Postop Ankle Fracture
Weight Bearing & Brace
This is dependent on the procedure performed:
Ankle Open Reduction & Internal Fixation
You will be placed in a splint in the operating room. You should keep this clean and dry and do not remove it until you clinic follow-up. You will also use a walker or crutches, and should be strictly non-weight bearing. Your ankle should be elevated above the level of your heart (on 2 pillows) at all times to minimize swelling except when you are using the restroom or transferring.
Moving Your Ankle
You will remain in your splint until it is removed by your surgeon. Advancement of your motion, including physical therapy, will be discussed at your first postoperative visit.
You may start doing straight leg lifts right away. While lying in bed, simply keep your leg straight and lift it off of the bed. Hold it up for a count of 5. Do this 10 times, and repeat three times a day. It will be difficult at first, but don’t give up, even just flexing your quad muscle without lifting your leg is helping make your leg stronger. You may start doing knee extensions at the edge of your bed as comfort allows.
Use a commercially available ice bag or fill a large plastic bag with ice and water. (Do not place a plastic bag directly on your skin, but place a towel on your ankle in between your skin and the ice bag.) You can ice your ankle 20 minutes on and 20 minutes off throughout the day. Do not ice your leg longer than 30 minutes at a time, as this can cause frost bite. Ice is most helpful in the first 3 days after surgery, but can help up to 2 weeks after surgery. We do not recommend that you use heat, as this can increase swelling.
If you have a hard splint, keep it clean and dry and do not remove it until your clinic follow up. It is OK to get your incisions wet after the bandage is removed, but it is very important not to soak the incision underwater (no bath, pool, hot tub etc…) for 3 weeks. It is OK to wash the incisions gently with soap and gently pat dry with a towel. Do not place any lotion or other ointment on your incisions. Put the ACE wrap on just tight enough so that it does not fall off.
You will be given a narcotic pain medicine (such as Percocet – oxycodone, Norco – hydrocodone, or Tylenol#3 – Codeine). We will prescribe a different medication if you cannot take these. Take this AS NEEDED only. Do not take additional Tylenol (sometimes called acetaminophen) with these medicines, as they already have Tylenol in them. You may SUBSTITUTE Tylenol for a narcotic pill if you choose to. Be certain that you do not exceed the maximum Tylenol dose as noted on the Tylenol bottle. Pain medicines often cause constipation, so you may want to purchase an over-the-counter stool softener (for example – Dulcolax, or you may also ask the Pharmacist) to take along with these medicines. It is best to take most of these medicines with some food, as they can all cause a little stomach upset.
You may have received Phenergan (promethazine) or Zofran (ondansetron). You may take these medications if you are having nausea or vomiting.
You should take Aspirin following surgery to help prevent a blood clot. Take one full-strength pill (325 mg) twice a day. If you are unable to take Aspirin, you should take another blood thinner. Discuss this immediately with your surgeon. You should also wear the compression stockings that were placed on you following surgery.
Please do not take NSAIDs such as Ibuprofen or Motrin, as these may slow healing of bone and tendon.
You should have a follow-up appointment with your surgeon in about 2 weeks if you stay overnight in the hospital. If you do not stay in the hospital, you will have an additional visit with the Physician’s Assistant within a few days of your surgery. Call (480) 964-2908 right away if you do not have an appointment already scheduled. We will check your incisions and remove any sutures at the 2-week visit. We will also answer any specific questions you may have about your surgery.
You will be instructed on home exercises and placed in a CamWalker at the 2-week follow-up visit. Physical therapy typically starts 6 weeks after surgery, or when you start walking in the boot. ALWAYS wear the boot at night to prevent loss of ankle motion.
Call our office at (480) 964-2908 with any urgent or emergent questions or concerns that you may have, or if you develop swelling in your leg with calf pain, swelling that will not go away when you elevate your leg, a temperature above 101.4, or drainage from your incisions.
If you experience any of these symptoms: go to an Emergency Department close to your house: High fever (above 102.5), chest pain, difficulty breathing, fainting, or bleeding.