I was kicked out of A&E super efficiently with a broken ankle and I didn’t get to ask anything I need to know - can anyone help?

[BrokenAnkle]

I’m not moaning about the hospital - they were great but I’m left with loads of questions as it was all done so quickly.

I slipped on wet decking on the 4th of July and buggered up my weak ankle for the umpteenth time over the years. It happens - I injured it in the 90s and it’s just a big baby that always folds at the first sign of trouble, so I thought nothing of it. I hobbled around on it until yesterday when I went to the GP for some prescription pain killers and she booked me in for an X-ray this morning after she saw it. Turns out this time it actually is broken after loads of false alarms over the years.

I’ve got a ‘spiral fracture of the distal fibula’ apparently

They said the fracture clinic doesn’t open until Monday morning and gave me a big boot and sent me on my way, which is fine but I’m really wondering about all kinds of questions.

Mainly

How long is this going to take to heal? When can I drive again?

Am I going to get a cast when the fracture clinic opens? Or is the boot the whole thing? What
will the fracture clinic be doing if I don’t need a cast? How long will I need either the boot or a cast?

What am I supposed to be doing? As little as possible or pottering about a bit? I’m supposed to be going to Portugal in 3 weeks. She said I can fly - do I m just have to basically sit still the whole time when I go?

I walked around in it for 10 days - Did I do any extra harm?

How on earth do I keep the boot hygienic?

I know this is a long shot and it’s asking for free medical advice but if anyone has any ideas on it I’d be incredibly grateful to have a bit more knowledge on what I’m in for.

it will all depend on the x ray

If I was you I'd take it super easy and stay home this weekend til you can get to the fracture clinic for the x-ray. In all likelihood they won't know what to advise you until they see that but for now don't risk hurting yourself more

Hi both - they did the X-ray and confirmed it’s a ‘spiral fracture of the distal fibula’ - will they X-ray it again?

It depends on the x Ray when you attend the fracture clinic, I was told they don't do casts now. I hated my boot, I'm not sure on healing as it will depend on the break and your body. Definitely rest those weekend and elevate your leg.

Without knowing a huge amount about that particular fracture, I'd say general advice would be keep the foot elevated when sitting to minimise swelling. Rest. Take painkillers if needed.
Longer term, you'll get all the advice at fracture clinic but usually it's at least 6 weeks for breaks to heal and that ones without complications. If they haven't told you not to put weight on it then that's a good sign as you should be able to be up and about by the time you go on holiday. I would be surprised if they put a cast on it, they seem to be all about the boots these days.
You will have to keep the boot clean and dry, sponge it down if you drop food on it! Wear socks so you don't make it sweaty.

Sorry to hear this! When my partner broke their ankle they had to wait a few days for fracture clinic and then got a cast same day for 6 weeks and later got a boot for further 4 weeks. Top tips were: use a bin bag to cover your cast if you want to shower/bathe. The boots come off to clean / sleep. We used a damp cloth and anti bacterial wipes to keep it clean. The rest of your questions are really best answered by your doctor.

My daughter had a boot last summer. We could wash the padding, it came out (attached by Velcro). We did this only when really necessary as it did take a little while to dry. Also she couldn't move at all until it was dry. The boot itself can be wiped over.

But until at least you speak to the fracture clinic - we had a virtual appointment at first; you should be resting with an elevated ankle as much as possible.
You will not be able to drive until you no longer need the boot. At least 6/8 weeks if it is a clean break healing well. Personally I would get used to not having the boot for at least a few days afterwards. The test is "could you adequately do an emergency stop "?

You're going to have to wait and see what the fracture clinic say on Monday.

In the meantime, keep wiggling your toes - that's not sarcasm, it was, according to one of my physios, absolutely vital to keep up the strength, blood supply and to make the healing process as quick/successful as possible.

The boots are great, though - so much easier to manage than casts.

Ice never understood why the fracture clinic isn't open to some extent at the weekends.

Hi OP not quite the same so not sure how helpful I'll be, but I broke my toe a few weeks ago that required surgery and a wire in place - I've been given a boot too, and basically told for the first two weeks to stay off my foot as much as humanly possible, and then the following 4 weeks I can walk about but only with the boot and crutches. I was told to elevate as much as possible when at rest, using an ice pack if needed. I was also told to take regular pain relief, paracetamol and ibuprofen (although I was prescribed morphine after my op which was bliss!) I had a follow up at the fracture clinic and back again in 4 weeks to have the wire removed.

It's been a nightmare having small DC so having lots of support in the first few weeks was vital for us as I couldn't really do much! I don't drive but was told could resume after 6 weeks.

Im only just getting my head around the idea that this has happened. I’ve had so many false alarms which, to be honest, were often significantly more painful than this but turned out to be sprains that I have been driving on it all this week, which with hindsight now scares the living daylights out of me. It’s my left foot, so not the brake, for what it’s worth.

I don't have any medical training but guessing from family experience you will have something for about 4-6 weeks.
Because its likely swollen - they don't put full casts on limbs until the swelling goes down. they might keep you in the boot - but remember the idea is to be still so the bone can heal.

Bless you, it's such a nightmare isn’t it.I broke mine last summer.
I was phoned a few days after my A&E visit and given my first physio apt the following week. Weekly physio for 7 weeks then a couple more in the summer.
At my first physio I asked about a second boot liner so I could wash it and as they couldn't be bothered to faff finding just the liner they gave me a whole spare boot. So, one for house and bed and the other for outside.
6 weeks in boot (5 weeks of them of them overnight). Then I was driving again at week 7. It was a tiny break though.
Running after 12 weeks.
The more you rest and elevate it now, with little bits of gentle activity the better it will heal. Eat well and do the physio religiously.

It really depends on the break - did they say the bones were in place, or mention that you will need a reduction (where they push them back into place, usually from the outside but occasionally surgically)?

Do you have any conditions that affect your bones? As it takes a lot of force to break a bone like that usually.

Lastly, I'd take aspirin if you're not already (or ibuprofen) to reduce the risk of a blood clot.

oh blimey - I’m kind of used to having a rubbish sore ankle so I’m only just realising this isn’t the same thing. Physio? I was hoping to be back to normal by next week. Drat.

(is this the right way to reply directly? I’m not sure if I’m doing this correctly 🙂)

They didn’t say a lot really. I’ve been walking and driving on it so I’m assuming it’s very minor. It looks normal and the swelling has gone away but it’s very bruised.

You’re just going to have to take it easy until you get seen at # clinic as that’s where you’ll find out what the plan is.

It will inevitably be at least a few weeks of inconvenience.

Good to hear it’s your left foot. Are you in a position to beg, borrow, hire or steal an automatic car?

The fibula doesn’t take very much weight so my money is on the boot staying on for 4 weeks then another fracture clinic review.

The liner of the boot can get pretty sweaty and smelly so wear a sock which is easier to wash as you won’t be able to get about without crutches if you wash the boot liner until it is dry.

you can fly in boots.

I’m wondering now how on earth I stop this happening so often (the twists, not the fracture). In the 90s in a nightclub I was standing on a short flight o fly 3 or 4 stairs with one foot on one step and the other on the step down minding my own business when a fist fight blew up near me and one of the guys went down like a felled tree onto me and my ankles in daft strappy stilletos. Nothing broke then but I’ve been paying the price every few years ever since and now finally I’ve finished the job.

😁 I’m absolutely up for a touch of grand theft auto under the circumstances.

It would be a very reasonable defence 😁

they put it on me and I’ve not done anything with it since - I couldn’t get any of my shoes on over the swelling so I was in flip flops and I can tell already I would have been happier with socks on as it’s not cool inside this thing. I’ve no idea what comes apart or what can be washed yet. I guess I’ll see at bedtime. It was all spectacularly efficient to the point I didn’t have a chance to think. My personal experience of the NHS was really positive to the point of not having enough time to fully know what was happening!

With a spiral fracture one of your biggest concerns is making sure that you don't make the fracture worse. To some extent at the moment, it's pretty well holding itself together (which explains the lack of worse pain) but it is still weaker than normal and if you step on it funny or roll your ankle you could well end up making it a displaced fracture, and then you will REALLY know about it! So although you'll be walking on it with a boot, do be very careful and think about your steps before you take them +, same with any movement, go slowly and no twisting. If doing something gives you pain, LISTEN to it and stop doing it. You are more fragile than you feel!

Rest, ice (20 minutes at a time), and elevation to keep the swelling down. Elevate it with a pillow or two in bed. A little bit of movement to keep your joints mobile is a good thing but too much will make it swell up (and risk further breakage from stress fracture fatigue). Toe wiggling is good, yes!

Get onto chasing up for physio as soon as you've been seen by fracture clinic, there is usually a delay but it's going to be the thing that gets you back on your feet confidently and best.

Cigarettes, alcohol and fizzy drinks all slow bone healing. Try to eat a healthy diet with plenty of nutrition in it to support healing, and don't be surprised if you are more tired than usual. Honour that with plenty of rest.

Definitely ask the physio for advice on this when you see them. They'll give you ankle strengthening exercises to do.

Golly - lots to go on there. That makes a lot of sense about the twisting - our stairs go around a corner and that’s been my nemesis this last week.
so I should take the boot off and apply ice that regularly?

thank you for taking the time to help - I really appreciate it.