Question:I'm just home from a hospital stay for ankle surgery from a motorcyle accident. I have a bunch of screws in my ankle. I've been told not to put any weight on the foot until I see the doctor again in six weeks. It seems like with all those screws it should be safe enough to hobble around. What's the reason for not even being allowed to touch my foot to the floor?
Answer:It sounds like you had a significant ankle injury. Was there bone and soft tissue damage?
Fracture with rupture of the syndesmosis usually requires this type of treatment. The syndesmosis is a group of ligaments holding the two bones of the lower leg together at the ankle.
It takes about six weeks for bone to heal in the average, healthy, adult. The use of tobacco products can delay bone healing. The presence of some health conditions such as diabetes or osteoporosis can slow down the healing process. And it takes much longer than six weeks for healing to occur around the ligaments.
Although this point is debated, many surgeons advise their patients with a syndesmotic injury to avoid putting weight on that side for up to 12 weeks. Some surgeons allow weight-bearing after six weeks but the patient is in a walking cast.
After a few weeks, the soft ankle brace will replace the cast. Once the screws are removed, full weight-bearing is allowed. The screws are taken out around 12 weeks. Patients who put weight on the leg too soon run the risk of poor healing or nonhealing of the soft tissues. Weight-bearing can put enough pressure that the screws can come loose or even break.
Failure to follow your surgeon's instructions can lead to poor results of treatment. Ankle instability with chronic sprains and even dislocation can occur. Many studies of patients with this type of problem show that a poorly healed or nonhealed syndesmotic injury leads to decreased ankle function.Charalampos Zalavras, MD, PhD, and David Thordarson, MD. Ankle Syndesmotic Injury. In Journal of the American Academy of Orthopaedic Surgeons. June 2007. Vol. 15. No. 6. Pp. 330-339.
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