ORIF ankle fracture/acute dislocation question....

[Ingrid]

Hi,

I suffered an open fracture and acute dislocation to my right ankle about 2 weeks ago, which was treated with ORIF surgery. Since then, I have been placed in a short leg cast with instructions to return to my treating physician in 6 weeks, however no information has been given to me regarding recovery time, physiotherapy requirements etc..

The fracture was really quite bad, with my ankle joint basically shattered into many fragments of bone, the dslocation was also severe, as I was only approx. 15 minutes away from losing my foot due to blood supply restriction, and there is obviously a lot of soft tissue an ligament damage. I was wondering if anyone can give me a rough idea on the recovery time (basically how long until I will be able to go back to work in hosplitality which involves being on my feet for 10+ hours at a time)

Any help anyone can give me would be very much appreciated!

Thankyou..

[physiobob]

Hi Ingrid, firstly might I say that we all feel your pain....Ouch! This is difficult to answer really as the amount of damage from the fracture, your time for bone healing, you blood supply, the amount of/or lack of nerve involvement etc. Bones of course begin to "stick" together via a callous within about 6 weeks so long as the individuals body physiology is considered normal. Full ossification will however take at least 12 months.

We need perhaps to view some x-rays or MRI's. Is it possible for you to post them as attachments? We need to know whether the joint line was involved and or the talar dome (the curved part at the top of the ankle that makes the hinging movement possible) etc. One should not rush this due to the possible complications of reflex sympathetic dystrophy (now called Complex regional pain syndrome - CRPS).

I would not think about being on your feet 10 hours a day though for at least 6 months. Of course you will be walking normally much quicker than that.

By the way how did you get this injury?

p.s. Not to scare you, or make you paranoid but here's a short definition of CRPS for anyone reading this post. You should therefore get good Physio advice and treatment with your type of injury.

• Complex regional pain syndrome (CRPS) is a chronic pain condition that is believed to be the result of dysfunction in the central or peripheral nervous systems. Typical features include dramatic changes in the color and temperature of the skin over the affected limb or body part, accompanied by intense burning pain, skin sensitivity, sweating, and swelling.
• CRPS I is frequently triggered by tissue injury; the term describes all patients with the above symptoms but with no underlying nerve injury.
• Patients with CRPS II experience the same symptoms but their cases are clearly associated with a nerve injury.

Older terms used to describe CRPS are "reflex sympathetic dystrophy syndrome" and "causalgia," a term first used during the Civil War to describe the intense, hot pain felt by some veterans long after their wounds had healed.


CRPS can strike at any age and affects both men and women, although most experts agree that it is more common in young women.

[Ingrid]

Thanks so much for the reply!!

I can get the X-Rays sometime soon, but in the meantime, I can tell you that the "talar dome" was involved, the surgeon showed me the X-rays and I had snapped both ends off it. Does that have an impact on the recovery?

And, believe it or not, this was all caused by stepping out of a taxi in stilletos. Just, slipped on a bad angle and *snap*.. in fact, I think I need to make up a story, because the truth is rather embarassingly simple haha..

Thanks again for the reply!

Hope to hear from you further..

Ingrid..

[physiobob]

Originally Posted by Ingrid

I can tell you that the "talar dome" was involved, the surgeon showed me the X-rays and I had snapped both ends off it. Does that have an impact on the recovery?

In short, yes. This is going to take some time for the talar dome to heal. Have you got any images you can attach of the ankle pre and or post the surgery? Be progressive however if in doubt stay on the side of caution with regard to pain in the talar dome region. You need this to mend up as best as possible and it is best not to rush this area.

Have you an update from your follow-up appointment as yet?

[junior_physiotherapist]

[

We need to know whether the joint line was involved and or the talar dome (the curved part at the top of the ankle that makes the hinging movement possible) etc

.


Hi Mr Physiobob

*Would u please be so kind and explain why did u ask the patient about if there was a # at a talar dome!!?

** Another thing also i know the anatomical parts of talus is head,neck and body!
so please if u have a picture to show us the talus dome give us it please.

Regards

[physiobob]

Originally Posted by junior_physiotherapist

[ .


Hi Mr Physiobob

*Would u please be so kind and explain why did u ask the patient about if there was a # at a talar dome!!?

Because this is the part that takes the direct joint load and is also the part with the thin lining of articular cartilage. I will attach an image if I can find one.

[junior_physiotherapist]

Dear phyiobob

Thanks alot of ,sir.

Regards

[michaela]

Dear phyiobob can you tell me when i will be back to normal after my surgury, i went into hospital after a fall from work, i dislocated knee and broke my tib and fib and they repaired it with plates and pins, but my knee is still in great pain and also my leg. picture of my xray
thanks
michaela

ImageShack - Hosting :: xrayqq8.jpg

[physiorick]

Hi,is anyone able to give me some pointers RE a client i am treating.
he had an ankle inversion injury in april 08 but came to see me 4 months later.
he injured it as he landed after jumping over a style while out hiking.
on injury he had immediate swelling and symptoms of shock (clammy, nausea, dizzy)
he had no xray on it, and his main problems at present is that is aches++ at rest.
it is fine when he is walking around, but once he is sat down or in bed it aches profusely.
no swelling or local tenderness of the ligaments. end of range inversion and EOR plantaflexion --> a sharp pain but he is unable to pinpoint where the pain is originating.
the symptoms he gets vary in location but seem to be around the talar region.

does anyone have an idea of diagnosis for this? I suspect some form of small fracture and possibly some residual ligament injury (?interosseous talocalcaneal lig?)

thanks,
Rick