Post-Surgery Rehabilitation for Ankle Tibia Fractures: A Patient's Journey

Postoperative Rehabilitation Program for Tibial Injury in the Ankle Joint

Hello Dr.
Hong, I fell from a height of 2.5 meters, and upon landing, I heavily impacted my left foot, resulting in a fracture on the lateral side of the distal tibia.
I underwent surgery where two steel screws were inserted externally to stabilize the tibia.
Two weeks post-surgery, the doctor said my recovery was progressing well, and I was advised to use crutches and apply only 50% weight on the affected leg.
It has now been 34 days since the surgery, and I have been actively engaging in gradual rehabilitation and upper body workouts to promote bone healing.
Currently, I can take a few steps with normal weight-bearing without any discomfort in my foot.
However, my family insists that I should still use assistive devices and limit my weight-bearing to 50%.
I will have to wait another three weeks for a follow-up appointment and X-rays to assess the actual healing of the bone.
I would like to ask Dr.
Hong about my current recovery status: do I still need to use crutches for walking? If I walk short distances normally, will it affect the healing of the fracture?

Azhang, 40~49 year old female. Ask Date: 2017/06/16

Dr. Hong Ximing reply Orthopedics

After an ankle joint fracture, it is recommended to avoid weight-bearing for 6-8 weeks to maintain joint stability.
It is advised to use assistive devices for partial weight-bearing to prevent affecting fracture healing and joint stability.

Reply Date: 2017/06/16

More Info

Hello! Thank you for sharing your journey regarding your ankle tibia fracture and subsequent rehabilitation. It sounds like you've made significant progress since your surgery, and it's great to hear that you're actively participating in your recovery.

Based on your description, you underwent surgery to fixate the fracture with two screws, and your doctor has indicated that your recovery is on track. At 34 days post-surgery, it's understandable that you want to gauge whether you can transition to walking without crutches, especially since you are experiencing no discomfort during short-distance walking.

1. Current Recovery Status: Given that you are able to walk short distances without discomfort, it suggests that your body is responding well to the surgery and rehabilitation. However, the healing process for fractures, especially in the tibia, can be complex. The tibia bears a significant amount of weight, and premature weight-bearing can lead to complications such as delayed healing or even re-fracture.

2. Use of Crutches: Your family’s insistence on using crutches and limiting your weight-bearing to 50% is likely based on a precautionary approach. While you may feel comfortable walking, it’s essential to adhere to your doctor's recommendations until you receive further guidance during your next appointment. The use of crutches helps to offload the fracture site, allowing the bone to heal properly without undue stress.

3. Impact of Walking on Recovery: Walking without crutches, especially if you are applying full weight, can potentially impact the healing process. The bone needs time to regenerate and strengthen, and any excessive strain could hinder this process. It’s crucial to follow the weight-bearing restrictions set by your healthcare provider. Engaging in short-distance walking with crutches may be a safer option until your next evaluation.

4. Next Steps: At your upcoming appointment in three weeks, your doctor will likely assess the healing progress through X-rays. This will provide a clearer picture of how well the bone has healed and whether you can gradually increase your weight-bearing activities. If the X-rays show good healing, your doctor may allow you to start reducing your reliance on crutches.

5. Rehabilitation Exercises: Continue with your rehabilitation exercises as prescribed by your physical therapist. These exercises are designed to improve strength, flexibility, and range of motion, which are crucial for a successful recovery. Engaging in upper body workouts is also beneficial, as it helps maintain overall fitness while your lower body heals.

6. Listening to Your Body: It’s essential to listen to your body during this recovery phase. If you experience any pain, swelling, or discomfort while walking, it’s a sign that you may need to revert to using crutches or limit your activity.
In conclusion, while your progress is commendable, it’s vital to prioritize the healing of your fracture. Adhering to your doctor's advice regarding weight-bearing and the use of crutches will significantly contribute to a successful recovery. Keep up with your rehabilitation exercises, and don’t hesitate to communicate any concerns with your healthcare team. Wishing you a smooth and speedy recovery!

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