Post-Ankle Fracture Surgery: Recovery Tips and Concerns for Your Mom

Postoperative care for ankle fractures?

Hello, my mother is currently 55 years old and fell from a tour bus on January 17, resulting in an ankle fracture.
The doctor mentioned that both sides of her ankle were broken.
At that time, the doctor performed surgery, applied a cast, and sutured approximately 4 stitches on one side and about 10 stitches on the other side.
She had the cast removed and was discharged on January 24.
The doctor did not provide any discharge instructions regarding care after discharge, the removal of stitches, or the removal of the L-shaped fixation plate.

I would like to ask if it was too early for my mother to have her cast removed.
I see that younger individuals typically have their casts on for more than three weeks.
When can the L-shaped plate be removed? Additionally, the plate is causing significant pressure on her heel, resulting in large areas of deep purple bruising; is this normal? I am concerned that prolonged pressure may affect her blood circulation.
When is the appropriate time for stitch removal? Thank you for your response, and I appreciate your help.

Ting, 20~29 year old female. Ask Date: 2016/01/27

Dr. Hong Ximing reply Orthopedics

Bilateral ankle fractures, after surgical fixation, do not require casting if stable, but weight-bearing should be avoided.
The sutures can typically be removed after about one week to ten days.
As for the bruising around the heel, it is likely due to blood seepage into the surrounding tissue following the fracture injury.

Reply Date: 2016/01/27

More Info

Hello! It sounds like your mother has been through quite a challenging experience with her ankle fracture and subsequent surgery. Recovery from an ankle fracture can be complex, and it's important to follow the right steps to ensure proper healing. Here are some insights and tips regarding her recovery process.

Recovery Timeline and Considerations
1. Timing of Cast Removal: The timing of cast removal can vary based on the severity of the fracture and the surgical intervention. Generally, a cast is kept on for about 4 to 6 weeks, depending on the healing progress. If your mother had her cast removed just a week after surgery, it might seem early, especially if the doctor did not provide clear guidance on her specific case. It's crucial to follow up with her orthopedic surgeon to assess the healing of the bones through X-rays or clinical evaluation.

2. L-Plate Removal: The L-plate (or any internal fixation device) is typically left in place until the bone has sufficiently healed, which can take several weeks to months. The surgeon will determine when it is safe to remove the plate based on the healing progress. This usually involves follow-up appointments where X-rays are taken to evaluate the bone's stability and alignment.

3. Bruising and Pressure from the L-Plate: It is not uncommon for patients to experience bruising and discomfort around the area where the L-plate is fixed. However, significant bruising or pain should be monitored closely. If the bruising is extensive or if your mother experiences increased pain, it is advisable to consult her doctor. They can assess whether the pressure from the plate is affecting circulation or if there are other underlying issues.

4. Suture Removal: The timing for suture removal typically occurs about 7 to 14 days post-surgery, depending on the type of sutures used and the healing of the skin. If the sutures are not dissolvable, they will need to be removed by a healthcare professional. It's important to keep the incision site clean and dry until the sutures are removed.

Rehabilitation and Physical Therapy
Once the cast is removed and the doctor gives the green light, physical therapy will be essential for your mother's recovery. Here are some tips for rehabilitation:
- Start Slowly: Initially, focus on gentle range-of-motion exercises to prevent stiffness. Gradually increase the intensity as tolerated.

- Weight Bearing: Follow the doctor's advice regarding weight-bearing activities. If advised to avoid putting weight on the ankle, use crutches or a walker until cleared.

- Physical Therapy: Engaging with a physical therapist can help your mother regain strength and mobility in her ankle. They can provide tailored exercises and monitor her progress.

- Pain Management: If your mother experiences pain during recovery, over-the-counter pain relievers may be helpful. However, consult her doctor before starting any medication.

Monitoring for Complications
It's essential to watch for signs of complications during recovery, such as:
- Increased swelling or pain in the ankle.

- Changes in skin color or temperature, which could indicate circulation issues.

- Fever or signs of infection at the surgical site.

Conclusion
In summary, your mother's recovery from her ankle fracture will require careful monitoring and adherence to medical advice. If there are any concerns about the timing of her cast removal, the condition of her L-plate, or her overall recovery process, do not hesitate to reach out to her orthopedic surgeon for clarification and guidance. Regular follow-up appointments are crucial to ensure that her healing is on track and to address any complications that may arise. Wishing your mother a smooth and speedy recovery!

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