Managing Ankle Fractures: Walking, Pain, and Swelling Solutions

Accidentally stepping on the affected limb after a fracture?

Hello Doctor, I have had a fracture for 25 days and have not undergone surgery.
For the first two weeks, I was in a cast, and now I am using a pneumatic ankle brace.
I would like to know if it is safe to walk in this type of brace.
A few days ago, I tried to gently put weight on the injured limb while using crutches, but it was very painful, so I quickly supported myself with the crutches.
I was wearing the pneumatic ankle brace at the time.
I usually take it off to shower and move my ankle a bit, but since I tried to put weight on it yesterday, my ankle feels tighter, and even after a day, it still feels the same.
It was previously much more relaxed and could move up and down, but now there is some pain.
Is there a possibility of misalignment? Additionally, since it has been a while since the fracture, the injured area of my ankle is still quite swollen.
Is there a faster way to reduce the swelling? Should I be using ice or heat for treatment?

Rosie Wu, 20~29 year old female. Ask Date: 2019/02/01

Dr. Chen Yongxue reply Orthopedics

Hello, your message only mentions that the fracture occurred 25 days ago, but it does not specify the location of the fracture or the degree of displacement.
Therefore, I cannot provide accurate information.
It is advisable to consult your attending physician.
Regarding methods to reduce swelling, it is important to elevate the affected limb (above the level of the heart for better swelling reduction).
If elevating the limb is not possible, external compression methods such as ankle braces or compression stockings can be used.
Thank you.

Reply Date: 2019/02/01

More Info

Managing ankle fractures can be a challenging process, especially when it comes to pain, swelling, and the ability to walk. Based on your description, it seems you are currently in the recovery phase after a non-surgical treatment for your ankle fracture, which is a positive sign. However, it is essential to address your concerns regarding pain, swelling, and mobility effectively.

Firstly, regarding the use of a pneumatic ankle brace, it is generally designed to provide support and stability while allowing for some mobility. You can wear it while walking, but it is crucial to follow your doctor's advice regarding the amount of weight you should put on your injured ankle. Since you experienced sharp pain when attempting to bear weight, it indicates that your ankle may not yet be ready for full weight-bearing activities. Pain is a signal from your body that something may not be right, and it is essential to listen to it. If the pain persists, it might be wise to consult your physician to ensure there are no complications, such as misalignment or additional injury.

As for the tightness and increased pain in your ankle after attempting to walk, this could be due to several factors. After a period of immobilization, the muscles and ligaments around the ankle can become stiff, leading to discomfort when you start to move them again. It is also possible that you may have overexerted yourself, causing temporary inflammation. If you are concerned about the possibility of misalignment, it is best to seek a follow-up appointment with your healthcare provider for a thorough evaluation.

In terms of managing swelling, there are several effective strategies. The RICE method (Rest, Ice, Compression, Elevation) is commonly recommended for managing swelling after an injury. Here’s how you can apply it:
1. Rest: Avoid putting weight on the injured ankle as much as possible, especially if you are experiencing pain.

2. Ice: Apply ice packs to the swollen area for 15-20 minutes every few hours. This can help reduce swelling and numb the pain. Make sure to wrap the ice pack in a cloth to prevent frostbite.

3. Compression: Use an elastic bandage or a compression wrap to help control swelling. Be careful not to wrap it too tightly, as this can impede circulation.

4. Elevation: Keep your ankle elevated above the level of your heart whenever possible. This can help reduce swelling by allowing fluids to drain away from the injured area.

As for whether to use heat or ice, it is generally recommended to use ice during the acute phase of an injury (the first 48-72 hours) to reduce swelling and numb pain. After this period, heat can be beneficial for promoting blood flow and relaxing tight muscles, but it should be used cautiously and not applied directly to swollen areas.

In conclusion, managing an ankle fracture involves a careful balance of rest, appropriate use of supportive devices, and effective swelling management techniques. If you continue to experience significant pain or swelling, or if you have concerns about your recovery, it is crucial to consult your healthcare provider for further evaluation and guidance. They may recommend physical therapy to help regain strength and mobility in your ankle as you progress in your recovery. Remember, patience is key in the healing process, and gradual progression is essential to avoid setbacks.

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