Broken Fibula and Dislocated Tibia

by Nick C
(SpringHill, FL)

My Leg X-ray

About 7 weeks ago I was playing football and broke my leg. I fractured my lower left fibula and the tibia dislocated from the ankle. I had surgery to put in a titanium plate and screws on the fibula. I had a cast on for 6 weeks and just had that taken off.

My Dr said I still cant put any weight on my leg for another month but that I could start range of motion exercises for my ankle. My ankle seems to be the only place I really have pain. My leg doesn't hurt at all where the break was.

What are some exercises I can do with my ankle to get motion back? and how long can I expect to be down from this injury.

I'm 24 years old and have played sports all my life. This is my first serious injury....

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Broken Fibula and Dislocated Tibia

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Oct 21, 2008
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Broken Fibula and Dislocated Tibia
by: Jenny

In my experience, the most important exercise you should do is try to achieve dorsiflexion in your ankle. I would recommend go see a good sport physiotherapist, take your dad/friend/sibling with you, so they can learn techniques on how to manipulate your ankle, then do it at home. When you can start to bear weight on your ankle, then put your broken foot flat on the ground, and try to move your knee forward and backwards, this helps to mobilise your ankle joint. Its important that you do your exercises in the right way and not over or under-do them, so its worthwhile to pay some money to get advice from a good physiotherapist. Good luck.

Oct 23, 2008
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range of motion
by: Bart - SII

Range of motion is going to be your biggest challenge. Your ankle is going to end up being way more of a problem than the fracture site - simply because of the disruption of the ligaments, the time in the cast, and the fact that the ankle joint likes to get locked up and cause problems.

Working on simple exercises like pointing your toes, pulling them toward you, making circles, writing the alphabet will all help. As you get a little further out, you need to make sure you get into rehab with a clinician who can mobilize your ankle and foot - that is likely going to be the key to regaining your motion. I am a big believer in doing this early - within a few weeks after surgery. If done correctly, joint mobilizations will not harm the healing tissues and will help to limit your motion loss.

I would plan on several months for your recovery to full unrestricted activity. Running will take some time to get back to, as will building up your strength.

There are some examples of ankle exercises on the site under the rehab section - Ankle Sprain Solutions also has a lot of good motion and strengthening exercises for the ankle as well.

Bart

Oct 23, 2008
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Broken Fibula and Dislocated Tibia
by: Nick C

Bart,

As far as certain range of motoion excercises go, would two screws going completely across my lower ankle inhibit me from performing certain things? I cant seem to make very big circles at all with my ankle. I have no issues at all pointing my toes or pulling them back. Im due back to the surgeon in a few weeks to have the screws removed and then i plan on going to a rehab center from there. How long can I expect to be out of any sports activities from this? Any time I've seen a pro athlete with a similar injury they are back in a couple months, injury reports say 4-6 weeks....Im really eager to get back to playing, I feel like a part of me is missing without being able to play! Thanks

Nick C

Oct 23, 2008
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syndesmosis screws
by: Bart - SII

Syndesmosis screws, or screws that go through both the fibula and tibia will restrict your motion - usually though it is more of a dorsiflexion restriction. The circles are going to take some time to get back - partially because of the break, partially because of the muscle strength. Just do what you can and keep it moving without pain. Your motion will get much better once you can walk and start rehab.

2-3 months is likely a good estimate of how long it will take to get back to sports - thats after you start weight bearing and rehab. Pro athletes are not always a good comparison, simply because they have facilities beyond compare, and they often go back sooner than it is safe. But it is a good goal to keep to get back as fast as it is safe.

Bart

Oct 24, 2008
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Broken Fibula and Dislocated Tibia
by: Nick C

Bart,

Thankyou for explaining everything so well. It definitely helps to have someone answer some of my questions. Do I have to worry about any setbacks with the hardware removal or is that really not going to affect me any because my leg has already lost alot of mobility and strength? Also, is there anything I can do for the swelling in my ankle? Should I be iceing my ankle or anything like that? Thanks!!!

Nick C

Oct 24, 2008
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hardware removal
by: Bart - SII

The recovery after the hardware removal should be a piece of cake compared the the first time around. You will have some soreness and likely more swelling, but those things should subside in a few days or weeks.

You are going to continue to have swelling for awhile - just part of the process. Ice after activities, elevation when it is really bad. Anti-inflammatories if your doctor says they are alright - these can all help, but your body is still healing and swelling is part of that process.

You can also try massage, as that can help loosen up the tissues in the area and move the fluid around.

Bart

Nov 18, 2008
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Follow Up Appointment....
by: Nick C

Ok, so today I went to the Dr for a follow up appointment on my leg and for what I thought was to set up the surgery for my hardware removal. Well Im in the office with the Dr and he decides to tell me that since basically Im uninsured/self pay that he wont take my screws out of my ankle until I have paid my bill in full. Is this legal? I cant put any weight on my leg let alone get back to work until this procedure is done. This just does not seem ethical at all... This cant be right...

I was originally submitted thru the ER for the surgery so there were no questions asked...Isnt hardware removal part of the original surgery? and to think I thought today was gonna be good news and one step more towards being able to rehab and play sports again....

Nov 21, 2008
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Injury
by: Anonymous

Thats an unfortunate story. Hope you heal well!!

Nov 30, 2008
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Ankle Braces
by: Nick C

Bart,

I was browsing the web for a brace for my ankle when I get back into sports and rehabing and I came across a site called ankleshop.com. I was looking at the Stirrup braces and was just curious on what type of brace you might recommend for this type of injury. Thanks!!

Dec 02, 2008
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Ankle Brace
by: Bart - SII

My brace of choice is the ASO - Ankle Stabilizing Orthosis. That is what I have always recommended to my patients and would use myself with an ankle injury.

Bart

Dec 03, 2008
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Ankle Brace
by: Nick C

Bart,

That brace looks like a very nice one. What is the difference between that type of brace and a stirrup brace? Just curious what the difference is... Thanks!

Dec 03, 2008
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brace difference
by: Bart - SII

The biggest difference is the heel straps. There are two straps that lock around the ankle and help to support both inversion and eversion motions. Also, compared to a stirrup brace, the ASO provides a bit more circumferential compression, which is thought to improve function of the joint proprioceptors. I know the ASO is also fairly well made and should last for at least a couple full seasons of sports.

Bart

Dec 04, 2008
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Brace
by: Nick C

Bart,

Thanks for the information. Do you know anything about the AirCast Air-Sport Ankle Brace?? That is the one I had been looking at. I havent been able to talk to my doctor yet about any of this yet so....Im scheduled for hardware removal on monday sp I planned on asking him then. Thanks!!

Dec 09, 2008
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Screws Removed/ Ankle Brace
by: Nick C

Ok, So i had surgery monday morning to remove the syndesmosis screws and I have been up and walking ever since. It feels good to finally be up on my feet and not having to use crutches all the time...So Im finally On my way to rehabbing and getting back to baseball and hockey....

Bart,

I was curious if you were familiar with the AirCast Air-Sport Ankle Brace in comparison with the ASO brace. I asked my doctor and he said a brace wasnt necessary but id rather be safe than sorry....Any information is helpful... Thanks!!!

NICK

Dec 10, 2008
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ankle brace
by: Bart - SII

I am not as familiar with the stirrup braces - I have always felt like the strap braces provide a better support because of the mechanics of the straps. The other factor is that they provide compression around the entire joint versus just on the sides - can help with proprioception.

I would probably agree with your doc - if you go through the rehab and get your strength and balance back, a brace likely isn't necessary for the long run - but it may give some support early on when you start skating again.

Bart

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Broken Fibula and Dislocated Tibia

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