Check for swelling in your foot and ankle. I remember I was one month in bed afterwards or at least keeping my foot above my heart, and so I had all the time I wanted to watch YouTube and play guitar and goof off on Facebook. If your fracture does not heal properly, further surgery may be required. Conclusions: At more than three years after the injury, pilon fractures can have persistent and devastating consequences on patients' health and well-being. You will most likely start moving your ankle after 2 to 6 weeks. Eric, Almost two years post surgery. They often result in an obvious deformity of the ankle joint. In most cases, your doctor will first apply a splint to hold your ankle in place. Your doctor will closely monitor the healing of your fracture. I am hopeful that I find some good news. from the American Academy of Orthopaedic Surgeons, The amount and size of the broken bone fragments. If you have significant swelling or blisters, your doctor will delay your surgery until the swelling goes down. I’m dealing with both legs right now. Despite surgical management, outcomes are predictably poorly characterized by functional deficits secondary to pain and stiffness. As soon as your pain begins to improve, stop taking opioids. If you have an external fixator, you may not be able to start moving your ankle until the external fixator is removed. This type of fracture is particularly serious because, once the skin is broken, infection can occur in both the wound and the bone. Today is 4/16/20. After you fracture a bone, a physical therapist may visit you in the hospital. Both the time of being able to stand unipedal on the injured side and to walk without crutches were significantly shorter in patients using WBs (WB, 2.6 weeks; PC, 4.5 weeks, p = 0.01; WB, 1.4 weeks; PC, 3.1 weeks, p = 0.03). Most of the time, it includes breaks in both the tibia and fibula of the lower leg. I am having problems with circulation…. This study was conducted on 80 consecutive cases (78 patients) treated by surgery and hardware removal after bony u… I’ll be non-weight bearing for at least another month he thinks, but I start basic PT next week. Watch out at the six-month point for the change. Examine your lower leg and ankle, looking for cuts from the injury and gently pushing on different areas to see if it hurts. An x-ray can show if there is an injury to your bones or if the joints in your ankle are out of place. Your doctor may recommend that you use crutches, a cane, or a walker during this time. To fully evaluate your fracture, your doctor may recommend an x-ray (left), a CT scan (center), or a three-dimensional CT scan (right). Many types of medicines are available to help manage pain, including opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), and local anesthetics. Saw my surgeon today, about 5 weeks post-surgery and he likes the way the bones are healing. In some cases, nerves may be injured at the same time that the bone is broken. I have no idea what to expect as time goes on. Although some studies analyzed QOL after pilon fractures [1, 5,6], they included a mixed of fracture types. I joined a CrossFit gym and used my knee scooter to get around and they had me do a lot of upper body and core work to stay fit and it really helped pass the time. Your doctor will develop a treatment plan based on your individual symptoms. Please note that some fractures can give no symptoms or symptoms can be only minor. Not to be a total downer, here is a story about things I CAN DO while hobbling around on this ankle.. https://www.strava.com/activities/413271549/embed/ddf196e6cd9d52343e4c9b9651d9dd63ba126def” target=”_blank”>Click here for a glimpse of the possibilities for those of us with a bad ankle. In the majority of cases, your ankle will not be the same as it was before your injury. Complications that may occur with pilon fractures include: Stiffness. While air bags enable more people to survive high-speed car crashes, they do not protect the legs—so many of the survivors wind up with pilon fractures and other leg injuries. It depends on the type and cause of the fracture (motor vehicle accident versus a fall, for example). The lower ends of these bones make up part of the ankle. Copyright ©1995-2020 by the American Academy of Orthopaedic Surgeons. Your doctor may use a combination of these medications to improve pain relief, as well as minimize the need for opioids. I am 14 weeks post surgery that resulted in 2 plates and 18 screws. All rights reserved. Mine happens march 9th 2020. I tried to convince her that I had some good results from PT, and massage, but she ignored me and said it was time I find a ankle specialist who was skilled in post-pilon fracture treatments, and explore my options. Because of the energy required to cause a pilon fracture, patients may have other injuries that require treatment as well. 7 Months Post Op and 3 Months of “Walking”, An Update, It has been 5 and a half months after my pilon fracture surgery, 7 Months Post Op and 3 Months of “Walking”, An Update, Ankle dorsiflexion limited after 6 months post injury at 2 degrees, Dorsiflexion through anterior ankle impingement, https://www.strava.com/activities/413271549/embed/ddf196e6cd9d52343e4c9b9651d9dd63ba126def, //pagead2.googlesyndication.com/pagead/js/adsbygoogle.js, Follow Pilon Fractures Suck! If you don’t get cartilage loss will be pacific, you must be proactive to have a good prognosis, good luck…. Minor infections can be treated with antibiotics and dressing changes. Change ), You are commenting using your Google account. You will probably walk like a zombie in the first stages of walking again, but with rehab and practice, you will get much better at it and faster. The external fixator also helps to restore proper limb length and provides stability. Change ), You are commenting using your Twitter account. Posttraumatic arthritis is a type of arthritis that develops after an injury. I am so bummed. The tibia may break in one place or shatter into multiple pieces. Therapy is necessary to regain motion, decrease inflammation and swelling, as well to regain strength in the ankle. If there is a problem consult your ortho immediately. Sometimes, a new plate or screws may also be needed. The external fixator is usually removed after the plates and screws have been placed. While I knew that the likelihood of pilon fracture-related cartilage loss and joint collapse was very high, I was very hopeful that I was going to be one of the luckier patients and get a few years of fun in before I had to deal with arthritis, more surgery, etc. This article addresses pilon fractures—a specific type of fracture that occurs in the lower leg near the ankle. Nonsurgical treatment may be recommended for stable fractures in which the pieces of bone are not displaced or are minimally displaced. With this type of injury, the other bone in the lower leg, the fibula, is frequently broken as well. Be aware that although opioids help relieve pain after surgery, they are a narcotic and can be addictive. A pilon fracture typically occurs as the result of a high-energy event, such as a car collision or fall from a height. The bone graft will come from either your own bone (autograft) or from a donor (allograft). 7 Months Post Op and 3 Months of “Walking”, An Update; Ankle dorsiflexion limited after 6 months post injury at 2 degrees. With pilon fractures, there can be total cartilage death after 6 months. Sunsets are just as pretty post pilon fracture, In fact…I’m glad to be alive. … Is it common to experience cramps in foot after ankle fracture In a walking cast Ten days after injury. if so what degree and how did that effect you? Waighing the pros and cons of operating while waiting for the swelling to go down. Change ). I was riding 7-10 hours a week (5-6 days) before and hope I can get back to that eventually. I am so bummed. About Tibial Pilon Fractures; Pilon Blog. Thanks. Did they put a lot of hardware in there? Wow I hope that your impact was light and you have good cartilage survival. Results. To fully evaluate your fracture, your doctor may recommend an x-ray. In many pilon fractures, the bone may be crushed or split into several pieces due to the high-energy impact that caused the injury. Your doctor may order a CT scan right away, or may wait until later in your treatment—after an external fixator is applied. Please check if you can move the toes well without any pain and there is no redness or swelling in the exposed leg. My Pilon fracture can’t stop the bike riding. Open reduction means the surgeon makes an open incision to treat the fracture. To find in-depth information on ankle fractures, please read Ankle Fractures (Broken Ankle). I can't wait to get back to strength training and skateboarding in a couple of months, and I'll be back vlogging every other day. I see the surgeons this week and I am seeking more specialists to talk to before I take the plunge into more surgery. ( Log Out /  Certain social, demographic, and treatment variables seem to contribute to these poor outcomes. Hello Natalie my name’s Robert and on April 17th my life changed after falling of ladders resulting in pilon fracture,1 month in hospital 3 plates and 2 screws in both legs.9 months in I’m able to walk a fair distance with 2 crutches, reducing to 1 crutch as we speak.swelling has gone down,both ankles look like they should.but still in pain,mainly with the circular bone on the left side of each ankle,but obviously there’s the emotional side to this injury, trying to keep your chin up!! During this time, your doctor may recommend that you use crutches or a walker. Unfortunately, the boot keeps my foot in one place and because of the difference between a normal left shoe and a right boot it hurts my back incredibly to walk much distance. The fracture involves the larger bone of the lower leg (tibia), and extends into the weight bearing surface of the ankle joint. When will I be able to start putting weight on my leg? These patients may also have additional injuries to the head, chest, abdomen, or legs. This includes how to use the device to walk up and down stairs or to get into and out of a car. Most of the time, it involves breaks in both the tibia and fibula of the lower leg. So with this horrible news on my mind I drove home contemplating more surgery and no good thoughts. Well… my surgeon walked in the room after I got out of x-ray and didn’t look very excited to see me. X-rays provide images of dense structures, such as bone. This can result in infection. Depending of the fracture location and bones dislocation, you may have no symptoms at all. Over time have you been able to stand on the pedals more and more? 1-5 Most studies that report outcomes after these fractures have assessed patients at a single point in time and report an average length of follow up. This is a tool used for crushing. How long was your surgery? It usually occurs following a significant force to the foot, such as a fall from a height or motor vehicle accident (MVA). The severity of the injury depends on several factors, including: If the bone breaks in such a way that bone fragments stick out through the skin or a wound penetrates down to the broken bone, the fracture is called an "open" or compound fracture. While they fix the pain of walking, they are by no means the return to normalcy. when this happens I feel we are in a tunnel in a foreign country and learning as we go…. All material on this website is protected by copyright. He or she will: Information from imaging studies will help your doctor decide whether surgery is required and will be important for surgical planning. The amount each piece is out of place (displaced). ( Log Out /  Your doctor may place your ankle in a splint until your surgery, or recommend that you have an initial smaller surgery to protect your ankle while waiting for the second surgery. This is very typical.” She went on to say that the impact of the initial injury (the talus bone ramming upward and shattering the plafond of the tibia, ripping the cartilage to pieces in the process) leads to cartilage death many months after. ( Log Out /  Will I develop arthritis or any other complications. In most cases, surgery is needed to restore the damaged bone to its normal position. The term "pilon" comes from the French word for pestle. Doctors have seen an increase in pilon fractures since the introduction of air bags in motor vehicles. Went through the surgery and was bed-bound for another 4 weeks. Because your leg and ankle will be immobilized for a period of time, you will be at greater risk for developing blood clots. Recovery. In the majority of cases, your ankle will not be the same as it was before your injury. Monitoring. Outpatient physical therapy will begin once the skin is healed, usually two to six weeks after the final ankle surgery. Patients with pilon fractures usually experience immediate and severe pain. I got 2 plates (one each tib/fib), 14 screws, 3 incisions and I think it took them about 3 hours. If you experience a pilon fracture, you will probably have many questions about your treatment and recovery. She said ankle fusion or ankle replacement were her assumptions of my next procedure but that it wold not be her that did the surgery (Dr Herzog is a orthopedic trauma surgeon and the person who fixed me up when I came into the ER on March 6th.) The lower ends of these bones make up part of the ankle. If you participate in high-impact sports, you may be able to resume activities 6 months after your surgery or injury. However, for some patients, there is little pain and no need for further surgery. I almost cried. In some cases (those luckier than me) the cartilage survives enough t allow pain-free walking and much normal use of the ankle. Mine was 12 hours. It is important to tell you doctor if you have pain in other parts of your body. Rotator Cuff and Shoulder Conditioning Program. Trying to get my hands on a knee scooter now and hoping (is this insane?) A tibial pilon fracture can be a result of impact from a fall, a twist, or a car accident. In summary, this study does not demonstrate a clinical benefit in patients with gait derangements after pilon fracture at walking speeds. This risk has been brought down to about 10% or less for patients with pilon fractures. There were no patients with loss of reduction or nonunion. Was hit by a car 2 days ago and have fractured lower tibia in two places and lower fibula in three places. Because your ankle can continue to improve for up to 2 years, it is important to continue the exercises even after you have completed the formal physical therapy program. If their injuries cause significant blood loss, it could lead to shock—a life-threatening condition that can result in organ failure. That is why x-ray should be done at first to have it clear. Painful plates and screws—patients who experience discomfort may choose to have their plates and screws removed after the bone has healed, Blood vessel or nerve damage—this may occur at the time of the injury or during surgery, Whether you have other injuries or medical problems. Ankle stiffness is very common after a pilon fracture. It may also be recommended for patients who are unable to walk or patients with very serious medical problems who may not be able to tolerate surgery. A broken ankle can severely limit your ability to perform basic functional tasks like running and walking. Be sure to ask questions if you have any. Luckily my daughter works for a group of orthopedic doctors. For example, it may be difficult to bend it the same way, go up and down stairs, or climb a ladder. Fill in your details below or click an icon to log in: You are commenting using your WordPress.com account. These impairments can make performing your normal everyday activities difficult or impossible. Surgery to promote healing usually includes placing a bone graft in the fracture. To help you maximize your abilities, your doctor and/or physical therapist will guide you in a slow progression to more vigorous movement. Long healing or worsening is one of possible fracture symptoms. Once the swelling and blisters have gone away, your doctor will perform a second surgery. Today I became 100% weight bearing. Good luck to all dealing with this. Do I have any specific risks for not doing well? This is a natural part of the healing process. What happens after a tibia/fibula fracture open reduction and internal fixation? Computerized tomography (CT) scans. Surgery is commonly recommended for unstable fractures in which the bones are out of place. Sharing our pilon fracture experience; It has been 5 and a half months after my pilon fracture surgery. Some degree of posttraumatic arthritis occurs in about half of all patients with pilon fractures. In this case, your fracture may be treated with an external fixator only or with an external fixator and some screws. I can’t believe how quickly my muscles vanished. It is important to use opioids only as directed by your doctor. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS Find an Orthopaedist program on this website. Ankle fractures and dislocations can be either simple—involving just one bone—or complex—involving multiple bones. Ankle stiffness is very common after a pilon fracture. You will most likely be unable to bear weight on your ankle for up to 12 weeks after your injury. A tibial pilon fracture is a break at the bottom or distal portion of the tibia, more commonly known as the shinbone. The indications and clinical necessity for routine hardware removal after treating ankle or distal tibia fracture with open reduction and internal fixation are disputed even when hardware-related pain is insignificant. A CT scan will also help your doctor plan your treatment. I don’t believe there was any benefit in pushing my progress. Physical Therapy Guidelines for Ankle Fracture with Surgery This was written and developed by the therapists of MGH Physical Therapy Services. A pilon fracture is a type of break of the shinbone (tibia) that happens near the ankle. 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