OT: Fractured Ankle

[St. Anger]

Fractured the "styloid tip", which is basically the bottom base of the fibula where it connects to the foot. Didn't appear that obvious to the doc on the x-ray but that was the diagnosis.

Anyway, curious if anyone has fractured an ankle and where you were a week in, how long it took to heal, etc. I'm in a boot but still in a lot of pain and weight bearing also hurts like hell.

I'm sure healing varies by person. Just wondering what to expect as far as a timeline goes and when it will finally stop hurting like hell.

Any advice appreciated.

 

[SantaBarbaraSker]

Fractured mine in a dirtbike riding accident about three years ago. Had surgery, installed six screws. Was in a full cast for two months then a walking boot for another month and then two months of rehab. Still not the same. In the next year or so I'm going to go see an orthopedist at the UCLA Center for sports medicine, and see if there's anything they can do.
Hopefully you will have a better outcome. Most likely you will. If you didn't have to have surgery (and hardware added) it probably wasn't that severe. Good luck to you.

 

[anon_umk0ifu6vj6zi]

Fractured the "styloid tip", which is basically the bottom base of the fibula where it connects to the foot. Didn't appear that obvious to the doc on the x-ray but that was the diagnosis.

Anyway, curious if anyone has fractured an ankle and where you were a week in, how long it took to heal, etc. I'm in a boot but still in a lot of pain and weight bearing also hurts like hell.

I'm sure healing varies by person. Just wondering what to expect as far as a timeline goes and when it will finally stop hurting like hell.

Any advice appreciated.

Had a fracured Right ankle the year we joined the B1G. Did it the week we went to Minnesota for football. Went on the trip and limped around the whole time. Thought it was a sprain. Went to the doc when I got back and he said there was not much they could do because healing was starting. I had to work and can't do that in an air cast. That happened a couple years after I had a torn ligament in the other ankle. Did the same thig and tried to tough it out. Wish I would have got them both looked at and fixed before waiting. Now I have terrible ankles and get plantar faschilitis in my Right foot. Lately the only way to relieve the plantar is to put pressure on that foot and "pop" it. Pretty sure walking on a "slightly" fractured ankle for a few years has messed up my foot. Hope you give it time to heal properly.

 

[SeaOfRed75]

Was it the tibia or fibula? Should be easier with the fibula like you said as its not weight bearing and doesnt actually connect with the foot iirc.

 

[St. Anger]

Was it the tibia or fibula? Should be easier with the fibula like you said as its not weight bearing and doesnt actually connect with the foot iirc.

Yes, fibula. The tip where it meets the foot. Doc said 4 weeks in walking boot and I should be fine but today is day 9 and it's incredibly sore and still feeling a bunch of pain from the break spot. Just wondering if this is normal or another trip to the doc is in my immediate future.

 

[puddinhead0404]

I mean I'm no doctor but maybe this is something you talk to your doctor about?

 

[St. Anger]

I mean I'm no doctor but maybe this is something you talk to your doctor about?

What an unbelievably useful addition to the thread. Can you tell us more?

 

[TheNewNU_rivals50820]

If that pain is that bad you should speak to your doctor. I'd recommend getting up and moving yourself around as much as possible, this will get your heart rate up and your body will be able to better supply oxygenated blood to the injury causing it to heal faster.

 

[St. Anger]

If that pain is that bad you should speak to your doctor. I'd recommend getting up and moving yourself around as much as possible, this will get your heart rate up and your body will be able to better supply oxygenated blood to the injury causing it to heal faster.

Yeah, I'm walking on the boot but it's painful. Doc said that's best though, go use it as much as you can. I'm just surprised it still hurts this bad on day 9. In the mornings it's ridiculously painful but I think that's because it's stiff. Once I get moving a little it helps.

 

[litespeedhuskerfan_rivals19671]

Sorry to hear about your issue and I hope you turn the corner quickly. I broke my fibula about 3 years ago in a cycling accident, and like you, no surgery. I was able to ride a bike (if you can call it that, around the block is pretty weak IMO) in about 30 days, so he is probably pretty close with his estimation time frame. For me, I could tell it was broken, but was able to ride anyway, slowly, and in 2.5 months it was a non issue.

 

[Hoosker Du]

Yeah, I'm walking on the boot but it's painful. Doc said that's best though, go use it as much as you can. I'm just surprised it still hurts this bad on day 9. In the mornings it's ridiculously painful but I think that's because it's stiff. Once I get moving a little it helps.

Does your Dr. have you on a pain med? I can't imagine the answer is no, but if not, you can take 800 mg. of ibuprofen 3 times per day until the healing has gotten to the point you can handle the pain of walking. I wish you well.

 

[St. Anger]

Sorry to hear about your issue and I hope you turn the corner quickly. I broke my fibula about 3 years ago in a cycling accident, and like you, no surgery. I was able to ride a bike (if you can call it that, around the block is pretty weak IMO) in about 30 days, so he is probably pretty close with his estimation time frame. For me, I could tell it was broken, but was able to ride anyway, slowly, and in 2.5 months it was a non issue.

Was it a clean break on your fibula?

 

[St. Anger]

Does your Dr. have you on a pain med? I can't imagine the answer is no, but if not, you can take 800 mg. of ibuprofen 3 times per day until the healing has gotten to the point you can handle the pain of walking. I wish you well.

Just naproxen (anti-inflammatory) but I'm taking some past scripts for pain...though not working that great.

I just can't tell if the pain is normal from the break (obviously) and the stiffness of not using the ankle or if I'm causing damage walking in the boot too soon. I sleep fine but it hurts like a mother when I first get up and put weight on it. That subsides as the day goes on. I know, I probably sound paranoid.

Really appreciate all the responses!

 

[litespeedhuskerfan_rivals19671]

Yes.

 

[St. Anger]

Yes.

Gotcha. I'm really hoping mine won't be as bad as yours (no offense). Mine is apparently a small fracture at the base of the fibula. Doc actually said, "4 weeks, you should be healed". It's day 9 and still hurts like hell. Maybe the answer is just "be patient". Considering a return visit to doc but don't want to pay him just to hear that.

 

[litespeedhuskerfan_rivals19671]

None taken, and I hope your recovery goes well for you.

 

[skintight]

how often are you icing the ankle? and what method of icing are you using?

 

[Shimmer003]

Bones take about 3 months to be "healed", with continued remodeling (pain free) for 6-12 months. The pain should subside sooner than that. The fibula is a weight bearing bone contrary to what the prior poster said (although only about 15% compared to 85% the tibia accounts for). If it really is just the distal portion of the fibula, walking boot is the correct treatment. But it really depends on the level. An avulsion injury of the fibula is no big deal, just going to give you pain for a while. If it's a little higher up though, at the level of the ankle joint or higher, then the stability of the ankle needs to be tested with a stress Xray to evaluate whether or not you need surgery to fix any ligamentous injury. As far as pain control, Tylenol 650 mg every 6 hours scheduled is best. Naproxen and ibuprofen might work a little better, but there is some evidence that those medications slow/prevent bone healing and thus aren't recommended for fracture pain control.

Assuming you have the right treatment plan (which isn't possible to evaluate without seeing your X-rays), you're just going to have to try to hang in there and back off the activity when the pain is getting to be too much. Ice and elevation are your friend at this point. If you keep the swelling down, your pain will be less. Don't be afraid the wrap an ace around the ankle as well.

If you're worried about it, maybe go see an orthopaedic surgeon. Primary care docs are great for a lot of things, but orthopedics isn't one of them for most.

 

[St. Anger]

Bones take about 3 months to be "healed", with continued remodeling (pain free) for 6-12 months. The pain should subside sooner than that. The fibula is a weight bearing bone contrary to what the prior poster said (although only about 15% compared to 85% the tibia accounts for). If it really is just the distal portion of the fibula, walking boot is the correct treatment. But it really depends on the level. An avulsion injury of the fibula is no big deal, just going to give you pain for a while. If it's a little higher up though, at the level of the ankle joint or higher, then the stability of the ankle needs to be tested with a stress Xray to evaluate whether or not you need surgery to fix any ligamentous injury. As far as pain control, Tylenol 650 mg every 6 hours scheduled is best. Naproxen and ibuprofen might work a little better, but there is some evidence that those medications slow/prevent bone healing and thus aren't recommended for fracture pain control.

Assuming you have the right treatment plan (which isn't possible to evaluate without seeing your X-rays), you're just going to have to try to hang in there and back off the activity when the pain is getting to be too much. Ice and elevation are your friend at this point. If you keep the swelling down, your pain will be less. Don't be afraid the wrap an ace around the ankle as well.

If you're worried about it, maybe go see an orthopaedic surgeon. Primary care docs are great for a lot of things, but orthopedics isn't one of them for most.

Thank you much for the reply. "Avulsion" is exactly what the doctor's note said, whatever that is. Right on the bottom tip of the fibula where it connects to the foot. Said I likely stretched the tendons so far that it pulled/cracked that area of bone.

The swelling has gone down significantly and haven't iced in a few days but do elevate when I can. The bruising is still very bad along the bottom of my foot. The worst pain is right in the morning when I get out of bed and put weight on it. Feels like it was doused in gasoline and lit on fire. It subsides after 5-10 mins though.

Really appreciate all the responses, helps a lot. Just more worried at this point if the pain is just a natural thing or if I should get back on the crutches and am pushing the boot too soon. Even in the boot, I'm not moving very fast.

 

[St. Anger]

One more question if anyone can answer. Ankle feeling better today in boot, but man is it swollen up like a balloon. Any way to get that down? Just ice and elevation? Anything to be concerned with? I need a beer.

 

[skintight]

Rest, ice , compression, elevation. you could simply use a bag of peas or corn--perhaps 2 bages and wrap it directly on your skin with and ace wrap for 30 minutes. do this 3-5 times a day. or you can buy a game ready or similar type of compressive cryotherapy. most people don't bother to elevate their foot---don't make that mistake. most people dont put the ice bag directly on the skin---dont make that mistake---real ice not chemical cold packs wont frost burn you. most people dont leave the ice on for at least 15 minutes.--dont make that mistake---just dont leave on more than 30 minutes.

 

[St. Anger]

Rest, ice , compression, elevation. you could simply use a bag of peas or corn--perhaps 2 bages and wrap it directly on your skin with and ace wrap for 30 minutes. do this 3-5 times a day. or you can buy a game ready or similar type of compressive cryotherapy. most people don't bother to elevate their foot---don't make that mistake. most people dont put the ice bag directly on the skin---dont make that mistake---real ice not chemical cold packs wont frost burn you. most people dont leave the ice on for at least 15 minutes.--dont make that mistake---just dont leave on more than 30 minutes.

Gotcha, very much appreciated. I think it's been my return to work. I work in an office, so my foot is definitely not elevated nor getting iced as much. My big concern is if there's something more medically I should be concerned with but it sounds like not. Just be patient and ice/elevate. Thanks again.

 

[dinglefritz]

Gotcha, very much appreciated. I think it's been my return to work. I work in an office, so my foot is definitely not elevated nor getting iced as much. My big concern is if there's something more medically I should be concerned with but it sounds like not. Just be patient and ice/elevate. Thanks again.

You can add Tylenol in with your Alleve for extra pain relief. They sell an 8 hour extended release Tylenol that works well. Light compression wrap should help the swelling, but whatever you do try to limit all motion in your ankle. If you don't, you will most definitely slow healing and potentially could cause a non-union fracture. That would be a bad deal. IF its swelling and that sore, I'm kind of surprised that he didn't put you on crutches as well to try to prevent any motion whatsoever at the fracture site. Stay off of it, elevate, and ice when you can.

 

[St. Anger]

You can add Tylenol in with your Alleve for extra pain relief. They sell an 8 hour extended release Tylenol that works well. Light compression wrap should help the swelling, but whatever you do try to limit all motion in your ankle. If you don't, you will most definitely slow healing and potentially could cause a non-union fracture. That would be a bad deal. IF its swelling and that sore, I'm kind of surprised that he didn't put you on crutches as well to try to prevent any motion whatsoever at the fracture site. Stay off of it, elevate, and ice when you can.

I did get some tylenol to replace the naproxen/ibuprofen. Also, the doc did order me on crutches for 2-3 days (and I was already on them for 4 days) so basically was on crutches for a week and then transitioned to the boot. Sore as hell in the morning but the last couple days, once I get the boot on and walk around a bit, the pain goes way down. But the swelling is sticking around. Thanks for the reply.

 

[dinglefritz]

I did get some tylenol to replace the naproxen/ibuprofen. Also, the doc did order me on crutches for 2-3 days (and I was already on them for 4 days) so basically was on crutches for a week and then transitioned to the boot. Sore as hell in the morning but the last couple days, once I get the boot on and walk around a bit, the pain goes way down. But the swelling is sticking around. Thanks for the reply.

If you are having pain you can take naproxen(Alleve) AND the tylenol together. I'm sure your doc knows what he's doing but generally with a fracture you want to prevent any motion whatsoever at the fracture site for 4 weeks.

 

[Shimmer003]

Not to call you out dinglefritz, but the "no motion" thing is absolutely not true. He has a stable ankle fracture and what most likely sounds like a fibula avulsion. It's a nothing fracture. He can do about whatever he wants on it without fear of making it worse.

When to start motion and the advancement of activity in fractures is widely variable based on the injury and the treatment of the injury (non-op vs operative management). In fact, absolutely stability is bad for any fracture not treated with anatomic operative alignment with rigid fixation.

Again, for an avulsion injury such as the one being discussed, you can't really mess up the treatment. But for more significant fractures, all NSAIDS should be avoided, as they prevent healing.

 

[St. Anger]

Not to call you out dinglefritz, but the "no motion" thing is absolutely not true. He has a stable ankle fracture and what most likely sounds like a fibula avulsion. It's a nothing fracture. He can do about whatever he wants on it without fear of making it worse.

When to start motion and the advancement of activity in fractures is widely variable based on the injury and the treatment of the injury (non-op vs operative management). In fact, absolutely stability is bad for any fracture not treated with anatomic operative alignment with rigid fixation.

Again, for an avulsion injury such as the one being discussed, you can't really mess up the treatment. But for more significant fractures, all NSAIDS should be avoided, as they prevent healing.

Thanks for the reply. What you said, "fibula avulsion" is exactly what the doc said. Fractured 2 weeks ago today and have been in boot for 1 week. Still very sore but once I get up and walking in the boot, that soreness wears off and feels pretty good. Just impatient as hell. Wake up every morning (don't sleep in the boot) and think it'll be good to go, but not just yet. The morning's hurt the worst.

For the most part, it's completely stabilized in the boot. Any prediction on healing time? Thanks again.

 

[dinglefritz]

And your m

Not to call you out dinglefritz, but the "no motion" thing is absolutely not true. He has a stable ankle fracture and what most likely sounds like a fibula avulsion. It's a nothing fracture. He can do about whatever he wants on it without fear of making it worse.

When to start motion and the advancement of activity in fractures is widely variable based on the injury and the treatment of the injury (non-op vs operative management). In fact, absolutely stability is bad for any fracture not treated with anatomic operative alignment with rigid fixation.

Again, for an avulsion injury such as the one being discussed, you can't really mess up the treatment. But for more significant fractures, all NSAIDS should be avoided, as they prevent healing.

Not to call you out dinglefritz, but the "no motion" thing is absolutely not true. He has a stable ankle fracture and what most likely sounds like a fibula avulsion. It's a nothing fracture. He can do about whatever he wants on it without fear of making it worse.

When to start motion and the advancement of activity in fractures is widely variable based on the injury and the treatment of the injury (non-op vs operative management). In fact, absolutely stability is bad for any fracture not treated with anatomic operative alignment with rigid fixation.

Again, for an avulsion injury such as the one being discussed, you can't really mess up the treatment. But for more significant fractures, all NSAIDS should be avoided, as they prevent healing.

And your doctorate is from which school? I've done orthopedic surgery. While it is true that some NSAIDs may slow healing, Alleve (naproxen) does NOT inhibit chondroblast and osteoblast recruitment to the degree that Ibuprofen does and Tylenol has no effect on fracture healing. I repeat, any motion at a fracture site (avulsion or otherwise) slows and may totally prevent healing. You can end up with a non-union fracture that never heals without surgery. While "absolute stability" may actually reduce or slow callus formation, it is most certainly a desirable condition when using internal fixation. There's no way in hell you can get "absolute stability" with a boot or even a cast. While a non-union alvusion fx at that location likely won't cause long term loss of function, it still could cause other discomfort down the road. As I said, I'm sure his Dr. is on top of the sitution.

 

[St. Anger]

Sorry for more posts, wanted to check in, ask a question or two.

10 days in the boot, 17 days since fracture, getting around pretty good after I get the soreness out in the morning. Still icing at night. Question, the area of the fracture (the little bone nub on the outside of the foot) is still really tender, sore, and swollen. Just swollen in that area though, the rest of the foot swelling went way down.

Toying with the idea of going to an Ortho doc but wondering if that's just a waste of time. Guess I'm just worried about that fracture area and whether or not that needs looked at again.

Been some really helpful posts on here, thanks again.

 

[dinglefritz]

Sorry for more posts, wanted to check in, ask a question or two.

10 days in the boot, 17 days since fracture, getting around pretty good after I get the soreness out in the morning. Still icing at night. Question, the area of the fracture (the little bone nub on the outside of the foot) is still really tender, sore, and swollen. Just swollen in that area though, the rest of the foot swelling went way down.

Toying with the idea of going to an Ortho doc but wondering if that's just a waste of time. Guess I'm just worried about that fracture area and whether or not that needs looked at again.

Been some really helpful posts on here, thanks again.

Soooo....who diagnosed your ankle fracture if you didn't see an orthopedist the first time? If you haven't seen one already you probably should or at least I would.

 

[St. Anger]

Soooo....who diagnosed your ankle fracture if you didn't see an orthopedist the first time? If you haven't seen one already you probably should or at least I would.

My regular doctor.

 

[dinglefritz]

My regular doctor.

Family doc? If so, I guess it depends on how much you think he knows about orthopedics. Personally if you were my kid and somebody told me you had a fracture, you would have an appointment with an orthopedist. JMHO. Better safe than sorry.

 

[St. Anger]

Quick update (thanks for the previous responses). Got out of boot per Doc visit and am on about day 5 of walking without the boot. It is absolutely sore as hell, all over. One minute it's the calf, the next my toes, the next my achilles. Feels like it's on fire in the morning and then feels much better as the day goes on.

Regular doc recommended physical therapy. Ortho said give it a couple weeks first. Anyway, just wondered how sore fresh out of the boot/cast any of you guys were.

 

[otismotis08]

Fractured the growth plate during a basketball game years ago. Not much they could do, except immobilize everything for a while in a cast. Never had a problem with it again.

 

[8990]

Mine was more like Santa Barbara's. Mine was broken across both bones in lower leg by getting stomped on while knocked out and lying on the ground (gang - no I was not in one). Plate and screws are still in there 13 years later and yes it still hurts sometimes, it is tight EVERY day when I get up, and if I have to stand or walk more than 1 hour I can feel it coming on. Plaster cast for a couple months IIRC and then a boot forever it seemed but probably 3 months. No physical therapy for some reason but I do stretch it out almost daily with the calf muscles or it would probably be worse.

Good luck.

 

[St. Anger]

Family doc? If so, I guess it depends on how much you think he knows about orthopedics. Personally if you were my kid and somebody told me you had a fracture, you would have an appointment with an orthopedist. JMHO. Better safe than sorry.

Bumping the thread once more for to reply to Dingle's post. I pretty much booked the Ortho appt. once I saw this. Went in for last follow up visit with Ortho doc last night and he thought something sounded odd with my symptoms and sent me to the hospital. Have a blood clot behind my knee. Not sure if that would've been found unless I booked the Ortho doc appt., so thanks Dingle.

 

[otismotis08]

Wow. Hope they develop a solid treatment plan, and good they caught it now.