Ankle fracture: week 1 to recovery

How I got an Ankle fracture

At about 10 pm on the 13th of August 2020 right in the middle of the coronavirus (COVID-19) pandemic, while getting reading to go to bed, I caught my leg in my shoes and fell in my living room and fractured my fibula and ankle. I tried to get up and realised I could not move my leg. I was also in awfully bad pain. The leg appeared visibly deformed and felt agony when I tried to move my leg. I called for my partner who was at the gym to come home and get me to the hospital. I sat on the floor until he came and got me to the hospital.

Ankle fracture Symptoms and signs

  • Pain; After the fall, I felt a throbbing pain.
  • Tenderness: My ankle felt very tender to touch.
  • Swelling: My ankle became very swollen.
  • Unable to get up or walk (non-bearing weight).
  • Bruising: I had a little bruise. It was more visible the next day.
  • Deformity: My ankle appeared deformed.

At the hospital

We got to the hospital and it did not take us a lot of time before we got attended to. The pain was so unbearable even to touch. The nurse had a look at it and asked for the doctor to come and see me. The doctor asked for an X-ray of the leg and then confirmed that I had fractured my ankle and fibula. A cast was put on after having analgesia(painkillers) and I was transferred to the ward.

ankle fracture x ray
Picture shows X-ray ankle fracture before surgery

Is my ankle broken or sprained

After the first X-ray, I asked the doctor if my ankle was broken or if it was sprained. He told me I had fractured my fibula and my ankle. He also told me it was a serious injury. As a result, I required surgery to fix it.

Ankle Fracture Surgery

The next day 14/08/2020, I had a surgery called the open reduction and internal fixation (ORIF).  It is a surgery used to repair a fractured bone by using screws, plates or an intramedullary (IM) rod to stabilise the fractured bone.

ankle fracture at 3 weeks
Picture shows x-ray of ankle and bone with screws in

Discharge from hospital

I had surgery on the 14/08/2020 and was discharged from hospital on the 16/08/2020. I was told I could not weight bear (can’t put weight on it ) for 6 weeks. For discharge, I had input from the physiotherapist, occupational therapist, and pharmacist.

Physiotherapist’s input

The physiotherapist assessed to see if I could work with the Zimmer frame. After I passed that, he came back the next day and assessed me for stairs. This was done because I had an upstairs house and needed to know how to go up and down the stairs safely. I was supplied with 2 Zimmer frames, crutches and moon boots.

Moon boots

A moon boot also known as Controlled Ankle Motion (CAM) boot is an orthopaedic device that can be prescribed to help treat or stabilize severe fractures, sprains and tendon or ligament tears. It can be used as substitute for a cast it is hygienic, adjustable. reusable, and easily and completely removable. The boot takes some weight off the foot/ankle. It has a rocker sole which allows easier walking to allow your fractured ankle to heal properly.

wearing a moon boot
This is me wearing a moon boot

Occupational therapists’ input

The occupational therapist helped with things I needed to be able to live at home in my home while recovery. I was supplied with something to help raise the toilet seat for easy sitting and standing up, two commodes which I ended up not using and a chair that I used around the house like the kitchen. The occupational therapist visited the home on day of discharge and set everything up before I was discharged.

Pharmacist input

The pharmacist gave me my discharge medication. The medication was made up of codeine(painkiller), senna (for constipation) and enoxaparin brand name clexane (anticoagulant). Allow me to put on my pharmacist cap and explain why these medications were prescribed.

  • Codeine is a painkiller is obviously is to help with the pain.
  • Senna is to help with constipation as codeine can cause constipation
  • Enoxaparin is an anticoagulant. Anticoagulants are medicines which prevent blood clots from an ankle fracture. I injected daily for eight weeks.

So, I have been asked questions like can you get a blood clot from a broken ankle? can you get a blood clot from wearing an ankle boot? can you get a blood clot after ankle fracture? Is clexane used for an ankle fracture?

Some people get blood clots from ankle fracture (broken ankle). This is because when people have ankle fractures, they do not mobilise (walk around) or move the limb as they would normally do before they had the ankle fracture. Movement of your legs would usually help blood flow quickly through the veins without forming a clot as the action of the muscles help squeeze the veins. However, while immobile (not working) this does not happen. As a result, a blood clot could form in the deep vein of the legs. This is referred to as Deep Vein Thrombosis (DVT).

Clexane is the brand name of enoxaparin. Enoxaparin is an anticoagulant which is used to prevent blood clots. It is an injection which you may be prescribed to take every day for 6-8 weeks following ankle fracture surgery. A bit of the clot may break up and then travel to the lungs and cause  Pulmonary Embolism (PE).

clexane for ankle fracture
clexane used for preventing blood clots after ankle fracture
enoxaparin injection
enoxaparin injection

One week after ankle fracture

The first week after the fracture was the most difficult for me. I went from being able to do everything to depending on other people to help me. Simple things like having a bath or shower became a chore. I did not eat as much too. I was in a lot of pain and tried to stay on top of the pain by taking regular pain killers

While at the hospital, my legs were elevated, and I had an ice pack applied to the leg. I was also advised to apply RICE therapy when I get home. RICE therapy is an acronym that stands for:

  • R- Rest
  • I- Ice
  • C- Compression
  • E- Elevation
  1. Rest:  Rest and protect the fractured ankle.
  2. Ice: Apply an ice pack to the area to reduce swelling and pain. Do not apply ice directly on the skin. Place the ice pack wrapped in cloth or towel for twenty minutes at a time, three to four times a day.
  3. Compression. This means the compression or wrapping of an ankle. My ankle was wrapped in compression bandage after the surgery, so I did not need to do this myself. I was told that it is done to help reduce swelling.
  4. Elevation. Elevate the ankle area with pillows. Try to keep your ankle the area at or above the heart level to facilitate increased blood flow and minimize swelling.

Two week

The pain in the second week was a little bit better. I still had to take regular pain medication to keep on top of the pain. I have now removed the bandage and was able to use the activity chair to have daily for a shower. That felt good. My appetite was better.

Three weeks after ankle fracture

Three weeks after I had the broken ankle, I attended the appointment at the hospital. I had another X-ray done. This is was done to check that the fracture was healing as expected. The nurse at the fracture clinic also checked the surgery site to confirm it was healing fine and not infected. The picture below shows how the bone looked after three weeks.

ankle fracture at 3 weeks
ankle fracture at 3 weeks

Six weeks after

Six weeks after I had the broken ankle, I attended another appointment at the hospital. I had another X-ray done. The registrar told me to continue mobilising with moon boots until I see the physiotherapist. I was referred to the physiotherapists. At this time, I could partially weight bear. The picture below shows how the bone looked after three weeks.

ankle fracture 6 weeks
ankle fracture 6 weeks

Ankle fracture x-ray on the day of fracture, at three weeks and after 6 weeks

ankle fracture x ray
ankle fracture on day of fracture
ankle fracture at 3 weeks
ankle fracture after 3 weeks
ankle fracture 6 weeks
ankle fracture after 6 weeks

Driving after ankle surgery

I started driving about 10 weeks after I broke my ankle. I first practised driving around a parking lot before driving again. This leaflet about driving after injury may help you things to consider before starting to drive again after an ankle fracture. You are required by law to inform DVLA if you are unable to drive for more than 3 months because of a broken ankle.

About the author

Nwasom is a pharmacy graduate and a pharmacist currently practicing in the United Kingdom. I have  great experience communicating with patient and their family as gained through working as a pharmacist in both the hospital and community pharmacy sector. I love writing so it was a natural thing to try and pass medical and health information on through writing.