Ankle Swelling and Recovery After Fractures

Ankle swelling and its sequelae?

Hello Doctor, I sustained a closed fracture of both ankles on December 29th, with a displaced fracture of the right medial malleolus and a fracture of both the medial and lateral malleolus on the left foot.
I had a follow-up appointment on January 25th, and the doctor said the alignment looks good.
I am scheduled for another follow-up on February 15th.

I would like to ask if it is normal for my right lateral malleolus (which was not injured) to be swollen, protruding more than usual, even though I have been keeping my feet elevated and most of the swelling has subsided.
Additionally, how long will it take for me to be able to walk normally again? After recovery, will I have a limp when walking? (There was no damage to nerves or ligaments.) Thank you, Doctor.

Lele, 10~19 year old female. Ask Date: 2016/02/06

Dr. Shi Guozheng reply Orthopedics

It is normal to experience swelling for about six weeks after surgery, but complete recovery typically takes around three months, and you should not have a noticeable limp.

Reply Date: 2016/02/06

More Info

After sustaining a closed fracture of both ankles, it is understandable to have concerns about swelling and recovery. Based on your description, it seems that you are experiencing significant swelling in your right ankle, which is not the injured one. This situation can occur for several reasons, and it is essential to understand the underlying mechanisms and recovery expectations.

Firstly, swelling in the ankle, even if it is not the site of injury, can be attributed to several factors. When one ankle is injured, the body often compensates by shifting weight and altering gait patterns, which can lead to increased stress and swelling in the uninjured ankle. Additionally, immobilization of the injured ankle can result in reduced circulation and fluid accumulation in the surrounding tissues, contributing to swelling in both ankles. It is also possible that the swelling in the uninjured ankle is a response to the overall trauma and inflammation in the body.

To address your concerns about recovery and walking, it is important to follow your doctor's recommendations closely. Generally, the timeline for returning to normal walking after ankle fractures can vary significantly based on the severity of the fractures, the specific bones involved, and the effectiveness of rehabilitation. In many cases, patients can begin partial weight-bearing activities within a few weeks post-injury, but full recovery may take several months.
You mentioned that your doctor indicated the positioning of the bones was good, which is a positive sign. However, it is crucial to monitor your progress. If you are still experiencing significant swelling in the uninjured ankle, it may be beneficial to continue elevating your feet and applying ice to reduce inflammation. Compression wraps can also help manage swelling, but they should be used cautiously to avoid restricting circulation.

As for the concern about limping after recovery, it is common for individuals to experience some degree of altered gait following an ankle fracture. This can be due to muscle weakness, stiffness, or pain that may persist even after the bone has healed. Engaging in a structured rehabilitation program that includes physical therapy can be highly beneficial. A physical therapist can guide you through exercises to strengthen the muscles around the ankle, improve range of motion, and restore normal gait patterns.

In terms of timeline, while you may be able to start walking with assistance or a brace within a few weeks, achieving a normal gait can take longer. It is essential to listen to your body and not rush the recovery process. If you find that you are still limping significantly after several weeks of rehabilitation, it may be worth discussing this with your healthcare provider to ensure there are no underlying issues that need to be addressed.

In summary, while swelling in the uninjured ankle can be concerning, it is not uncommon following an injury to the opposite ankle. Continue to elevate and ice the swollen area, and engage in rehabilitation exercises as recommended by your healthcare provider. With time and appropriate care, you should be able to return to normal walking without a limp. Always consult your doctor for personalized advice and follow-up appointments to monitor your recovery progress.

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