metal hardware (plate and screws) that holds the bones in place while the healing of bones occurs naturally. A cast or splint will be required to immobilize the ankle following surgery.

YOU SHOULD KNOW THIS

    

1. In case of dislocation your doctor will do the reduction (locating the bone back into place). It is very important to do it as soon as possible to prevent the problems regarding nerve and blood vessel supply to the foot. Depending on the amount of pain and swelling, the doctor will give you painkillers, muscle relaxants or even anesthesia before the procedure.

He will give you a splint to protect your ankle and to keep the bones in correct positions. Then he will decide whether the surgery is required or not, or you will be alright with support of a cast to let it heal naturally.

2. If surgery is not advised (cases of closed, non displaced #) then your fracture will require a cast at least for 4- 6 weeks. Doctor gives back-slab cast for stabilization and elevation of injured foot (keeping the ankle raised) is advised to reduce the swelling.

Once it is removed, you will be advised for physical therapy before resuming your normal activities. 

3.  Surgery is advised mostly in unstable fractures to realign the bones and fix them in position. The surgeon may use metal plates, screws, nails and wires to hold the broken bones together. The wound is closed using stitches. The metal work is not removed unless it becomes a problem. This whole procedure is done under general or epidural anesthesia.It is difficult to judge the duration of total recovery as it depends on severity of injury and your lifestyle.

4. Mostly your surgeon will advise hospital stay for 2-3 days after surgery. My experience says you should stay for 4-5 days as you get enough rest. Post surgical pain will also bother you a lot. I had very bad contracting pains 2 hours after surgery and it continued at least for 3 days. In this period, painkillers will be your best friends. Without them it will be impossible to survive.

5. A plaster cast will be placed on your ankle before you go home.

CAST

Most ankle fractures require a cast or a splint for around 6 – 8 weeks. Immobilization is strictly advised for the first few weeks. So you will have to use either a walker or crutches for support as you are not allowed to put weight on the injured leg. In some cases the doctor might give a walking plaster – depending on the type of ankle fracture (walking is allowed in some cases).

Do follow up visits sincerely with your doctor. He can advise you the important things which help your ankle to heal. Serial x-rays may be advised to make sure healing is taking place.

POSSIBLE EARLY COMPLICATIONS  : 

• Diabetic patients, smokers and elderly persons are at a higher risk for complications after surgery. It may take longer time for their bones and wound to heal.
• Osteomyelities - It is a bone infection , mostly seen in open # 
•  Nerve and blood vessel damage especially after a displaced #   
• Compartment syndrome - It means severe swelling and pain in the leg immediately after injury. Mostly happens in high impact injuries such as car or bike accidents.
• Damage to the skin and soft tissues because of tight cast 
• Burns to the skin as the plaster hardens.
• Thrombophlebities – inflammation of veins of the lower leg.
• Failure of bones to unite together and heal well.
• Temporary complications of wearing cast - thinning of bones and wasting of muscles, can occur even in 4-6 week period of casting.
• DVT (deep vein thrombosis)– clotting of the deep veins which can relate both to reduced mobility and to pressure on the leg veins from swelling and casting. 

POSSIBLE LATER COMPLICATIONS INCLUDE:

·         Osteoarthritis of ankle joint.

·         Loss of flexibility and stiffness in the ankle.

RUSH TO THE HOSPITAL

      1. If your ankle is swollen too much

      2. Any problem with plaster cast (either you feel very tight or loose)

      3. If you get numbness or burning in toes

      4. If your skin around the ankle turns blue

      5. Any foul smelling discharge from the surgical wound

      6. Excessive pain in your ankle

Above signs may indicate infection or damage to the nerves or blood vessels which can affect the blood supply to the ankle.

HOW TO PREVENT SUCH INJURIES

• Exercise - It is very important to strengthen your knees and ankles. If you are prone to twist your ankle then you should do the strengthening exercises regularly for your ankle muscles. Simple walking is also good exercise.
• Wear Ankle Supports - This definitely helps to prevent sprain or break by supporting ankle muscles.
• Wear proper footwear - wearing a wrong one increases your risk of falling.  So wear proper shoes, neither too big nor too small.
• Walk on flat road -  There are chances of tripping on uneven surfaces. 
• Many fractures are result of walking in the dark (Like mine). So use nightlights.
• Keeping clutter off the floor can help you to avoid trip and falls. (no piles of clothes or boxes). 
• Lose weight if you are obese, overweight - losing weight decreases the strain and pressure to your ankle and it also makes your ankle stronger.
• Strengthen your bones by eating Calcium rich foods such as milk, yogurt, cheese etc and also Vit D supplements.
• Keep yourself more active physically. Do weight bearing exercises, resistance exercises, and flexibility and balance exercises regularly after consulting your doctor.

JUST HANG ON. Do not give up. My next post will be about my broken ankle story and  role of homeopathy medicines in my recovery. Thanks for reading my blog. See you soon; wish you a safe and speedy recovery. Hope this helps you................

                                                                                                                   -  Dimple