Will Ankle Fractures Cause Uneven Walking? Recovery Insights

Will a fractured ankle cause a limping gait?

Hello, Doctor.
I suffered a right ankle fracture in early November due to a car accident (I am unsure of the type of fracture).
The doctor said that two small bones in the ankle were displaced and required surgery.
After the operation, they used a plate and screws for fixation.
I am uncertain if my recovery is progressing well.
Three weeks post-surgery, there is swelling at the fracture site, but not much pain, although I do experience some discomfort and difficulty with medication.
The doctor advised me not to put weight on the operated foot (though sometimes I do put a little weight on it).
I will have the screws removed in two months, and I can start bearing weight in three months.

Additionally, the surgeon has been asking when I will be discharged since the day after the surgery, which led to an unpleasant interaction on the fourth day that made me cry, causing me to lose some trust in the doctor.
I would like to ask if, after rehabilitation, my ankle will return to its pre-injury condition? I have heard concerns about the foot becoming misaligned, walking with a limp, potential long-term effects, and the possibility of needing a second surgery, which is making me increasingly anxious.
Should I consider seeking a second opinion from another hospital? Thank you for your assistance, Doctor.

Too, 40~49 year old female. Ask Date: 2015/12/02

Dr. Shi Guozheng reply Orthopedics

The ankle joint has bones on both the medial and lateral sides.
The lateral side features the distal end of the fibula, known as the lateral malleolus, while the medial side has the distal end of the tibia, referred to as the medial malleolus.
In the case of a fracture, if there is displacement, surgery is the preferred treatment option.
Typically, it takes about three months for healing to occur, and this type of surgery is not overly complicated.
Patients can usually be discharged to home care one or two days after the procedure.
Approximately six weeks later, they can attempt to put weight on the affected foot, but they should not apply full weight and must use crutches.
If healing progresses well, there should be no long-term complications.

Reply Date: 2015/12/02

More Info

Ankle fractures can indeed lead to uneven walking, particularly if not properly managed during the recovery process. Your concerns about the potential for long-term complications, such as altered gait or residual pain, are valid and commonly shared by patients who have experienced similar injuries.

When an ankle fracture occurs, especially one that requires surgical intervention, the healing process can be complex. The use of plates and screws to stabilize the fracture is a common practice, and while this can facilitate proper healing, it also necessitates a period of immobilization. As you mentioned, your doctor has advised against putting weight on the affected foot for a certain period, which is crucial for ensuring that the bones heal correctly. During this time, it is essential to follow your doctor's recommendations closely to avoid complications such as malunion (where the bones heal improperly) or nonunion (where the bones fail to heal).

After the initial healing phase, rehabilitation becomes critical. Physical therapy will likely be necessary to regain strength, flexibility, and range of motion in your ankle. The timeline for recovery can vary significantly based on several factors, including the severity of the fracture, your age, overall health, and adherence to rehabilitation protocols. Generally, patients can expect to begin weight-bearing activities around six to eight weeks post-surgery, but this can vary based on individual circumstances and the specific nature of the fracture.

Regarding your concerns about walking unevenly or developing a limp, it is not uncommon for patients to experience some gait abnormalities following an ankle fracture. This can be due to pain, weakness, or stiffness in the ankle joint. However, with diligent rehabilitation, many patients can return to a gait that is close to their pre-injury state. It is essential to communicate openly with your physical therapist about any difficulties you encounter during your recovery. They can provide tailored exercises and strategies to help you regain a normal walking pattern.

As for the possibility of needing additional surgeries, this is typically determined by how well the fracture heals and whether any complications arise. If the initial surgery is successful and the bones heal properly, further surgical intervention may not be necessary. However, if there are issues such as persistent pain or instability, your doctor may recommend additional procedures.

It's understandable to feel apprehensive about your recovery, especially after a traumatic injury. If you feel uncertain about your current treatment plan or the advice you have received, seeking a second opinion from another orthopedic specialist can provide you with additional insights and reassurance. It is crucial to feel confident in your care team and to have your questions and concerns addressed thoroughly.

In summary, while ankle fractures can lead to uneven walking, many patients can achieve a good recovery with appropriate medical and rehabilitative care. Staying proactive in your recovery, adhering to your doctor's advice, and engaging in physical therapy will be key to regaining your mobility and confidence. Remember, recovery is a journey, and it is essential to be patient with yourself as you heal.

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