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.

I had a spiral fracture of my fibula, I was non weight-bearing for 2 weeks & then using crutches for 4 weeks. Keep it up as much as you can until the swelling stops, keep up with the painkillers.

You're very welcome. It's a combi of detailed animal injury recovery training I've had, human first aid training, and I had to do a lot of research for myself when I broke my own ankle!

I don't have much knowledge of boots, (I was in a cast and animals tend to be put in casts too!). If you're at home with your leg elevated (which should be your default) I'd think it was safe to take the boot off to let your skin breathe and to apply ice. For today though until you've worked out how the boot works I'd experiment with putting ice on over the boot, see if it cools your leg at all through it.

frozen peas are perfect, the bags are a good size for an ankle and they conform around the leg beautifully! Have 2 packs that you dedicate to ankle cooling so that you can rotate them and not worry about how much the peas have defrosted because you're not going to eat them :D

Just thinking about your planned holiday, don't forget to inform your insurers before you go and remember that you can get assistance through the airport. There should be a number on your airline's website. I went on holiday after I'd broken my foot some years ago and whilst I was out of the cast I was still on crutches. I felt a bit of a fraud to be honest but there is a lot of standing in queues in airports (probably even more now) and being able to bypass a lot of that really made a difference. Plus you are also not holding other people up if they are dashing to their gate and you are hobbling through the airport at snail's pace.

Oh, and they will want to Xray you again at the fracture clinic, partly to see if it's still in place, and partly because breaks show up a lot better a few days after the break. It's partly to do with cells headed to the break to start the healing, and partly because the break tends to drift wider over the first few days (yet another reason to keep on top of the swelling to minimise this!)

You might experience your leg sort of kicking out by itself in the first few days or week, particularly at night. It's a jerk and it can be blooming painful, because your muscles are doing something that the bone doesn't want to do! If it happens to you keep well on top of your painkillers for the first few days, and know that it does settle down.

The consultant will look at the x-ray and call you back in if she thinks it needs setting.

@BrokenAnkle if you use frozen peas make sure you do something to the packs to make sure anyone else in the house knows they are not for eating!!

DH managed to serve DS's knee peas up in spite of much labelling and having been told they were not for eating!!

They werent very nice (but that might have been because they were the cheapest of cheap peas) but we lived to tell the tale!!

You need a big sock to go inside the boot that you can swap and wash

Beanbags are ideal to elevate the foot on. And get two bags of cheap frozen peas so you can swap bags.
Office chair for the kitchen so you can self care and make the odd sandwich.
Bumbag so you can shuffle around the house and carry the odd item.

Our local fracture clinic is a bunfight - multiple people have the same appointment times, so to some extent it doesn't matter when you show up, they see you in order of arrival. Also they whisper some approximation of your name, once, out of a random door and move onto the next person if you don't immediately jump up. Usually first call is for moving from main room to xray waiting area, then back into main room to wait for someone else to whisper a mangled version of your name from another random corner before you then wait somewhere else to see orthopedics.

Daft Question, but how elevated is elevated? 😳

higher than your heart

You might have 'loose' lateral ligaments - apparently this is common in people who have a lot of sprains. I had a lot, some more serious than others, until a serious one 20 years ago which hung around longer than it should have. An x-ray showed a cartilage lesion/talar dome fracture. Three surgeries and a further serious sprain later I have had 3 surgeries and now need an ankle replacement. This is not to scare you, but to say maybe ask for a referral to an orthopaedic surgeon to discuss the repeated sprains. (And yes as mentioned by a PP, physio can help too). You can have a relatively simple surgery to tighten the ligaments, and after that you would be much less likely to go over on it. I had this as part of another more complicated surgery (I had actually detached the ligaments completely in another sprain so they had to be reconstructed). BUT this is likely to increase your chances of post-traumatic arthritis, which I'd already developed anyway, and is where I am now (obviously the arthritis is now very advanced, which is why I need the replacement).

In the meantime, did they give you crutches? I would stay off your foot as much as possible until the fracture clinic appointment. A break takes 6-8 weeks to heal so you may be in the boot that long, but if you aren't allowed to bear weight now, you probably will be before the 6-8 weeks are up.

Elevated means 'toes above nose'. I recommend getting a proper wedge cushion for this. If not, lie on the sofa with a pile of pillows. Be sure to support the whole lower leg when you elevate, otherwise you might put unnecessary strain somewhere (knees, hips, back, even on the injury itself). And wholly recommend ice. A frozen 500ml plastic water bottle behind the knee is very effective at getting the cold to the ankle area. Wrap it in a tea towel to avoid ice burns!