Walking after ORIF surgery, fractured distal fibula

by Jenn
(PA)

I broke my left distal fibula and my 3rd metatarsal on Sept 12, 2009. I then had surgery on October 2. Had to wait so long due to swelling and doctors schedule. I had 6 screws and a plate. I was in a partial plaster splint until October 15 and was then given a walking boot to wear however was told not to bear any weight for 7 weeks. I just started physical therapy on November 9. I believe that I get to start walking with my boot and possibly one crutch this week. I am finding it very frustrating that my doctor is very busy and doesn't spend any time explaining anything to me and will not give me any idea of how long my recovery will be. I had a couple of questions that I was hoping you may be able to help me with. I have noticed that when let my leg hang down after having it elevated my foot turns a shade of purple/blue, but once I elevate it again my foot turns back to its normal color. Is this normal? I also have noticed now that since the swelling has gone down that the ankle bone that sticks out on the outside of my leg seems to have a type of bump on top of it. Is this a screw or part of the plate? When I went to my last ortho appt on November 5 I was told that I would get to walk in 2 weeks and to just "go" ahead and walk. Am I going to be in a lot of pain when I walk? And my last question is how long will I have to wear the walking boot for? My next ortho appt is not until Dec 7. My physical therapist has no clue about why my foot may be turning the color that it is and can't really answer any of my questions/concerns. Sorry to overload you with questions I am just getting very antsy to get back to normal since it has already been 2 months since I last walked. I hope you can help.

Thanks!
Jenn

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Walking after ORIF surgery, fractured distal fibula

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Nov 18, 2009
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questions
by: Bart - SII

It is frustrating when your doctor doesn't seem to have time for your questions - thats a pet peeve of mine!

The circulation in your foot is likely what is causing the color change. Because you are not walking on it and using the muscles normally, the return blood flow is not as efficient - couple that with the healing and inflammation that is going on, and you get a pooling of blood in the foot when it hangs down, and that can turn it a shade of purple. This will get better with time.

The bump on your lateral malleolus is likely either a screw or part of the plate. There isn't much padding between the skin and the bone, so they can sometimes be felt and seen. This area may give you some trouble when you start wearing regular shoes again.

You will probably have some pain when you start to walk. As well as limited range of motion. You will probably feel like you don't even know how to walk. IT WILL get better, but your therapist should take you through some gait training exercises to help improve your walking, and you should progress slowly. Just because the doc says you CAN walk, doesn't mean you have to all right away and at once. You will probably also have some increased swelling when you first start weight bearing again. That is normal.

There are a lot of encouraging stories on the site under the ankle questions section - many people with ORIF like you. They may help provide some encouragement.

Bart

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Nov 18, 2009
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Submitted by: Bart - SII

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It is frustrating when your doctor doesn't seem to have time for your questions - thats a pet peeve of mine! The circulation in your foot is likely what is causing the color change. Because you are not walking on it and using the muscles normally, the return blood flow is not as efficient - couple that with the healing and inflammation that is going on, and you get a pooling of blood in the foot when it hangs down, and that can turn it a shade of purple. This will get better with time. The bump on your lateral malleolus is likely either a screw or part of the plate. There isn't much padding between the skin and the bone, so they can sometimes be felt and seen. This area may give you some trouble when you start wearing regular shoes again. You will probably have some pain when you start to walk. As well as limited range of motion. You will probably feel like you don't even know how to walk. IT WILL get better, but your therapist should take you through some gait training exercises to help improve your walking, and you should progress slowly. Just because the doc says you CAN walk, doesn't mean you have to all right away and at once. You will probably also have some increased swelling when you first start weight bearing again. That is normal. There are a lot of encouraging stories on the site under the ankle questions section - many people with ORIF like you. They may help provide some encouragement. Bart

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Nov 19, 2009
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Thank you
by: Jenn

Thank you so much for answering my questions. I feel better knowing that what I am experiencing is normal. I was giving the thumbs up today to start weight bearing, using both crutched thru the weekend and then starting with one crutch on monday at next PT appt. I finally feel like I can see the light at the end of the tunnel and am feeling better each day. Thank you again.

Mar 09, 2010
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your orif
by: Anonymous

Hey Jenn, I fractured my distal fibula whilst bushwalking and had to have an orif too. I am in my 4th week from surgery ( 10cm plate and 5 screws)and have been told that in 2 weeks time i will need to start weight bearing...this is a bit scary for me also. My foot when hung down also goes a nice shade of deep purple so was glad to read this is normal also.
I have had a great deal of shooting pain or nerve pain which has been hard to deal with....my doctor has put me on gabapentin which has helped...I hope your recovery is going ok...its frustrating but we will get there! Just take it one day at a time
Beth