Ankle Fracture Surgery

Post-operative Guide

Surgery for ankle fractures also known as ankle ORIF surgery

Plaster backslab

Plaster backslab - 2 weeks

This is applied in the OR. To be left intact – do not remove. Keep clean and dry at all times.

Elevate

Elevate

As much as possible

Ice

Ice

At least 3 times per day 20 mins on, 20 mins off. Ice should not be directly contacting skin, or dampen the plaster.

Procedure

Wounds

Please keep the wounds with any dressings applied at the time of surgery clean and dry and intact.

The dressings will be changed at the time of first review in the office, 10-14 days post surgery.

Signs Of Infection

Increased redness, swelling, malodorous discharge or persistent wound ooze, feeling unwell, fever.

If these occur please contact the office straight away.

Weight Bearing Status

  • NON weight bearing for 2 weeks after surgery
    • crutches/scooter
  • 2-6 weeks
    • non weight bearing with crutches/scooter and CAM Boot
    • boot for sleeping
    • may be permitted to commence gradual, progressive weight bearing in boot
  • 6 week review
    • progressive weight bearing initially in boot then wean as comfortable
    • strengthening, reintroduction of exercises
Pain Medication

Strong pain medication may be prescribed on discharge from hospital. In general this will not be required for >1 week. It is important to take pain relief as required to stay comfortable post surgery.

Change to simple pain medication when the pain has reduced e.g. panadol/panadeine.

No alcohol or driving whilst taking strong pain medication. Please note that narcotics such as Endone are not prescribed in the office.

DVT (Deep Venous Thrombosis or blood clots) prophylaxis:
100mg aspirin daily whilst NWB / 6 weeks OR other anticoagulation as prescribed

Vitamin D
You may take up to 4000IU per day.
Please check your current dietary supplements for dosages.

Exercises

  • First 2 weeks
    • no exercises of foot/ankle whilst in plaster
    • may do knee ROM, core strengthening, arms, toe stretches
  • 2-6 weeks
    • gentle ankle ROM exercises
  • 6-12 weeks
    • walking as tolerated
    • stationary bike, swimming, non impact cardio
Driving

  • Casts and boots and strong pain medications can interfere with your ability to drive
  • You must be able to safely operate the vehicle including the accelerator, brake and clutch pedals at all times and respond appropriately in the event of an emergency
  • When safely weight bearing without crutches
  • Minimum 6-9 weeks if the driving foot was operated on
Swelling

  • Expected to decrease when elevated
  • May have persistent swelling for up to 2 years post surgery
Physiotherapy

  • 6 weeks
    • gait retraining
    • protected WB as above
    • core strengthening and upper limb program
    • low impact exercise e.g. elliptical, swimming, stationary bike
  • 12 weeks
    • may progress with gait retraining
    • generalised stretching/strengthening fitness program
    • progressive increase in lower limb weight bearing exercises
    • continue low impact exercise e.g. elliptical, swimming, stationary bike
Travel

Please discuss any travel plans prior to your surgery.

It is usually safe to travel short distances on a plane or car 1 week after surgery. You may experience increased swelling therefore try and keep the limb elevated

It is more difficult to get around the airport and plane. You will need assistance. If there is any concern regarding DVT then air travel or long car travel is not advised. In general long haul flights should be avoided for at least 3 months post surgery.

Please take usual precautions for healthy travel such as elevation of the limb, regular movements of the limb and moving around the cabin, stay well hydrated and avoiding alcohol. Additional DVT prophylaxis may be required.

Follow Up

  • 2 weeks
    • office for wound review
    • continue non weight bearing
    • CAM Boot
  • 6 weeks
    • repeat X-rays and decision as to weight bearing status
  • 12 weeks
    • repeat X-rays

For all appointments and enquiries, please phone 07 5645 6913 or email info@salusfootsurgeon.com.au

9 Kinloch Avenue
Benowa QLD 4217

   

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