Your doctor may apply an external fixator to hold your pilon fracture in place and stabilize your ankle until your second surgery can take place. Certain social, demographic, and treatment variables seem to contribute to these poor outcomes. 7 Months Post Op and 3 Months of “Walking”, An Update; Ankle dorsiflexion limited after 6 months post injury at 2 degrees. If I have to have surgery, what are the benefits and risks? It depends on the type and cause of the fracture (motor vehicle accident versus a fall, for example). Unfortunately, the boot keeps my foot in one place and because of the difference between a normal left shoe and a right boot it hurts my back incredibly to walk much distance. 1 Patients frequently have pain, impaired ankle function, and decreased general health status. I almost cried. Today I became 100% weight bearing. Be aware that although opioids help relieve pain after surgery, they are a narcotic and can be addictive. The fracture involves the larger bone of the lower leg (tibia), and extends into the weight bearing surface of the ankle joint. Most patients are not able to put all of their weight on their injured ankle for 2 to 3 months. I see the surgeons this week and I am seeking more specialists to talk to before I take the plunge into more surgery. It is very common to have difficulty bending your ankle as far back as you were able to before your injury. Hi, This is a common symptom. Copyright ©1995-2020 by the American Academy of Orthopaedic Surgeons. Recovery depends on the type, location, complexity and treatment. Check for swelling in your foot and ankle. Physical Therapy Guidelines for Ankle Fracture with Surgery This was written and developed by the therapists of MGH Physical Therapy Services. This is a tool used for crushing. I was riding 7-10 hours a week (5-6 days) before and hope I can get back to that eventually. The external fixator is usually removed after the plates and screws have been placed. She said ankle fusion or ankle replacement were her assumptions of my next procedure but that it wold not be her that did the surgery (Dr Herzog is a orthopedic trauma surgeon and the person who fixed me up when I came into the ER on March 6th.) A pilon fracture typically occurs as the result of a high-energy event, such as a car collision or fall from a height. Walking with crutches is the first step toward rehabilitation. While I knew that the likelihood of pilon fracture-related cartilage loss and joint collapse was very high, I was very hopeful that I was going to be one of the luckier patients and get a few years of fun in before I had to deal with arthritis, more surgery, etc. In some cases, nerves may be injured at the same time that the bone is broken. Be sure to ask questions if you have any. You will most likely be unable to bear weight on your ankle for up to 12 weeks after your injury. A pilon fracture is a type of break of the shinbone (tibia) that happens near the ankle. I am having problems with circulation…. By delaying surgery in severe injuries, doctors have continued to decrease the risk of infection and wound problems. Many pilon fractures require surgery but, rarely, some stable fractures can be treated nonsurgically. ( Log Out /  However, for some patients, there is little pain and no need for further surgery. Depending on the severity of your pilon fracture, your recovery time may vary. on WordPress.com. I’m freaking out about these fat ugly ankles. It usually occurs following a significant force to the foot, such as a fall from a height or motor vehicle accident (MVA). More severe infections may require intravenous antibiotics for several weeks at a time. This type of fracture is particularly serious because, once the skin is broken, infection can occur in both the wound and the bone. This will offer protection while your ankle continues to heal. Mine happens march 9th 2020. CONCLUSIONS: At more than three years after the injury, pilon fractures can have persistent and devastating consequences on patients' health and well-being. If you don’t get cartilage loss will be pacific, you must be proactive to have a good prognosis, good luck…. Some degree of posttraumatic arthritis occurs in about half of all patients with pilon fractures. A CT scan will also help your doctor plan your treatment. Performing surgery too soon increases your risk for infection or problems with your incision. … She said my lack of dorsiflexion was from the bone at the front of the tibia hitting the talus, and that wasn’t going to stop happening through more physical therapy. Check your pulse at key points of the foot to be sure that there is a good blood supply to your foot and ankle. ….will get there. Post was not sent - check your email addresses! I tried to convince her that I had some good results from PT, and massage, but she ignored me and said it was time I find a ankle specialist who was skilled in post-pilon fracture treatments, and explore my options. Once the swelling goes down, he or she will replace the splint with a short leg cast. The external fixator also helps to restore proper limb length and provides stability. Anyone else had any issues like this? It may also be recommended for patients who are unable to walk or patients with very serious medical problems who may not be able to tolerate surgery. About Tibial Pilon Fractures; Pilon Blog. Will I develop arthritis or any other complications. Pilon is the French word for "pestle"—an instrument used for crushing or pounding. (She is also very awesome). Out of the cast a week today. Well… my surgeon walked in the room after I got out of x-ray and didn’t look very excited to see me. In some cases, surgery may be necessary to get rid of an infection. Because the ankle and foot have been immobile for some time, strengthening the muscles that support the ankle and loosening up tight ligaments and muscles is necessary. My Pilon fracture can’t stop the bike riding. In most cases, your doctor will first apply a splint to hold your ankle in place. Other complications of pilon fractures may include: How soon you are able to resume your normal activities will depend upon several factors, including: Some people are able to return to preinjury activity levels after pilon fractures. Did they put a lot of hardware in there? You may be able to bear weight between two to three months. For example, it may be difficult to bend it the same way, go up and down stairs, or climb a ladder. Painful plates and screws—patients who experience discomfort may choose to have their plates and screws removed after the bone has healed, Blood vessel or nerve damage—this may occur at the time of the injury or during surgery, Whether you have other injuries or medical problems. that it will eventually allow me to do what had been a twice daily 10-15 minute walking portion of my commute in New York City. A pilon fracture is a type of break that occurs at the bottom of the tibia (shinbone) and involves the weight-bearing surface of the ankle joint. Rotator Cuff and Shoulder Conditioning Program. ( Log Out /  ( Log Out /  X-rays of the leg, ankle, and foot are commonly done to evaluate a pilon fracture. did anyone have infection due to break going through skin? Long healing or worsening is one of possible fracture symptoms. Eric, Almost two years post surgery. And not just severe ankle fractures but those requiring open reduction and internal fixation (ORIF). For this reason, as the swelling in your ankle decreases, you may need frequent cast changes. Thus, we determined the clinical effects of routine hardware removal irrespective of the degree of hardware-related pain, especially in the perspective of patients’ daily activities. What happens after a tibia/fibula fracture open reduction and internal fixation? Monitoring. The tibia may break in one place or shatter into multiple pieces. In some cases (those luckier than me) the cartilage survives enough t allow pain-free walking and much normal use of the ankle. Surgery is commonly recommended for unstable fractures in which the bones are out of place. Pilon fracture with bones thru the side of my ankle. A CT scan can provide valuable information about the severity of the fracture by helping your doctor see the fracture lines more clearly. Splints and casts. If your fibula is also broken, your doctor might first perform surgery to fix the fibular fracture and get your ankle back into place—and then apply an external fixator to hold your pilon fracture in place. After discussing your symptoms and medical history, your doctor will perform a careful examination. The talus is a small foot bone that works as a hinge between the tibia and fibula. You will probably walk like a zombie in the first stages of walking again, but with rehab and practice, you will get much better at it and faster. Ankle stiffness is very common after a pilon fracture. Sharing our pilon fracture experience; It has been 5 and a half months after my pilon fracture surgery. Your doctor may recommend that you use crutches, a cane, or a walker during this time. If you experience a pilon fracture, you will probably have many questions about your treatment and recovery. Open reduction means the surgeon makes an open incision to treat the fracture. The three bones that come together to form the ankle joint. The bone of the lower part of the ankle joint (talus) is driven into the top of the ankle joint, causing a fracture to the weight bearing portion of t… Posttraumatic arthritis is a type of arthritis that develops after an injury. Examine your lower leg and ankle, looking for cuts from the injury and gently pushing on different areas to see if it hurts. What do you mean proactive? Patients with pilon fractures usually experience immediate and severe pain. Your doctor may place your ankle in a splint until your surgery, or recommend that you have an initial smaller surgery to protect your ankle while waiting for the second surgery. Minor infections can be treated with antibiotics and dressing changes. Determine whether you have sustained any other injuries by examining the rest of your body. Some patients with posttraumatic arthritis may need further surgery to relieve symptoms. However, if your job involves manual labor or if you participate in high-impact sports, you may not be able to return to the same level of activity as before your injury. The external fixator acts as a frame to help hold your ankle in a good position until a second surgery can be performed. Surgeon also thinks I ought to be able to begin light pedaling (I’m not going to call it cycling at that point) when I start weight-bearing – so I’m looking forward to that for both mind and body. Your doctor will develop a treatment plan based on your individual symptoms. No weight on it till end of June. Medications are often prescribed for short-term pain relief after surgery. Her first words were “you’ve lost the joint space, the cartilage is gone. The displaced bone fragments will be repositioned (reduced) into their normal alignment and held in place with metal plates and screws. Reference: footeducation.com . ( Log Out /  This risk has been brought down to about 10% or less for patients with pilon fractures. The term "pilon" comes from the French word for pestle. I’ll start that on the indoor trainer at first when the time comes. To find in-depth information on ankle fractures, please read Ankle Fractures (Broken Ankle). Together, these three bones—tibia, fibula, and talus—make up the ankle joint. My ladder broke while I was taking down my life size gingerbread house….grrrrr, Fell off a ladder March 9 2020. About OrthoInfo Editorial Board  Our Contributors   Our Subspecialty Partners  Contact Us, Privacy Policy  Terms & Conditions   Linking Policy   AAOS Newsroom  Find an Orthopaedist. Your doctor will closely monitor the healing of your fracture. I joined a CrossFit gym and used my knee scooter to get around and they had me do a lot of upper body and core work to stay fit and it really helped pass the time. Your surgery may be delayed for up to 2 weeks or more, depending on how long it takes for the swelling to go down. This is very typical.” She went on to say that the impact of the initial injury (the talus bone ramming upward and shattering the plafond of the tibia, ripping the cartilage to pieces in the process) leads to cartilage death many months after. Check to see if you can move your toes and feel things throughout your foot. Do I have any specific risks for not doing well? Any who my question ro you is when did the swelling stop & how are you today ? In this operation, your doctor makes small incisions into the skin and inserts metal pins through the bones. This can result in infection. Change ), You are commenting using your Google account. Not to be a total downer, here is a story about things I CAN DO while hobbling around on this ankle.. https://www.strava.com/activities/413271549/embed/ddf196e6cd9d52343e4c9b9651d9dd63ba126def” target=”_blank”>Click here for a glimpse of the possibilities for those of us with a bad ankle. A pilon fracture is a type of break of the shinbone (tibia) that happens near the ankle. Even when your bones heal normally, the cartilage protecting the bones can be damaged, leading to pain and stiffness over time. Computerized tomography (CT) scans. Six months after cartilage is injured you get to see what is going to stay and what is going to dissolve. from the American Academy of Orthopaedic Surgeons, The amount and size of the broken bone fragments. If you participate in high-impact sports, you may be able to resume activities 6 months after your surgery or injury. They say it’s because I am staying very active. The amount each piece is out of place (displaced). 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