Broken Tibia, Fibula, Talus, dislocated ankle & ORIF ankle surgery

by JC
(San Diego)

Almost 4 months ago, I dislocated my ankle and broke my tibia, Fibula, and talus. I was hiking on a steep trail, lost footing and fell hard on my ankle. I had ORIF surgery-a plate and 6 screws put in. I started physical therapy two weeks after surgery and went every week and have been good about doing my strengthening/ range of motion exercises--at least 3 sessions a day, mostly 4-5 sessions a day. I have been using a stationary bike and swimming for 3 weeks. I have been walking in shoes for about 6 weeks, and can walk 75% of the time without a limp. Going down stairs is awkward, but getting better.

questions:

My calf muscle is still much smaller than my other-how long until the muscle comes back?

I had been an avid hiker and runner--did about 22+ miles a week and wonder if I'll ever run again? If so, how long until I can do this?

When I stretch my Achilles tendon, heel to the ground and bend my knee, I feel a lot of tightness on each side of my ankle, especially the side with the screws. Is this normal?

Thanks a lot for your help!

JC

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Broken Tibia, Fibula, Talus, dislocated ankle & ORIF ankle surgery

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Aug 16, 2008
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Wow!
by: Bart - SII

That is a nasty hiking injury - your dedication to your therapy sessions will make a huge difference in your recovery...and you were lucky that you started so quickly after surgery.

I had a patient last spring that I treated who had a similiar injury and surgery - he wasn't referred to therapy until almost 8 months out from surgery - they just told him to move his foot around and work on motion at home. Needless to say, his ankle and foot were stuck - and he will probably never be able to run again without pain - despite all of my best efforts in therapy.

Your questions:

It will take a long time for your calf muscle to return to size. I would say close to 6-9 months or longer.

Running is hard to guage - if you get almost all of your motion back, it could be possible - you probably won't know for at least a year after surgery though.

The tightness along the ankle when you stretch your achilles is normal - you probably still have some restrictions in your ankle - not quite all of your motion back, and the joints are not moving as well as they should. This is something that your therapist may be able to address with joint mobilizations - anterior and posterior talar glides, as well as fibular head glides might help to reduce some of the restrictions and improve your accessory motion in the joint.

This injury is going to take a long time to recover from, especially when you talk about getting back to running and sports - at 4 months you are on your way, but it can take 12-18 months to get to your maximum potential.

Great questions - feel free to post more

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Aug 16, 2008
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Submitted by: Bart - SII

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That is a nasty hiking injury - your dedication to your therapy sessions will make a huge difference in your recovery...and you were lucky that you started so quickly after surgery. I had a patient last spring that I treated who had a similiar injury and surgery - he wasn't referred to therapy until almost 8 months out from surgery - they just told him to move his foot around and work on motion at home. Needless to say, his ankle and foot were stuck - and he will probably never be able to run again without pain - despite all of my best efforts in therapy. Your questions: It will take a long time for your calf muscle to return to size. I would say close to 6-9 months or longer. Running is hard to guage - if you get almost all of your motion back, it could be possible - you probably won't know for at least a year after surgery though. The tightness along the ankle when you stretch your achilles is normal - you probably still have some restrictions in your ankle - not quite all of your motion back, and the joints are not moving as well as they should. This is something that your therapist may be able to address with joint mobilizations - anterior and posterior talar glides, as well as fibular head glides might help to reduce some of the restrictions and improve your accessory motion in the joint. This injury is going to take a long time to recover from, especially when you talk about getting back to running and sports - at 4 months you are on your way, but it can take 12-18 months to get to your maximum potential. Great questions - feel free to post more

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Aug 16, 2008
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Thanks!
by: JC

Thanks Bart for these thorough answers! It seems like I'm getting strength and mobility back more quickly now that I'm swimming & doing the stationary bike--I alternate days and go 5-6 times a week.

What are the glides that you mentioned? Are they exercises/stretches that I can do, or are they manipulations that my physical therapist has to do?

Thanks again for your advice. I want to do everything I possibly can to get back to running and hiking.

JC

Aug 16, 2008
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Joint Mobilizations...
by: Bart - SII

The glides that I talked about are a form of joint mobilization that is performed by your therapist. Basically, if you think about any joint in the body, the bones all go through specific accessory motions when you move the joint. So, for example, in the knee when you bend your knee, your femur has to both roll backwards as well as slide forward in order to maintain its position on the tibia. We call this arthrokinematic motion or accessory motion.

After a period of immobilization, disuse, or even after injury, these normal accessory motions are disrupted, and so instead of the bones moving freely against each other, they bind and get caught up - so when you are trying to stretch your achilles and dorsiflex your ankle, instead of your talus moving correctly, it binds and causes the pressure on both sides of your ankle.

Your therapist can work on improving these accessory motions and restoring full physiologic motion.

Bart

Sep 25, 2008
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dislocated ankle, broken tibia
by: Anonymous

I am curious what the "normal" time frame is for physio., after dislocated ankle and broken tibia?

Sep 25, 2008
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normal time frame
by: Bart - SII

A normal time frame for how long a person would be in physio? Well, there are obviously lots and lots of variables, but 2-3 times a week for 4-6 weeks should, if everything is going right, be enough time to get a person enough range of motion, strength, and balance to then be able to transition to a home care program.

Bart

Oct 23, 2008
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broken tibia and fibul
by: jackie

Hi, I broke my fibula and tibia on sept 1, 2008. I had surgery on the 2nd, received a total of 9 screws and a plate in left leg. It was very painful. I just got the cast removed, I am now wearing a walking boot. Physical therapy starts in 1 week. I can't wait until I walk again. Oh did I forget to mention I broke the bones on a fishing trip. First and last time I will try to fish. I've learn my lesson, next time I want fish I'll get take out!!

Nov 07, 2008
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iceskating fall
by: JudyAnn

Hi, on Sunday Nov.2 I fell iceskating and fractured my ankle. The xrays show Tibia has two fractures near Talus bone leaving a slight space between bones and also a break in the fibula. None broke skin and are still pretty much in line. I have seen two specialist who both want to operation and put plate, screws in. I am extremely nervous of operation and do not want to do this. The one specialist said I have a 60% chance of full recovery without operation. 8 weeks in fiberglass type cast.
I have a hard time believing first of the two doctors, who wants to put screws on exterior of skin and says I can put pressure on foot in two weeks and it's a one day in hospital visit. While second doctor says overnite hospital no walking for 6 to 8 weeks.
I know I am giving a load of information but wonder if the first doctor is a quack or perhaps the second doctor is old fashion and doesn't understand the necesity of us woman who have to get back to work????? Thanks for any tips, JudyAnn

Nov 18, 2008
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Responding to Judy Ann
by: Charlotte

I had a fibula fracture and ORIF surgery. One plate, 4 screws. I was prescribed 6 week non-weightbearing and 3 weeks gradually adding weights. I was also ordered on bed rest for the first 3 weeks. I was on crutches for a total of 9 weeks. It felt like a long time and it was difficult to get to and from work but I figured that I only have one chance to heal properly so I better follow doctors orders. I used a Roll-A-Bout in the office and it was great, highly recommended.
I'm on my 10 month of recovery now and the ankle feels pretty good. The range of motion is still a tiny bit limited and the ankle hurts if I wear high heels. The doctor told me that I must wait 12 months before running again, so I'm still waiting for that.
One more thing I'd like to add is that it's so important that you find a talented physical therapist who will do range of motion work on the ankle.
Good luck with your receovery. :-)

Nov 29, 2008
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Broken Ankle, Tibia and Fibula
by: xixi

I have broken:
Ankle, Tibia and Fibula, playing soccer.
I have 7 screws and a plate. its been 3 weeks since operation. I still take Oxycodone for pain 1 pill every 6h. the most pain is on the ankle where i have 6 screws and knee from where doctor inserted the plate down to the ankle. I wonder how long i will have pain, because i don't want to get hooked on this drug, and what is the best exercise, also after how many weeks you guys started to walk with out crutches?
thanks

Nov 30, 2008
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Broken Tibia had IM Surgery
by: Shane

Hey I broke my right Tibia on the 19th of July playing football. I had surgery and had an IM rod and 4 screws placed down the leg. I am now able to run on a turf field and do olympic lifts again, but still cannot jog on concrete. My ankle is still a little stiffand often clicks when rotating. I am 28 and still play football at a competitive level; I was wondering how much longer do I have till I can get back to contact? I have been told that I am pretty far ahead...I'm hoping to be able to return to for my indoor season in March

Nov 30, 2008
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Broken tibia and fibula
by: Almasa

After reading all these posts, I must say that my case is more extreme. I broke both tibia and fibula on October 21 when I was bouldering. Three days later I had a surgery where doctor installed a metal plate on each side of my right ankle with 11 screws. It has been almost six weeks since the surgery and honestly I can't wait to start walking again. My next appointment is in three days and hopefully I will get a walking boot and start with physical therapy. I would like to know how long does it take to recover with this many plates and screws? Would you recommend removing all the hardware after certain amount of time?

Dec 04, 2008
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Broken Fibula
by: Chris

I broke my fibula in April 2008. Had a plate and seven screws done the next day. Began swimming and stationary bike after 2 mos. Tried to start running again in September and ended up with shin splints and a stress fracture. Be careful not to start too soon and take it slow. I'm going to "attempt" to train for a half marathon in March. If you attend a gym, use the eleiptical as much as possible to get the range of motion back without the pounding.

Jan 01, 2009
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borken tib/fib with ankle dislocation
by: Elaine

On Oct. 19 I broke both bones just above my ankle and dislocated the ankle. I had surgery the same day with no weight bearing for 6 weeks. I am now at 10.5 weeks and still have a significant limp when walking with a shoe but do fairly well with the boot. I have been in PT for almost 6 weeks, 3 times a week. I work in a prison and will not be allowed back in until I can walk and move about normally. I'm beginning to wonder just how long this process will take?

Jan 04, 2009
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Broke Tibia
by: Dale La

I broke my tibia while mowing the lawn two years ago, it took roughly a year for my tibia to heal. I just recently started jogging again and noticed while jogging it feels as if a cork screw is being turned only in the area where the impact from the rock broke my tibia. I wondering should i be overly concerned...could it be that i need more cushion in my running shoe in addition to the 30 lb gain.

Jan 04, 2009
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running after fracture
by: Elaine

Dale - I have wondered how long it will take me to start running again. Has it taken 2 years for you to get back to running because of pain or are you just now starging? I am so surprised how slow this whole process is. It's three months now I'm only so-so at walking!

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Broken Tibia, Fibula, Talus, dislocated ankle & ORIF ankle surgery

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Broken Tibia, Fibula, Talus, dislocated ankle & ORIF ankle surgery