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Old 11-20-2012, 06:47 AM   #1
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lateral ankle stabilization and debridement

Hi all,
I had my surgery 5 weeks ago , I was in a heavy non weight bearing cast for 2 weeks then a lighter cast for 3 weeks (partial weight bearing). Last night my surgeon took the lighter cast off 1 week early and took my crutches off me.
Anyway I reluctantly walked out of the hospital and back to my home. However last night the pain was relentless , in fact it was as bad as the pain I experienced when the nerve block wore off after the initial surgery. Please can someone advise if this is normal? Over the last 3 weeks I was under the impression I was making good progress, ie I had no pain and was walking properly with the crutches.
Today I feel like Im back to square one again and had to take tramadol 2 x50mg and morphine 1 x 10 mg to control the pain. Today its extremely painful to walk on. Im in an aircast splint now for 7 weeks , can someone please advise if you wear this at night?
Any response would be appreciated,
thanks
NOEL

 
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Old 11-20-2012, 06:43 PM   #2
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Re: lateral ankle stabilization and debridement

Hi
I had similar surgery plus a few other things done on top of this 6.5 weeks ago. Was in back slab plaster for 10 days (NWB), then fibreglass plaster for 2wks (NWB) and then ankle brace and WBAT on crutches to come off these over 1 to 2 wks. It was very painful to put weight on my foot again after 3.5 weeks NWB and the surgery.
It took me a week to get rid of the crutches totally (used both for 2 days, then 1 for 5 days). Still really painful to walk on and stiff etc, but I did start physiotherapy 3 days after coming out of plaster and have been going twice per week since then.
Each day there is a little improvement (a couple of times I felt like I have gone backwards - like today) - but I am focussing on healing and improvement.
Just take each day as it comes - the pain will improve over time.
It really fascinates me how each OS has a different protocol after similar surgeries.
Sorry, I can't comment on the aircast splint, other than to say that I have to wear my brace all day, every day for 6 to 8 weeks, and then only for long walks, treadmill at gym etc for another 3 mths after this. I was told I could take it off at night and if I am going to be sitting down for a while so I can do ROM exercises.
Hope that helps - don't forget, you are now putting full weight on the ankle and it's going to let you know for a little while.
Hope your pain improves
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6 Oct '12: OCD talar, lat menis lesion, decomp ant ankle, osteotomy post proc talus, synovec post ankle, modified Brostrom-Gould, release PTT

 
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Old 11-21-2012, 06:42 AM   #3
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Re: lateral ankle stabilization and debridement

Hi Angelite, I really appreciate your response and yes I do agree with your comments about each OS and their advice. My surgeon was particularly anti - physio , he said they push you too hard and can undo his work. Therefore I dont actually start physio for 3 months.
Last night I removed the aircast splint and slept much better, the pain I experienced when I first put all my weight down has subsided and today I went for a small walk up and down the street.
In 2006 I had surgery to reconstruct my right ACL, medial ligaments and meniscus , I got back to playing sports but it was a long slow process.
This ankle stabilization seems longer and more inconvenient as I cant drive.
However like you said I think each day there is an improvement and the key is to take things easy.
I had the surgery done because my surgeon said that I had ruptured 2 of the 3 laterla ligaments and had early arthritis , this surgery he said should pospone the arthritis for a while I hope.
I was very active playing football , swimming & cycling , he told me no more football but that the other two sports are possible.
Thanks again for sharing your experiences and let me know how your going
best regards
Noel

 
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Old 11-21-2012, 06:44 AM   #4
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Re: lateral ankle stabilization and debridement

Hi Angelite, I really appreciate your response and yes I do agree with your comments about each OS and their advice. My surgeon was particularly anti - physio , he said they push you too hard and can undo his work. Therefore I dont actually start physio for 3 months.
Last night I removed the aircast splint and slept much better, the pain I experienced when I first put all my weight down has subsided and today I went for a small walk up and down the street.
In 2006 I had surgery to reconstruct my right ACL, medial ligaments and meniscus , I got back to playing sports but it was a long slow process.
This ankle stabilization seems longer and more inconvenient as I cant drive.
However like you said I think each day there is an improvement and the key is to take things easy.
I had the surgery done because my surgeon said that I had ruptured 2 of the 3 lateral ligaments and had early arthritis , this surgery he said should pospone the arthritis for a while I hope.
I was very active playing football , swimming & cycling , he told me no more football but that the other two sports are possible.
Thanks again for sharing your experiences and let me know how your going
best regards
Noel

Last edited by noelokane; 11-21-2012 at 06:45 AM.

 
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Old 11-21-2012, 04:28 PM   #5
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Re: lateral ankle stabilization and debridement

Hi Noel
I have put below what I had done just FYI (I had posted in the foot problems section under health - you will find lots of foot/ankle issues there).
Had (mostly in surgeon's terms):
Arthroscopy:
to remove osteochondral lesion of the central talar dome which included micro-fracturing, debrided with residual low grade cartilaginous pathology but cartilage all intact, minor synovitis, excision of significant lateral meniscoid lesion and decompression of the anterior ankle.

Then had open surgery on lateral side of ankle:
large posterior process of the talus clearly impinging - osteotomised, synovectomised the posterior ankle, preserved inferior extensor retinaculum and performed anterior inferior arthrotomy and performed Kaarlson modification of Brostrom Gould reconstruction.

Then had open surgery on the medial side of the ankle:
mild stenosis of tibialis posterior and tendon, tibialis posterior release (dissected well distal to the medial malleolus and more proximally).

Phew!!
Lots of stitching on both sides of the ankle!

Had first physio appt on Nov 2. Went to 1 crutch on Oct 31 and totally off crutches on Nov 7. Was still sore as hell and couldn't walk fast, too far or walk "heel to toe", but little improvements.

At 6 weeks post surgery and I had eversion and inversion exercises to do with a theraband (but have to be sensible - any sharp pain, stop). And next appt, first proprioception exercise - try and balance on foot without brace for 30 secs to 1 min - on hard floor - ha! not easy.

Was also given permission to get on stationary bike for 10mins, slow pace. Let's just say that my ankle got cranky on Tuesday night even though I iced and elevated afterwards for 2 hours. I might need to start back on anti-inflammatories as I stopped these on Monday. Will ask physio later today when I see him.

My physio has pretty much just been doing lots of massaging with my calf muscle, achilles and the foot (except for the reconstruction area). And checking ROM each time I go, which is twice per week at the moment.

Not good that you won't be able to participate in football - that's a shame. Is that even if you were to wear a brace?

Hope things improve for you and your recovery goes well - I think I would get really frustrated if I couldn't go to physio for 3 mths.
Cheers
Julie
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6 Oct '12: OCD talar, lat menis lesion, decomp ant ankle, osteotomy post proc talus, synovec post ankle, modified Brostrom-Gould, release PTT

Last edited by angelee43; 11-21-2012 at 04:31 PM. Reason: forgot something

 
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Old 11-22-2012, 09:08 AM   #6
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Re: lateral ankle stabilization and debridement

Hi Julie , thats some surgery you have endured!
Was this a sports injury?
My injuries were both football related.
My surgeon did tell me that he did a variation of the brostrum - gould technique but he was reluctant to give me the detail on the rest of the surgery even when I asked him whether I had any screws or plates inserted!
Ive been keeping busy with sit ups and press ups and last night when I took the splint off I did a lot of exercises moving the foot up and down.
However I once again was up about 4am with pain and had to hit the tramadol, codeine and paracetamol. Today Im not doing anything but rest , its so frustrating.
Im off work now into my 6th week , are you in the same boat?
Im dying to drive again but the danger is the emergency stop, I wouldnt be confident enough.
Thanks for advice on other posts
best regards
NOEL

 
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Old 11-22-2012, 09:10 AM   #7
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Re: lateral ankle stabilization and debridement

Hi Julie , thats some surgery you have endured!
Was this a sports injury?
My injuries were both football related.
My surgeon did tell me that he did a variation of the brostrum - gould technique but he was reluctant to give me the detail on the rest of the surgery even when I asked him whether I had any screws or plates inserted!
Ive been keeping busy with sit ups and press ups and last night when I took the splint off I did a lot of exercises moving the foot up and down.
However I once again was up about 4am with pain and had to hit the tramadol, codeine and paracetamol. Today Im not doing anything but rest , its so frustrating.
Im off work now into my 6th week , are you in the same boat?
Im dying to drive again but the danger is the emergency stop, I wouldnt be confident enough.
Thanks for advice on other posts
best regards
NOEL

 
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Old 11-22-2012, 06:52 PM   #8
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Re: lateral ankle stabilization and debridement

Hi Noel,
no, not a sporting injury - slid down a ramp on a damp morning, sudden stop at the end and twisted it 2 ways - and it just didn't heal. OS said about 10% of sprains don't. But it could have been an accumulation over the years and this just topped it off - again, he said I will never know for sure. Oh well! (I have been on a 'health mission' this year and have lost almost 50kgs since mid-March - hence the treadmill obsession - lol!!).
I actually went to gym on the treadmill for 30mins after I did it - hoping to 'walk it off'. When I couldn't actually stand on it 2 nights later, I knew I had problems - then 3.5 mths of test and physio before OS.
The modification of the Brostrom-Gould I had is the most common one. No plates or screws - if you google, there are plenty of resources and videos about it. Mine was the Karlsson modification which just means that as well as drilling a trough and holes in my fibula to attach the CFL and ATFL to, the extensor retinaculum is also brought up and secured there for extra strength and my OS also brought down a periosteum flap from the bone and secured this there as well. Some use suture anchors, but mine didn't. It's a very tight repair that usually holds well unless you majorly sprain your ankle again. (I think I spend too much time on the internet - lol!! - but I like to know everything that has gone on inside my ankle).
My surgeon actually gave me a printed copy of his notes when I got my plaster changed - so I know everything (including when I was laying on my back or my side).
I had 6 weeks off work and have just gone back this week - could have had 7, but 6 was long enough. I drove my car the day after getting my ankle brace - just around the block to see how I went, and the pain I felt was actually less for me than what it was prior to surgery - I was in a lot of pain when driving before.
So, it's all relative.!!
My physio gave me a new exercise last night but said to stop if I feel any pain around the incision areas - let's see
Hope you start to improve soon.
and you know what, we all heal differently.

Oh!! one thing my surgeon does not know and I am not telling him because he doesn't believe in complementary medicine, I chewed on Arnica tablets from the moment I got home to help with the shock to the body and the healing, and have also taken glucosamine with chondrotin and msm since I came home from hospital - not sure if that has helped with my recovery.

My physio did remind me last night that the healing and rehab is a slow process
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6 Oct '12: OCD talar, lat menis lesion, decomp ant ankle, osteotomy post proc talus, synovec post ankle, modified Brostrom-Gould, release PTT

 
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Old 11-23-2012, 01:10 PM   #9
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Re: lateral ankle stabilization and debridement

Hi Julie,
yes I had a ruptured CFL and ATFL. The surgeon says its a cumulation of 25 years of football and constantly rolling the ankle. The arthritis is part of that.
I managed last night without pain relief and made it up the stairs in my apartment. Did the hoovering and washing and drove back down to my parents although its not far and Im still not confident.
I cant believe I cant press ahead with the physio, but Im not going to dismiss my surgeons advice for the sake of a few weeks.
Ive been taking glucosamine with chondrotin since 2006 when I did my ACL, the jury is out on them, however I dont think they are doing me any harm.
The fact that Im still relying on people is the most annoying part of all of this and Christmas coming up I havent been out.
I would hate to have a drink and slip or something, would be a nightmare.
Ive heard of Arnica tablets I think my dad has some I must try them
thanks again Julie keep in touch
Noel

 
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Old 11-23-2012, 01:12 PM   #10
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Re: lateral ankle stabilization and debridement

Hi Julie,
yes I had a ruptured CFL and ATFL. The surgeon says its a cumulation of 25 years of football and constantly rolling the ankle. The arthritis is part of that.
I managed last night without pain relief and made it up the stairs in my apartment. Did the hoovering and washing and drove back down to my parents although its not far and Im still not confident.
I cant believe I cant press ahead with the physio, but Im not going to dismiss my surgeons advice for the sake of a few weeks.
Ive been taking glucosamine with chondrotin since 2006 when I did my ACL, the jury is out on them, however I dont think they are doing me any harm.
The fact that Im still relying on people is the most annoying part of all of this and Christmas coming up I havent been out.
I would hate to have a drink and slip or something, would be a nightmare.
Ive heard of Arnica tablets I think my dad has some I must try them
thanks again Julie keep in touch
Noel

 
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Old 11-25-2012, 04:36 AM   #11
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Re: lateral ankle stabilization and debridement

Hi Noel,
My ligaments were close to rupture
Well done on making it with no pain relief last night - and doing the hoovering an washing - that is awesome progress!
Must have been so difficult with the stairs for you - at least I only have 2 at the front door.
Definitely don't dismiss your surgeon's advice - he knows what works for him and his patients and he knows you.
I really feel your annoyance and frustration about relying on people - that was one of the most difficult things for me too.
I have to laugh - someone offered me a drink when I was on crutches and I had already had a couple of tumbles - one where I had slammed into the doorway giving myself a massive bruise on my arm - lol!! NO way was I going to have a drink!
The only other thing that I didn't cope with too well was having a lot of 'thinking time' - too much time in my head.
My surgeon also had me injecting myself with a blood thinner every night whilst I was in the back slab and cast - I do not miss that at all.
I last saw my surgeon 10days post surgery and now not until 3mth review on 3rd Jan.
Hope you have managed to have a better weekend.
Take care
Julie
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6 Oct '12: OCD talar, lat menis lesion, decomp ant ankle, osteotomy post proc talus, synovec post ankle, modified Brostrom-Gould, release PTT

 
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Old 11-26-2012, 01:45 PM   #12
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Re: lateral ankle stabilization and debridement

Hi Julie, I went down to watch the lads play football (Sat afternoon) and was on my feet for 3 hours , it was about 1 degree , anyway I had pain sat night and sunday and have just rested up today. Im just so afraid that Ive injured the ankle , its very sore to walk on which wasnt the case last week.
Im going to see how tomorrow goes before I contact my surgeon , im just hoping its only a minor setback.
Nothing is ever straight forward with ligaments. I was at 6 weeks on sunday
best regards
Noel

 
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Old 11-26-2012, 01:46 PM   #13
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Re: lateral ankle stabilization and debridement

Hi Julie, I went down to watch the lads play football (Sat afternoon) and was on my feet for 3 hours , it was about 1 degree , anyway I had pain sat night and sunday and have just rested up today. Im just so afraid that Ive injured the ankle , its very sore to walk on which wasnt the case last week.
Im going to see how tomorrow goes before I contact my surgeon , im just hoping its only a minor setback.
Nothing is ever straight forward with ligaments. I was at 6 weeks on sunday
best regards
Noel

 
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Old 11-27-2012, 06:55 PM   #14
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Re: lateral ankle stabilization and debridement

Hi,

I had the brostrom procedure and peroneal tenolysis 4 weeks ago. I cannot imagine putting weight on my foot yet!
I was in a cast for 2 weeks after surgery, then my surgeon said he usually puts people in a cast for another 2 or 3 weeks but because of the peroneal problems he put me in a boot for 4-6 more weeks so I am able to do slight dorsiflexion and plantarflexion movements but strictly keeping my boot on all the rest of the time! He said I could weight bear as tolerated at my 2 week appointment but it's now 4 weeks post op and I still can't at all.

I know it's still early but what worries me is that one of my friends had the same surgery 10 days after me, and she's in a cast but she can already put weight on her foot. Is it because she's in a cast so her foot's maybe more comfortable than mine in the boot? I am still having a lot of pain whereas she's fine and doesn't have much pain at all. My incision also still stings!

Another thing I'm worried about if that I can't curl my toes at all. I can pull them up but I can't curl them down, they just won't go. It's almost like when I had the nerve block and as hard as you try you cannot wiggle your toes! But I can pull them up just not curl them down! It's strange.. is this normal?!

Hope your recovery's going well!
Keep us updated!

Noelokane- I also tore my ACL in 2007! Strange huh!

 
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Old 11-27-2012, 07:09 PM   #15
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Re: lateral ankle stabilization and debridement

Hey Noel!
I'm not an expert but I am sure you haven't damaged your ankle - I think you have just made it very angry and it's telling you so (mine does that).
Wow! 3hrs in 1 degree - that's what I call support for the team! (we are having some warm weather here now - going to be 35 tomorrow - too hot - lol).
Yeah, I knew nothing about ligaments, cartilage etc until all of this. I keep asking my physio lots of questions about healing times for ligaments, fibrocartilage - and he said 'months'. I think I need more patience. I managed 20mins on the bike at gym today - not fast. Now, after my physio worked on scar tissue last night, my ankle is firing off lots of nerve pain in different parts all day long.
Did you ice your ankle when you got home? I find I have to ice it after physio and when I get home from work etc.........hope it's not as bad today.
Julie
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6 Oct '12: OCD talar, lat menis lesion, decomp ant ankle, osteotomy post proc talus, synovec post ankle, modified Brostrom-Gould, release PTT

 
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