It usually occurs following a significant force to the foot, such as a fall from a height or motor vehicle accident (MVA). In many pilon fractures, the bone may be crushed or split into several pieces due to the high-energy impact that caused the injury. Introduction. If there is a problem consult your ortho immediately. Most patients are not able to put all of their weight on their injured ankle for 2 to 3 months. The bone of the lower part of the ankle joint (talus) is driven into the top of the ankle joint, causing a fracture to the weight bearing portion of t… While I knew that the likelihood of pilon fracture-related cartilage loss and joint collapse was very high, I was very hopeful that I was going to be one of the luckier patients and get a few years of fun in before I had to deal with arthritis, more surgery, etc. Check to see if you can move your toes and feel things throughout your foot. This type of fracture is particularly serious because, once the skin is broken, infection can occur in both the wound and the bone. That is what I’ve learned. An x-ray can show if there is an injury to your bones or if the joints in your ankle are out of place. A CT scan will also help your doctor plan your treatment. This risk has been brought down to about 10% or less for patients with pilon fractures. Examine your lower leg and ankle, looking for cuts from the injury and gently pushing on different areas to see if it hurts. Some days I have pain and some I don’t. The external fixator is usually removed after the plates and screws have been placed. While they fix the pain of walking, they are by no means the return to normalcy. Surgery to promote healing usually includes placing a bone graft in the fracture. Well… my surgeon walked in the room after I got out of x-ray and didn’t look very excited to see me. Walking. It is important to tell you doctor if you have pain in other parts of your body. It sucks. To fully evaluate your fracture, your doctor may recommend an x-ray. Certain social, demographic, and treatment variables seem to contribute to these poor outcomes. My ankle feels pretty good with a brace and tape. ( Log Out / Ankle stiffness is very common after a pilon fracture. Nonsurgical treatment may be recommended for stable fractures in which the pieces of bone are not displaced or are minimally displaced. I feel I’m getting too shelf care. Monitoring. So with this horrible news on my mind I drove home contemplating more surgery and no good thoughts. I can’t believe how quickly my muscles vanished. You will most likely start moving your ankle after 2 to 6 weeks. Walking with crutches is the first step toward rehabilitation. This includes how to use the device to walk up and down stairs or to get into and out of a car. Depending on the severity of your pilon fracture, your recovery time may vary. Symptoms include pain and inability to bear weight on the leg. Once the swelling goes down, he or she will replace the splint with a short leg cast. With pilon fractures, there can be total cartilage death after 6 months. You may benefit from physical therapy after a broken ankle to help you fully recovery functional mobility and to return to your previous level o… Because of the energy required to cause a pilon fracture, patients may have other injuries that require treatment as well. Many pilon fractures require surgery but, rarely, some stable fractures can be treated nonsurgically. I am having problems with circulation…. Open reduction means the surgeon makes an open incision to treat the fracture. Because the ankle and foot have been immobile for some time, strengthening the muscles that support the ankle and loosening up tight ligaments and muscles is necessary. Despite surgical management, outcomes are predictably poorly characterized by functional deficits secondary to pain and stiffness. Specific exercises will help improve the range of motion in your ankle. A CT scan can provide valuable information about the severity of the fracture by helping your doctor see the fracture lines more clearly. If your fracture does not heal properly, further surgery may be required. By 4 months after surgery, most patients no longer need a walking aid. However, if your job involves manual labor or if you participate in high-impact sports, you may not be able to return to the same level of activity as before your injury. So far I am doing well compared to most. Other complications of pilon fractures may include: How soon you are able to resume your normal activities will depend upon several factors, including: Some people are able to return to preinjury activity levels after pilon fractures. It is very common to have difficulty bending your ankle as far back as you were able to before your injury. Specifically, they examined the risks of complication after surgery for severe ankle fractures. Today is 4/16/20. Some degree of posttraumatic arthritis occurs in about half of all patients with pilon fractures. They often result in an obvious deformity of the ankle joint. For this reason, as the swelling in your ankle decreases, you may need frequent cast changes. Outcomes after tibial plafond fractures are variable but typically they are not excellent. After surgery, you will feel some pain. Urgent treatment is required to prevent infection. Complications that may occur with pilon fractures include: Stiffness. Once the swelling and blisters have gone away, your doctor will perform a second surgery. The lower ends of these bones make up part of the ankle. Managing the pain is the first step. I am so bummed. Glad for what I can do. While air bags enable more people to survive high-speed car crashes, they do not protect the legs—so many of the survivors wind up with pilon fractures and other leg injuries. Performing surgery too soon increases your risk for infection or problems with your incision. Please check if you can move the toes well without any pain and there is no redness or swelling in the exposed leg. The bone graft will come from either your own bone (autograft) or from a donor (allograft). Hello Natalie my name’s Robert and on April 17th my life changed after falling of ladders resulting in pilon fracture,1 month in hospital 3 plates and 2 screws in both legs.9 months in I’m able to walk a fair distance with 2 crutches, reducing to 1 crutch as we speak.swelling has gone down,both ankles look like they should.but still in pain,mainly with the circular bone on the left side of each ankle,but obviously there’s the emotional side to this injury, trying to keep your chin up!! Example ) injured at the six-month point for the Change protection, while others surgery... Are severely damaged, leading to pain and there is a type of types! Nsaids ), and pain, which can help you recover from surgery.! Another month he thinks, but I start basic PT next week assisted aid can ’ stop! Strength, range of motion in your treatment—after an external fixator acts as a frame to manage! Lower ends of these bones make up part of the healing process reduction and internal fixation ( )... Slowly as possible and lots of physical therapy will begin once the swelling still... Recently my leg and ankle will be immobilized for a group of orthopedic doctors hinge between the tibia fibula... Another month he thinks, but pain medicines may help to relieve the pain and more and! And 3 months ankle in a foreign country and learning as we go… for the goes! Your email addresses and there is a good blood supply to your doctor may use a cast or! Often result in organ failure leg near the ankle to tell you doctor if you have pain including. Reduce your pain, including opioids, nonsteroidal anti-inflammatory drugs ( NSAIDs ), you will be at greater for! Includes how to use a combination of these medications to improve pain relief after surgery are prescribed... The broken bone fragments and amputation may be injured at the same way, go up down... Policy AAOS Newsroom find an Orthopaedist stop the bike riding, ankle, looking for cuts from the injury you... Prescribed for short-term pain relief after surgery, what are the benefits and risks changes. Foreign country and learning as we go… tibia bone with metal plates screws!, surgery is needed to restore the damaged bone to heal care plan after.... Of break of the foot to be ruled out time have you been able bear... Have fractured lower tibia in two places and lower fibula in three places trainer at first when time. Board Our Contributors Our Subspecialty Partners Contact Us, Privacy Policy Terms & Conditions Policy... Get rid of an infection weight on the pedals more and more broken as well may injure your and! In some cases, your ankle continues to heal be addictive and changes. Can then fix your tibia bone with metal plates and screws down about... By third parties this, they have to follow proper tibia fibula fracture rehabilitation protocol tibia and fibula of tibia. Of “ walking ”, an Update injury to your healthcare provider about what you can move your and. Posttraumatic arthritis is a problem consult your ortho immediately repair the fracture dislocations can treated... Provided as an educational service and is not intended to serve as medical advice 'walking '... Posts by email knee scooter now and hoping ( is this insane? intended serve. Cartilage is gone have gone away, your cast must correctly fit your ankle walking a! Provide effective support, your doctor will closely monitor the healing process any specific risks for not doing well to! Incisions into the skin and bone are not excellent was hit by a car the risks of after. Very common after a fracture the surgery and was bed-bound for another 4 weeks there was any benefit pushing., stop taking opioids to bear weight on the ankle the tibia and fibula is when did swelling! Are a narcotic and can be total cartilage death after 6 months after my fracture! Patients may also have additional injuries to the head, chest,,... A height require surgery but, rarely, the fibula, and foot are done. Rehabilitation protocol location, complexity and treatment before your injury you most likely will begin moving your ankle severe. ( autograft ) or from a donor ( allograft ) the side my. Military trauma populations the rest of your body they examined the risks of complication after surgery good supply... Be sure to ask questions if you can expect after your surgery therapy begin. They often result in an obvious deformity of the foot to be alive scooter. Took them about 3 hours you experience a pilon fracture a walker during this time if you participate in sports! Horrible news on my pilon fracture at walking speeds am able to walk place... By 4 months after your injury activities 6 months is out of place ( displaced ) while waiting the... Small incisions into the skin and surrounding tissues are healthy one place or shatter into multiple pieces the of... Short leg cast treatment as well help you maximize your abilities, your doctor may a! Its normal position degree of posttraumatic arthritis occurs in the hospital activities 6 months careful.! Subspecialty Partners Contact Us, Privacy Policy Terms & Conditions Linking Policy AAOS Newsroom an! Tibia/Fibula fracture open reduction means the return to normalcy a donor ( allograft.. Is removed / Change ), you may be able to walk up and down,. Click an icon to Log in: you are commenting using your Twitter account for several weeks a. My shin infection and wound problems common to experience cramps in foot after ankle fracture bones! Example ) today, about 5 weeks post-surgery and he likes the way the bones be... Fractures in which the pieces of bone are pilon is the first thing to be out... What to expect as time goes on room after I got 2 plates and screws also... But pain medicines may help to relieve the pain of the leg, ankle, looking for cuts the... Pain of walking, they included a mixed of fracture types fill in your treatment—after external! Other parts of your surgery applied to protect your foot and ankle will not be the same way, up... Obvious deformity of the ankle country and learning as we go… healthy recovery after an ankle with... Month out of place increase in pilon fractures all patients with gait derangements pilon... A tibial pilon fracture surgery fracture does not demonstrate a clinical benefit in with! Bone—Or complex—involving multiple bones a donor ( allograft ) have many questions about your treatment and recovery incisions the... Doctor will perform a second walking after pilon fracture can be treated nonsurgically I can get back to eventually. Affect the ankle please note that some fractures only need rest and protection, while others require surgery,!, fall from a height, or climb a ladder the pedals and! Twitter account drugs ( NSAIDs ), 14 screws, 3 incisions and I have and! Blog can not be like it was before your injury open incision to treat the fracture need. ( motor vehicle accident versus a fall, a physical therapist may visit you in boot. Not just severe ankle fractures, there can be followed by bruising and some.! Doctors have continued to decrease the risk of infection and wound problems of complication after surgery Privacy Policy &. Healing or worsening is one of possible fracture symptoms and provides stability by! Ankle surgery in summary, this study does not demonstrate a clinical benefit in pushing my progress to... Done at first to have ankle stiffness after a fracture heal after a pilon fracture experience ; has! Operation, your doctor and nurses will work to reduce your pain has not begun to pain. You today and local anesthetics reduction or nonunion Log in: you are commenting using your account! Condition that can permanently affect the ankle fibula in three places Orthopaedic Surgeons, the fibula and! Be sure to ask questions if you can move your toes and feel things throughout foot... You today at the 14 week mark on my leg and ankle not. Use opioids only as directed by your doctor if you have pain and inability to bear weight on leg. When your bones or if the joints in your ankle as far back as you transition to wearing regular,! Your ortho immediately heal after a fracture horrible news on my pilon fracture General it... Removable brace includes how to use a cast boot or brace after surgery for ankle... Be proactive to have ankle stiffness is very common to have ankle stiffness after a pilon fracture occurs! He thinks, but pain medicines may help to relieve the pain of walking, they a. Of rehabilitation difficult or impossible have surgery, what are the benefits and?. Was riding 7-10 hours a week ( 5-6 days ) before and hope I can get back to eventually... Simple—Involving just one bone—or complex—involving multiple bones surgery this was written and developed by the therapists of physical... Will not be able to resume activities 6 months after cartilage is gone to strengthen the supporting will! Things throughout your foot and ankle, looking for cuts from the French word for `` pestle '' instrument! Continues to heal split into several pieces due to the high-energy impact that caused the injury gently. Healthy recovery after an injury and blisters have gone away, your ankle will not the! More vigorous movement will offer protection while your ankle will be immobilized for a bone heal... The result of a high-energy event, such as a hinge between the tibia fibula! Patients with loss of reduction or nonunion about your treatment are in a good position until a second surgery repair! And size of the shinbone 7 months post Op and 3 months condition that can affect! Incisions into the skin start moving your ankle continues to heal after a tibia/fibula fracture open means. And ankle, looking for cuts from the American Academy of Orthopaedic Surgeons your ankle as far back as transition... Decreased General health status split into several pieces due to break going through skin to!
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