Broken Ankle at 13 months

My ankle is no long bionic and the hardware was taken out! I mentioned, in last month’s post, that I was planning to talk with the surgeon about hardware removal. I had an appointment with her, she felt how the screws on the fibula were visible and palpable and painful to touch, and agreed that removing them would help. She also said she’d look at the peroneal tendon since it might be irritated by the hardware. I called her assistant the next day and had the hardware removal surgery 2 weeks later.

Ankle xray showing hardware from ORIF surgery June 2022 and ankle xray from June 2023 showing no hardware (and holes to fill with new bone)

Ankle hardware removal surgery

• Just scheduling this and thinking about it brought back memories of the trauma a year ago. On the way to the hospital I cried and worried. Of course this surgery&recovery would be easier even as my emotions ran amuck.
• It was all so much easier than the story the trauma memory was telling me.
• I changed into hospital gown, held onto the rainborn unicorn squeeze toy from my daughter, and a nurse put an IV in my hand. It caused a bruise, she apologized, I said, no big deal, it’ll heal (and it has).
• I talked with anesthesiologists, asked for no or minimal opioids (because they don’t usually reduce pain for me), no problem, they would give me a nerve block.
• There was a gender+age dynamic while a younger resident (female) was getting nerve block started and older doctor (male) was doing the ultrasound and needle&med for nerve block. I mentioned that the nerve block last year lasted 36 hours. The older male doctor didn’t believe me and said, “it only lasts 12–18 hours for everyone.” Then the resident female doctor said she believed me because all bodies are different.
• Another anesthesiologist arrived and said he’d be the one with me in surgery. I appreciated that he had a flowered cap so it’d be easier to see him without my glasses on. I repeated my wish for minimal to no opioids and he said no problem, he’d give NSAIDs.
• In the OR it took a while before I was put under with versed. They needed to place a new IV. The flowered cap anesthesiologist did it on the side of my wrist. So slick. That healed up faster, on my wrist, than the one on the back of my hand.
• After surgery this time I didn’t have a sore throat at all! I did have some nausea for a couple days that I managed with zofran. They hadn’t given me a scopolamine patch like they did a year ago.
• My foot, toes, ankle, leg, were totally numb after surgery because of the nerve block. It made my foot feel like a sponge. A year ago I appreciated the nerve block because I had been in so much pain already for a week. This time the nerve block felt annoying until it wore off.
• My wife brough a thermos of iced black tea for me and it felt so refreshing to drink it after surgery. She also brought the amazing mobilegs crutches I had used last year.
• My ankle was wrapped in a lot of gauze, that felt a bit stiff, and then a stretchy bandage. No splint and no cast!
• We got home and I realized we’d been gone around 7 hours. I checked my mychart account and found an xray, from surgery, showing hardware gone and smiled. From the xray it looks like the fibula has some work to do to fill in the screw holes. We can do that!
• The surgeon also cleaned up some fraying on peroneal tendon probably caused by hardware and cleaned up some scar tissue.
• I didn’t fill the oxy prescription this time since last year it didn’t do much for my pain. I took high doses, alternating, of ibuprofen and acetaminophen, and set alarms to remember to take them every 6–8 hours.
• The nerve block wore off after 2 days. I went from 2 crutches to 1 crutch to walking unassisted within 3 days.
• The only pain I’ve felt from this surgery is incision pain.
• I will need to wear CAM boot while bones fill in the screw holes. I tried wearing CAM boot but it rubs against the fibula incision.
• I haven’t been going outside since I can’t wear CAM boot to protect my bones and I’m planning to stay mostly inside for a couple weeks while incisions heal.
• The best part of this recovery is experiencing how much easier it is from the initial broken ankle, ER, surgery, recovery experience.
• For first couple days I got up and down the stairs in our house by sitting on stairs (and having my wife or daughter bring crutches up or down for me).
• By the 3rd day I could walk unassisted and up and down the stairs (slowly).
• By the 4th day I was no longer taking pain meds.
• I sit on a shower stool and pour water over myself to get clean — just like I did all last summer. This time it’s only 2 weeks until I can take a real shower again. Nurse said best not to shower with cast cover because I don’t have a cast and water can leak into the cast cover.

What’s Next

I had a post-op appointment 1 week after surgery. The surgeon checked the incisions, rewrapped my ankle in gauze and a stretchy wrap, told me to not worry about wearing boot and focus on incision healing and be careful for now. I was so happy to see my ankle not at all swollen when she took the initial wrapping off (and I can still do full range of motion with it). It feels a wee bit queasy to see a large gash, over fibula, stitched up once again. I felt relieved to see she didn’t need to go back through the scar on my tibia and instead just two little holes to get the screws out of the medial malleolus.

I go back in a couple weeks to get stitches out (because surgeon is on vacation so waiting an extra week until she’s back). After she confirms incision is healed then she’ll send me back to PT and told me I could do non-impact exercises. Until then I’m limited to arm and shoulder weights, stretching and core exercises on a mat, and absolutely no lunges or squats or similar standing exercises.

The incision hurts when I walk because it rubs a bit against the gauze wrap so I walk slowly. I’m taking extra Vitamin D to help the bones heal where there were screws. I’m using a cold therapy machine (same one I used last year) and keeping ankle elevated to keep swelling down. I’m sleeping downstairs again because it’s too many stairs to climb, at my current slow walking and stair climbing rate, to sleep in the loft.

Hope for Progress

I hope that this means, within a few months, I will be able to wear more of my shoes and boots, cross my legs without hardware pain (and easily do reclined pigeon pose), continue work on regaining dorsiflexion, get stronger, run and walk faster, and get back to pre-injury life :)