Conservative Treatment for Leg and Ankle Fractures

Open fracture of both bones in the right lower leg and ankle fracture?

Hello Doctor, I would like to ask you about issues related to my lower leg and ankle fractures.
On October 12 (Monday), I was sent to the emergency room after a car accident.
The doctor assessed that I have fractures in two bones of my right foot and my ankle.
However, since the two fractured bones are close together and there is no displacement, the decision was made to use conservative treatment, and I was given a cast.
On October 14 (Wednesday), during a follow-up visit, the doctor reviewed the X-rays and mentioned that there was not much displacement, so I was switched to a fiberglass cast.
I will have another check-up next week to see if there is any displacement; if there is, surgery may be necessary.
I want to ask about my situation at home.
I only have larger movements when using the restroom or getting in and out of bed.
I weigh 45 kg and have insufficient muscle strength, so I feel that the cast is heavy.
When I stand up and shift my weight to my left foot, I still feel pain at the site of the fracture on my right foot.
Is this normal? Is there a risk of displacement? I am being very careful with my foot because I do not want to have surgery and end up with scars.
I hope to continue with conservative treatment.
Sometimes my foot feels a bit painful and sore; is this normal? Is it okay to avoid surgery? What is your assessment, Doctor? Is pain considered normal in this situation?

Chardae, 20~29 year old female. Ask Date: 2015/10/15

Dr. Luo Zhongwei reply Orthopedics

It is recommended that you schedule an appointment for further examination and evaluation.

Reply Date: 2015/10/15

More Info

When dealing with leg and ankle fractures, especially in the context of conservative treatment, it is essential to understand the nature of the injury, the healing process, and the importance of monitoring symptoms. Based on your description, you have sustained fractures in your right leg due to a car accident, and the medical team has opted for conservative treatment with casting, which is a common approach when fractures are non-displaced or minimally displaced.

Understanding Conservative Treatment
Conservative treatment typically involves immobilization of the affected area to allow for natural healing. In your case, the use of a cast is appropriate as it stabilizes the bones and prevents movement that could lead to further injury or displacement. The fact that your doctor has noted no significant displacement in the X-rays is a positive sign, indicating that the bones are in a position conducive to healing.

Pain and Discomfort
Experiencing pain and discomfort in the area of the fracture is quite normal, especially in the early stages of recovery. Pain can arise from several factors, including:
1. Inflammation: After a fracture, the body initiates an inflammatory response, which can cause swelling and pain.

2. Muscle Atrophy: Due to immobilization, the muscles surrounding the fracture site may weaken, leading to discomfort when you attempt to use the leg.

3. Nerve Sensitivity: The area around the fracture may be sensitive as the nerves heal, which can contribute to pain.

It is important to differentiate between normal post-fracture pain and pain that may indicate complications. If the pain is sharp, worsening, or accompanied by increased swelling or changes in skin color, it would be prudent to consult your physician.

Risk of Displacement
Your concern about the potential for displacement is valid. While you are being cautious and taking care of your leg, it is crucial to follow your doctor's advice regarding weight-bearing activities. Since you mentioned that you are using your left leg to bear weight, ensure that you are not putting excessive pressure on the right leg until you receive further guidance from your doctor.

Monitoring and Follow-Up
Regular follow-up appointments are essential in conservative treatment. Your doctor will likely monitor the healing process through X-rays to ensure that the bones remain in alignment. If there are any signs of displacement or if your symptoms worsen, surgical intervention may be necessary. However, if the fractures remain stable, conservative treatment can be continued.

Conclusion
In summary, the pain you are experiencing is likely a normal part of the healing process, especially given the nature of your injury and the immobilization required. It is essential to continue monitoring your symptoms and to communicate any concerns with your healthcare provider. If the fractures remain stable and there is no significant displacement, it is possible to continue with conservative treatment without the need for surgery. Always prioritize your safety and follow your doctor's recommendations regarding activity levels and follow-up care.
If you have any further questions or concerns, do not hesitate to reach out to your healthcare provider for personalized advice and support. Your recovery is important, and staying informed will help you navigate this process more effectively.

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