Ankle Fracture Recovery: Bruising, Pain, and Rehabilitation

Post-fracture bruising on the lateral ankle and associated rehabilitation issues?

Hello, about a week after my ankle fracture on the outer side, I was allowed by my doctor to switch to a pneumatic brace.
The person selling the brace told me that I could start to lightly bear weight and use crutches while wearing it.
However, since it was only a week after the injury and putting weight on it was painful, I only occasionally put my foot down.
After a few more days, I started to notice bruising and pain on the outer side of my lower leg (originally, the pain was only near the sole of my foot).
I'm wondering if this is due to starting to bear weight too early? Could it potentially cause a displacement of the bone (which was originally non-displaced)? I would like to know how long after a non-displaced fracture it is generally recommended to start gradually bearing weight and walking.
Additionally, I have been experiencing swelling in my foot for two weeks since the injury; is this normal? Thank you!

Miss Hsu, 30~39 year old female. Ask Date: 2020/08/11

Dr. Chen Bochen reply Orthopedics

Hello, Miss Hsu.
The information provided below is based on averages, and your condition requires X-rays and clinical examination for a definitive diagnosis.

1.
For a non-displaced lateral ankle fracture without surgery, using an air cast and crutches is recommended.
Generally, it is safe to start putting light weight on the foot after about 2-3 weeks.

2.
Whether the bone is displaced cannot be determined by bruising; an X-ray is necessary for that.
If you are concerned, it is advisable to get an X-ray.

3.
Swelling from a fracture for up to a month is quite normal, and in some cases, it may last even longer.
It is recommended to apply ice and elevate the foot frequently.

Reply Date: 2020/08/11

More Info

Recovering from an ankle fracture can be a complex process, especially when it involves managing pain, swelling, and the rehabilitation process. Your concerns about bruising, pain, and the timing of rehabilitation are valid and common among individuals who have experienced similar injuries.

First, it's important to understand that after an ankle fracture, particularly one that is non-displaced (meaning the bone has not moved out of its normal alignment), the recovery timeline can vary significantly from person to person. Generally, for non-displaced fractures, patients may be advised to begin partial weight-bearing activities within a few weeks, depending on the specific nature of the fracture and the guidance of their orthopedic surgeon.

In your case, since you began using a pneumatic brace and were encouraged to start light weight-bearing activities, it’s crucial to listen to your body. If you experience pain while attempting to put weight on your foot, it may be a sign that you are progressing too quickly. Pain is a natural response to injury, and it serves as a protective mechanism. If the pain is significant, it could indicate that the fracture site is still healing, and you may need to reduce the amount of weight you place on the injured ankle.

The bruising and pain you are experiencing in the lower outer calf could be attributed to several factors. It might be a result of compensatory movements as you adjust to walking with the injury, which can lead to strain in surrounding muscles and tissues. Additionally, bruising can occur due to the trauma of the injury itself, as well as from any swelling that may be present. Swelling is a common response to injury and can persist for several weeks, especially if the ankle is not elevated regularly or if you are engaging in activities that put stress on the area.

Regarding your question about when to start walking, it is generally recommended to wait until you have been cleared by your physician to begin weight-bearing activities. This is often around 2 to 6 weeks post-injury, depending on the specific fracture and your healing progress. If your fracture was stable and non-displaced, you might be able to start gradual weight-bearing earlier, but this should always be done under the guidance of your healthcare provider.

As for the persistent swelling in your foot, it is not uncommon for swelling to last for several weeks after an ankle fracture. However, if the swelling is significant or worsening, it is advisable to consult your doctor. They may recommend elevating your foot, applying ice, and possibly using compression to help manage the swelling. Additionally, they may want to assess the injury to ensure there are no complications, such as a blood clot or infection.

In summary, while some discomfort and swelling are normal after an ankle fracture, it is essential to communicate any concerns with your healthcare provider. They can provide personalized advice based on your specific situation and help you develop a rehabilitation plan that promotes healing while minimizing the risk of complications. Remember, patience is key in the recovery process, and following your doctor's recommendations will help ensure a successful return to normal activities.

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