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I broke the end of my right fibula in a fall at home a week ago.  I've got a fracture boot now and I'm on crutches.  Its still tender, but I can apply some weight to it, though it doesn't feel good.

The ankle and foot are still swollen. My doctor said they would be for quite some time.  He estimated recovery to be 6-8 weeks.

Anyone have experience with this type of injury and any advice?  I was thinking of trying out a stationary bike soon, to see how pedaling feels with the boot.

Should I just lay off?  Are there things I can do to avoid this turning into a long-term problem?

Thanks.

P.S.  I need to travel to MI soon.  Are there restrictions on renting/driving a car while in a cast/boot?

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Sorry to hear it. You will need to lay off the bike, even the stationary bike, until the bone at least starts to knit. You're also going to need some physical therapy - I'd ask the PT once you get started on that if you can start on the stationary.

Driving might be a bit of a hassle but you might find a way to make it work - I guess it depends on the car? Can you drape your right leg over the center console and use the left for brake/gas?

Wait. Don't attempt a stationary bike until you can comfortably put weight on the foot, have good balance and  little or no residual swelling. When you've healed enough, your doctor or a physical therapist can recommend exercises to strengthen the injured area and help you return to normal function and protect against reinjury.

You might not be able to drive for several weeks, especially to travel a distance like that.


Are there things you can do to avoid this turning into a long-term problem? Listen to your doctor about recovery time. Don't put full weight on it prematurely. Go slow when returning to normal activities. If you need to modify activities, ask for help, cancel trips, etc. to avoid putting stress on that ankle and foot, do what you need to do.  Explain to people that you need time to heal.  Having to ask for help sucks, but it's better than getting hurt trying to do something your body can't handle yet.

I'm speaking from experience with many weight-bearing orthopedic injuries - my own and helping close friends. If you reinjure a foot or ankle problem once (or more than once), it's too easy for it to turn into a chronic problem that could affect your mobility and/or sleep for years - or for the rest of your life. 

Just my $0.02... after creating permanent damage situations by jumping back in too soon. Wish I could go back in time and not do the stupid things I did to create a foot/ankle situation that still affects me 20 years later.

Wishing you good healing and minimal long-term pain.

I broke my right ankle in three or four places a little less than 2 years ago.  They had to do surgery to install a plate and screws because I sheared the fibula completely.

I'm guessing if they've got you in a walking boot right now, it's not quite as bad a break as I had.  I would keep weight off of it for as long as possible, just so the fracture heals correctly.  What also helped me a lot in the first 6 weeks was physical therapy.  There are lots of exercises you can do to keep the muscles in shape.

I basically couldn't drive anywhere in the boot, and I couldn't see a rental place allowing you to rent a car because of the liability.  The reaction time and modulation you need to drive properly are nowhere near what you have in the boot, and if it gets caught on a pedal or something, you could easily crash and put yourself in a worse situation.

With all the PT and surgery and everything, I was back on a bike at around 6 weeks for just slow stuff around the neighborhood, and I would say I was back to longer rides after 8-10 weeks or so.  Just take it slow and if it starts to hurt too much, lay off.  The bone will heal pretty well in around 6 weeks, so as long as you don't do anything too crazy before then, you shouldn't really have to worry about re-breaking it.

Still, nearly 2 years after the surgery, I still get pain from time to time, and my muscles haven't quite gotten back to where they were before the injury.  It's been a long, slow road for me, but hopefully you'll have better luck!

Thanks for the feedback.  It's pretty much what I expected.  It's just so damn frustrating and inconvenient; all the little things you take for granted.

I've got a follow-up appt next week.  I'll ask about PT.

I'll probably take Megabus to MI rather than drive.  Maybe I can guilt my way into a seat on the lower level.

I broke my right ankle in February 2008, then my left ankle later that year in September (moms, don't let our kids play hockey).  Very different experiences since one was treated by the NHS in the UK, and the other happened here in the US.  The two things I learned: Try to stay away from surgery unless it is necessary; and really work hard at the PT, especially the deep flexing and extending exercises.  You'll want to try and restore as much range of motion as you can.

[disclaimer: I'm no doctor]

Leaving aside the expense, which healthcare system did you prefer?

pat 5.5mi said:

I broke my right ankle in February 2008, then my left ankle later that year in September (moms, don't let our kids play hockey).  Very different experiences since one was treated by the NHS in the UK, and the other happened here in the US.  The two things I learned: Try to stay away from surgery unless it is necessary; and really work hard at the PT, especially the deep flexing and extending exercises.  You'll want to try and restore as much range of motion as you can.

[disclaimer: I'm no doctor]

I shattered my tib/fib in '99.  The bones were pretty much gravel from the ankle joint up about 5 inches. The Tibia needed to have a titanium rod inserted the entire length from the knee to the ankle (they had to open the kneecap like a car hood and drill down the center of the entire bone to make room for this for this rod) and the fibula needed a plate from the ankle to about halfway to the knee with 8 screws to hold it on.  The Tibia rod is anchored by 3 pins on each end going through perpendicularly every 120-degrees to fix it in place.

#1 issue is swelling.  Swelling = pain.  Whatever you are doing that causes swelling will cause pain.  Don't do that.  It's going to swell enough on its own already.  Load-bearing is what gave me pain and swellling. letting the boot get below my body gave me swelling and pain.  The boot's angle gave me swelling and pain but they put the boot at a steep ankle angle so that you don't loose mobility and get drop-toe.   But it hurts to high hell, let me tell you.

The best thing I found for swelling was to get two basins of water.  One basin filled with as hot as water as you can stand.  The other is filled with ice-water.   Alternate hot & cold every 2-5 minutes depending on how much of this you can stand.  I could literally FEEL the bones and tendons squeaking as the contracted with the swelling being driven out.  Drive the swelling out and the pain goes down a LOT.  It heals a lot faster this way too.  Mine was so bad that after the operation they couldn't even put the boot on for 2 weeks, they could only wrap it loosely with a splint thingy.  It was 3 months before they could give me my first cast and 2 months out before I could get out of a wheelchair and use crutches the swelling was so bad and my first walking cast was at over 4 months.   

Physical Therapy.  Don't skimp on this.  DO NOT.  It hurts and it is expensive if you don't have very good medical coverage.  Demand that they give you as much as they will give you and pay for more as much as you can afford.  The more the better.  You will lose a lot of mobility and strength, and especially balance.  They will give you exercises for those but if you don't keep up on them you will walk with a limp for a very long time.  Fibula breaks will do this.  After 14 years I still walk with a limp when I am tired. 

Scar tissue adhesion.  Broken fibulas heal fast but because they are so close to the skin and there are tendons right there it tends to form a big ball of scar tissue nastiness at the break right up against the skin. You want to break this crap up before it gets bad. The more you let time go by the worse it gets.  I'm STILL working at getting all of mine broken free after 14 years of this. It hurts and if I wear tight boots or, god forbid, try and rollerblade for more than a little while that scar tissue is like someone is burning me with hot oil.  Try and get it broken up and not let it get out of hand.  I know it hurts.  Talk to your doctor and physical therapist about this and make sure you have a good therapy plan for it.  Take it from me you DO NOT want to let that scar tissue get out of hand and have your skin and tendons stuck with scar tissue to your healed bone. 

Typically you would be allowed to board first.

JeffB (7+ miles) said:

I'll probably take Megabus to MI rather than drive.  Maybe I can guilt my way into a seat on the lower level.

That's what I would hope. But you probably know how those crowds get, especially if the bus is as late as it usually is.  Plus, I'd be traveling alone and would have to stow my luggage first, while others line up at the door.  We'll see.  Although now that I think of it, how do I pull my suitcase while on crutches?  Maybe I'll just have to pack light and carry my bag on my shoulders.

h' 1.0 said:

Typically you would be allowed to board first.

JeffB (7+ miles) said:

I'll probably take Megabus to MI rather than drive.  Maybe I can guilt my way into a seat on the lower level.

Long stories but I preferred the UK bar far.  Both in terms of the quality of the medical care and my personal experience as a patient (ER experience, finding doctors, making appointments, insurance, personal interactions).



JeffB (7+ miles) said:

Leaving aside the expense, which healthcare system did you prefer?

You should be allowed to board first. When I've had to get around on crutches and didn't have anyone with me to help, I've found it much easier to travel light and use a backpack.

Yes, there are so many things we take for granted until we're physically unable to do them. It's something you don't realize unless you have limited mobility or are assisting someone who does.

JeffB (7+ miles) said:

That's what I would hope. But you probably know how those crowds get, especially if the bus is as late as it usually is.  Plus, I'd be traveling alone and would have to stow my luggage first, while others line up at the door.  We'll see.  Although now that I think of it, how do I pull my suitcase while on crutches?  Maybe I'll just have to pack light and carry my bag on my shoulders.

h' 1.0 said:

Typically you would be allowed to board first.

Shattered my fibula 2 years ago and did some ligament damage, had surgery and a plate/screws put in.  My advice is pretty similar to what's already been said.  Don't skimp on PT, do not lose the crutches before the doctor advises, do PT first before you attempt any exercises on your own, do not ride a bike with your boot.  The physical therapist should get your doctor notes on your healing process and will adjust your therapy accordingly. 

I would avoid driving at all costs, but I'm not sure about the rental car policy.  Depending on where you're going in Michigan you could also consider Amtrak, although they can be just as shaky as Megabus.  If you need to fly with the boot on be prepared to be taken to the side and searched for a few extra minutes.

If you do need surgery, I'd recommend Midwest Orthopedics at Rush, Dr. Linn specifically.  If you don't have insurance ask the doctor you're seeing if they have any kind of charity policy for uninsured patients or discounts.

If the location is convenient, look into ATI for physical therapy.  They have a hired driver that will pick you up and take you to work afterwards that's included in the total pricing.  There is a maximum mileage limit though.  If ATI doesn't work out see what other companies have the driving program, it really helps out in getting around on your therapy days.

Feel free to send me any messages if you have any other specific questions, especially on the insurance issue as I work in healthcare finance.

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