ankle update at 9.5 weeks

While I alluded to this yesterday, I felt a more complete ankle update might be in order given that it’s been so long since I posted anything. As I said, short answer is I’m fine and healing as well as could be expected.

Monday a week ago, 3 June 2013, marked the 9.5-week mark since I injured myself and the 8.5-week mark since my surgery. The X-ray they took showed that the bone was starting to join, and that no AVN was yet evident. I could see the surgeon’s shoulders relax as he had a look: looks like we saved it, he said. He also told me I could acquire a CD-ROM of my X-rays if I wanted them, so I’ll have to have a look. Who knows, they might even give me my CAT scans, and if they store the data cubes in FITS format they’ll be simple enough to work with!

I can report anecdotally as well that things are much better than they were. The deep surgical wounds on either side of my ankle, once oozing fluids of all the colors of the rainbow, are now healed. The right incision has healed well enough, but the bottom half of the left incision has left a blotchy red scar, almost like a birthmark. I’ll spare the pictures of those (mostly because I’m too lazy to get my camera back out). I’ve removed the dressings and am even able to wear a sock on the injured foot. The injury feels a lot less fragile, and while I haven’t put any weight on it yet, I can take the boot off and not worry about a painful re-break if I so much as breathe on it wrong.

Range of motion is also returning, amid loud, boisterous pops from the stiff joint as it heals. I have almost full dorsiflexion back and more than half plantarflexion, as you can see from the photos below. The lateral motion is the most severely affected, and my left ankle now has only a small amount of motion in either direction compared to my uninjured right ankle. However, I have unusually loose joints in general — hyperextending elbows and very loose shoulders, for example — and have been told that my ankles are no exception, although I was previously unaware of this. It’s possible that the lateral degrees of freedom will return in time as well; I don’t see much progress day to day, but week to week, I can tell that things are on the mend.

Dorsiflexion

Dorsiflexion

Plantarflexion

Plantarflexion

Lateral flexion

Lateral flexion

Medial flexion

Medial flexion

Nevertheless, I am not yet out of the woods. The orthopedes at Fracture Clinic have told me I’m not to put any weight on it until the bone is fully joined, which they predict won’t be until at least week 12. We’ll review the prospect of partial weight bearing at my next Fracture Clinic, which will be shortly before I head to Melbourne for the Astronomical Society of Australia meeting at Monash. I expect that when it is time for partial weight bearing, I’ll be past much risk of doing much damage to the bone, but probably at vastly increased risk of spraining something, since the muscles which stabilize the joint against injury to themselves and associated ligaments and tendons will be much weaker. Then it will be time for lots of exciting physical therapy.

To everyone who keeps asking me how much longer I’m going to be in this boot: The truth is, I don’t know. The whole thing is a bit touch-and-go: the orthopedes gave me three months for the bone to heal, but even that I figured was simply an estimate based on typical healing times, and the actual healing outcomes would dictate the last word. While it looks like I’ll progress to partial weight bearing more or less on that schedule, the outcome of the physical therapy is anyone’s guess, and since my left leg has been doing basically nothing for three months, I’m expecting it will take at least that long to regain the strength it’s lost. Probably quite a bit longer, since it’ll be a very long time before I can do things like squats on that side alone, or go cycling (my previous favorite strength workout for my legs).

For the time being, I’m just leaving the ankle out of the boot as much as I can manage, and bringing it through as much range of motion as I can manage, stretching it with my hands along the stiff directions each day. Muscle strength will return with work, but I’m more concerned about loss in range of motion, so the more I keep moving it while waiting for the bone to mend, the better, I think.

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About Richard

I'm an American scientist who is building a new life in Australia. This space will contain words about science and math, but also philosophy, policy, literature, my travels, occasional rants, all sorts of things I find strange and awesome. The views expressed in this blog do not necessarily reflect the opinions of my employer at the time (currently University of Sydney), though personally, I think they should.
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