Caoimhin 12:17am Apr 10 2018
Complete history detailed below. In summary, I had a non-surgical conservative treatment of a bimalleolar fracture. At my 7 week follow-up, my OS gave me approval to begin walking again.
She put no explicit restrictions on weight bearing. She said I could bear as much as I could tolerate, and even encouraged me to try for more than 50% while I was still in the exam room. She suggested that I aim to be using one crutch only by the end of the week.
She tried to manipulate my foot a bit during her physical exam. She did a plantar flexion which hurt HORRIBLY in the soft tissue area in front of the ankle. She explained that this was due to the immobilization and that gradual stretching would improve it.
I am to return in 3 weeks for f/u and referral to PT.
I weight about 77 kg/170 lbs. On the scale I notice that I can tolerate about 52 kg/115 lbs on the injured ankle, so about 67%.
I asked about the likelihood of refracture during this period. She noted although it is certainly possible to refracture while in a boot, in my case the risk was from supination and pronation...not necessarily from weight bearing "straight down".
I'm already at one crutch, although it is not exactly comfortable. There is still pain in the soft tissue areas (blessedly, no pain at the location of the fractures), and considerable swelling when I remove the boot. I hope the pain begins to become more manageable and the muscle begins to rebuild as the days go on.
My most important question for anyone reading, however, concerns her allowance of me to remove the boot for sleep. This terrifies me at this point. I've had either a cast or a boot on my foot for the past two months. Removing it during showering is one thing, because I can carefully monitor and control its motion. But during sleep? I'm nervous that twisting and turning in the middle of the night will cause exactly the type of motion that could refracture the thing. That said, the OS did say "If I had any concerns, I would not be giving the approval to walk."
What have your experiences been in the early days of your weight bearing?
17 Feb - Nondisplaced bimalleolar Fx from skiing accident. Larger fracture on medial side. Quite a big chunk. Placed in slab splint.
19 Feb - Ortho puts in short leg cast.
26 Feb - Cast removed, repeat X-rays to confirm no movement. X-rays look
good, so another short leg cast and follow up in 3 weeks. NWB
19 Mar - Cast removed, repeat X-rays. Looks good, fracture line clearly visible but fainter than original 17 Feb x-ray. Given the option of short leg cast or boot. I chose boot. NWB, and must sleep in boot, but may remove for shower. Follow up in 3 weeks for eval for transition to PWB.
22 Mar - accidentally bore weight when crutch slipped out from under me. Repeat x-rays at urgent care. Radiologist didnít even note lateral malleolar fracture (and I never could see it on X-ray). Said everything still looked good.
6 Apr - 7 week f/u with ortho. X-rays look good. Given the go-ahead for as much weight bearing as I can tolerate in the boot. Recommended aiming for 1 crutch by end of the week. F/u in 3 weeks to begin PT.