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Forum Name: Bone trauma and fractures

Question: Fractured Ankle what next


 sjanegray - Fri Jun 01, 2007 5:52 am

So I fell down on Monday 05/28 and fractured my right ankle.
I was admitted into the hospital that night with surgery the following day.
I know they put screws and plates in my ankle and for some reason had to cut both sides open to get the hardware in there.
The doctor didn't really speak to me after the surgery as I was pretty out of it, he instead called my home.
Couple questions.
1. I am 3 days out of surgery and have such burning pain in my cast that it keeps me up all hours of the day and night
2. are they going to take the plate/ screws out?
3. Should my toes go from icy cold to totally hot on my cast foot?

I have a follow up appt on wed june 6th but after yet another restless night i think I will call the doctor today and have them look at this cast.
 Marceline F, RN - Wed Jul 04, 2007 6:29 pm

User avatar Dear Sjanegray,
I trust you have indeed had the cast checked. Swelling of a limb inside a cast can contribute to numbness and tingling in that limb by constricting circulation and putting pressure on sensitive nerves. As far as the surgery goes: you have had what is called an ORIF - open reduction internal fixation - of your foot and ankle. This involves the permanent placement of hardware to support bones that would not probably heal well without extra support. Certain types of fractures may heal without such drastic intervention. Sometimes the fractures are more complicated, or involve certain bones of the body that need the extra reinforcement in order to permit the patient to return to a place of normal or near-normal function. It sounds like you do not have an external fixator - if you have a cast, but the cast does need ongoing assessment. Ask your doctor what signs you should watch for that might signal problems, so you can let him/her know if they occur.
 sjanegray - Thu Jul 12, 2007 4:40 pm

Thanks for the advice.

I am now over 6 weeks out from the fracture. I do have a plate on the outer side of my ankle with 6 screws and two screws on the left or inside of the ankle. Progress has been great until approx 2 days ago. I expierenced little to no pain after they replaced the splint put on in the OR and actually could start to see the ankle bones and tendons.. Last friday I was released to Full weight bearing... However my ankle swelled up to the point that it started to blister, and turn purple.. it burns and is really hot to the touch. Blood work confirmed no infection, and I was taken off weight bearing today and am back in a splint as well as on Indomethacin 3 times daily.. Is it normal to have such terrible swelling not only in the ankle area but up my leg this far out from surgery?
 Marceline F, RN - Sat Jul 14, 2007 2:56 am

User avatar Dear Sjanegray,
Do you/did you have physical therapy working with you as you began your weight bearing? Having been off weight bearing for 6 weeks, sometimes you almost have to learn to walk again - due to changes in physical condition (remember you have hardware installed in your foot now) plus some atrophy in that R leg (it starts to set in very quickly in a limb that is not being used), plus some natural inherent extra caution pleaded out by the brain to be careful! Without seeing the area of purpling I can only guess, which wouldnt be fair to you. I do suspect however, if your Doctor put you back in a splint, then he/she has not determined this to be a major problem at this time. Keep your followup appointments, and ask if a referral to physical therapy is possible for when they release you again to weight bearing.

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