bimalleolar ankle fracture tendon ligament mobility recovery tips please

Hi, I have a bimalleolar ankle fracture that has been surigically repaired with 2 x two inch long screws in medial malleous and 1 smaller screw in lateral malleous along with a plate for stability held by a further 5 screws along fibular/lateral malleous. This happend nearly 5 weeks ago. I am currently in a camboot after being in a back slab cast for 4 weeks. I cannot get a right angle with my foot as my foot will just not move when i attempt to bring to toes up towards my ankle. Will this improve - i believe it is related to tendons and ligaments. Should I be concerned with the angle of my ankle? My heel does not even touch the base of the camboot to fit it properly. Not sure if I have given you enough info but am happy to add to this if anyone has some thoughts for me. THanks.

Sounds normal. You have a long road ahead so don't focus on the long-term goals. For now it will take a while for the ankle to free up enough to sit happily in the boot. once all that is off the physio can get the joint mobilising and release the connective tissue around it and the calf muscles to assist return to function. If you have an x-ray images you could post with a reply we'd love to see them :)

Thanks for your reply, its put my mind at ease. You just never know what is "normal" and when you should be concerned. I am including a scan of my X-ray print. I hope its clear enough. I am going to confirm with the doctors this week whether there was a third fracture as originally they said in three places, but there has been no mention of this third one since. I realise that some fracures would just heal without surgery so am just assuming that is the case as my ankle is immobilised to heal anyway. My suspicion is a small fracture somewhere in the talus/tibia/fibula meeting place, if that makes sense. Here is the image and I look forward to any further comments, thanks so much..
Attachment 994

Ok Ok Ok I went to the hospital appointment today and queried the third fracture. Yep there was three so its a tri malleolar fracture with a third fracture on the inner left rear part or my tibia. Apparently it has healed well and did not need surgical repair. Also a difficult fracture to spot. My ankle is still not moving very far, now 5.5wks since the trauma. Orthopeadic doc says not to be concerned yet as i've had setbacks with surgical wound infections. He seemed to make comment that is would be a good few months yet. I am in my camboot, if i go out, but is not confortable. My ankle has next to now mobility where would a physio start? what treatments are used. Its not a pain ful thing to try and move it my ankle just wont move! Look forward to you comments on the xrays and your insight into physiotherapy treatment possibility, cheers

Hi Bob,

I did post the x-rays did you see them? My question today...I am now in the 8th week post my ankle fractures and was told to still have 20% weight bare for further 4 weeks. I am about to start physio, but am wondering would you say my progress is still normal or slow and why if my break shows its healed cant i put more than 20% on that ankle yet???

hi there, have they told you you can remove your boot and begin range of motion exercises? typically there will be limitations for the amount of weight you can put through your leg as you mentioned, but with this type of fixation you can normally begin to move it once out of plaster...don't be concerned with the surgeon's weightbearing instructions, they will be based on a combination of the surgical technique, your bone stock quality and the nature of the fixation - it is always best to follow these instructions carefully as they are designed to prevent damaging the repair! everyone is different but you are by no means "not normal" :)
cady

Somebody please give me a realistic time frame - average for this kind of injury???

Thank you Cady for your response. Yes I have been removing the boot at night for a little while now and as of 3 days ago have been given exercises to do 3 times a day, about 40mins worth, to move and stretch the ankle. I have no pain while I am doing them but have noticed an ache in the area of my fibula fracture post starting the physio. Its not too painful and by no means needs pain relief so i am putting it down to actually using the unused ankle and it being normal - please advise if its a concern.

Just from the past three days of the physio instructions I have noticed less swelling and more movement within the foot itself, the ankle is still extemely stuck but mrer flexibility is noticable. As its freeing up it is difficult not too put more weight on my foot too. I am using a walking frame, not crutches and up until physio commencing I was hopping and hardly using the injured foot except for balance. Now I am limp walking with the frame and the ankle copes well - hey this could be causing that fibula ache??? No pain while walking - if anything its preferred as my left leg gets a break from bearing all the weight! I have also began a weight loss programme - purely diet at the moment for obvious reasons, and I am hoping this will help recovery speed as I need to shed a good 20kg for overall wellbeing.

Just in regards to weightbearing and walking normal again...In 3 weeks i see the surgeon again, would it be normal for them to say...ok start to try and walk normally with the frame, full weight - it would be 3 months by then?? I am eager to recover quickly too as i have 4 children 12yrs, 9 yrs, 4yrs, 16mths that need their mum and my husband is running out of leave and I really need to drive. Of course I am being wise cause dont want to go backwards but could somebody please give me a realistic time frame - average for this kind of injury??? Thanks all for your input. :))