What You Need To Know: Ankle Reconstruction Surgery
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Ankle Surgery
This will detail my experience with ankle reconstruction surgery.
Apparently sometime over the last year I injured my left ankle and didn't realize it. Towards the spring of 2009 I started noticing pain posterior to the malleolus (hard bumpy bone on the outside of the ankle). Soon after I began to notice swelling along with the pain. Being a new mom of an infant with health problems, I pushed the pain aside and went on with life. In July my husband, daughter, inlaws and I went on vacation to Savannah, Georgia. We walked all over the city looking at the sites. When we returned to the hotel, my ankle was swollen to twice its usual size and i could hardly walk due to stiffness and intense pain. Let me take this time to tell you that I am a horrible, horrible patient. I am a nurse, I despise going to the doctor and try to put stuff off as long as possible. That being said, I just took a few NSAIDS and iced it down for awhile.
When we returned home from our trip I knew I couldn't put off seeing the doctor any longer. I could hardly walk at times and at others I was fighting tears due to pain. I made an appointment with an orthopedic specialist to see what was going on. He did range of motion and flexibility tests and everything seemed fine, just some pain with movement. He then ordered xrays of my left foot and ankle. The xrays came back clean. So, he ordered physical therapy to determine if the problem was muscular and could be fixed with strengthening and conditioning.
The physical therapist performed the same range of motion and flexibility exercises on my ankle and could only comment on how flexible my ankle was. I told him I had been a cheerleader for 15 years and had ridden horses more than a few times (always pointing my toes for cheerleading and HEELS DOWN! for riding). He decided that would explain it and continued on with the exam. As he moved up my leg towards my calf he told me I was "lumpy." I asked what that meant and was told it usually meant a high sprain, though they're really painful and almost never go unnoticed. I continued to see the physical therapist for a couple of months while the pain and swelling continued. The doctor agreed that no progress was being made and ordered an MRI of the left foot and ankle.
Two weeks later I returned to the doctor to learn the results. I had, indeed, sprained my ankle numerous times and due to the extent of damage surgical repair was the only option. I saw the doctor on Wednesday and was scheduled for surgery the following Monday.
I was to arrive at the surgical hospital early Monday morning. Upon arrival I was registered as a patient and shown to my room. I was weighed, had my blood pressure taken, temperature taken, pulse monitored and an overall head to toe exam. I was then taken to pre-op where an IV was started with Lactated Ringers Solution, an oxygen cannula was placed in my nose, a pulse oximetry probe was placed and I was gowned and capped. The doctor came in and signed my left leg and had me sign as well to reduce the chance for wrong-site surgery. He went over the procedure with me again and asked if I had any questions. The anesthesiologist came in and described the type of anesthesia I would be under and gave me the option for a nerve block. I opted for the nerve block, which is very similar to the epidural women get when having babies. Soon after both doctors had seen me a low dose of anesthesia was started through the IV and I was carted back to the operating room.
I woke up a couple of hours later in post-op recovery groggy and with a giant toe to knee dressing. I couldn't feel my leg and I was painted orange with betadine to my thigh. Once my vitals were stable I was moved to the second recovery area where my family could come back to see me. The doctor came in and spoke with everyone about the surgery. He had to reconstruct my ankle as the ligaments had been severed and arthritis and scar tissue had begun to impede the joint. He scraped and cleaned the joint, removing the arthritis and scar tissue and then had to reconnect the ligaments.
A little while later, after being able to eat and drink a bit and use the bathroom, I was discharged home. I still couldn't feel my leg, which ended up being a blessing, because the swelling was incredible. After two days the numbness turned to tingling and finally intense pain. I was given Vicodin for pain and Vistaril for nausea, which I ended up taking around the clock; something very uncharacteristic of me as I try hard not to use pain medication. I had the toe-knee dressing for 10 days after which the staples were removed and I was given a toe-knee fiberglass cast. I was non-weight bearing for 4.5 weeks. At the end of the 4.5 weeks, the cast was removed to expose a non-healing incision. The incision wasn't infected, but it was not healing. Steri-strips had been left on it and some tissue had begun to grow over them, but the tissue was not healthy tissue. My incision had to be scrubbed out until it bled twice a day for two weeks. I had to do this myself because it made my husband sick :) I was also given a walking boot that went to my knee for another 4 weeks.
It was great to be able to bear weight again, but took a few days to learn how to do it with out the aid of a walker or crutches. I also had extremely sensitive nerves in the foot and leg after being away from touch for almost 3 months. Water hitting it from the shower was incredibly painful and I refused to let anyone but myself touch it. During this time I also had a lot of pain and stiffness in my toes and ankle. If I moved my ankle too far in either direction it felt like beef jerkey tearing (and I imagined that's what it looked like too). The pain during this time was pretty bad and I had to continue taking pain medication.
At the end of 4 weeks with the boot, the doctor ordered physical therapy to begin strengthening and conditioning on my ankle. Therapy started out slow with soft tissue massage and working to reduce the nerve sensitivity. Therapy progressed to range of motion exercises and strengthening exercises. I am still going to physical therapy today (it's January and I had surgery in the beginning of September) and am only now noticing a difference. I continued to swell and have moderate pain up until just a week or so ago. I am now able to lift weights again and have resumed cheerleading practice. I still have pain every once in awhile, especially if I have stressed the joint too much. The days it hurts the most is the days spent pounding the halls for 8-9 hours at the hospital.
Although this has been quite an ordeal, especially with having a baby to chase after and being in school full-time I'm glad I had the surgery. Even though it has taken a few months to recover, I can notice a difference in the mobility of my ankle. I no longer have to worry about swelling out of my shoes or not being able to walk. I do have to be careful, though, as re-injury is possible. I wear a stabilizing brace for working out, practice and working.
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Thanks, Putz! I'm tryin, I definitely don't want to do this again!
I am just learning that I need to have a surgery kind of similar to yours. I am kind of scared of how I will learn to walk again after the surgery. I have injured my ankle multiple times (3-4) a year and I knew that surgery would be inevitable and I know it will be painful from hearing what you and a friend of mine went through. I think it is amazing that you are able to start your cheerleading again. I'm in the marching band and I can't wait until I can do the parades and competitions again without crying half way through. I hope you make a good recovery and just be careful of uneven roads...they are torture!!
Hi Tori! Good luck with your surgery, it's really not *that* bad. Just be sure not to push yourself too hard too soon! Thanks for commenting!
I had almost the same ordeal except a little different. I had repeatively injured my ankle for 2 years and didn't do much about it except for the normal x-ray to make sure they were all breaks!! Then I had a different type of surgeyr then decribed above!! After that surgery I was on the mend to being healed when I injured my ankle twice more. I was very dis couraged and decided to see a diff. doctor...after two more x-rays the doc came to the conclusion that my ligament is shot it has no use so now I have to get Ligament Reconstructive Surgery also known as Brostrom Ligament Repair. These past 3 years have been an incredible journey especially since I am only 13 years old and love the sport of gymnastics... after the surgery I won't every be able to do the sport I love Gymnastics but I will find other hobbies and interests!!!
Hi Christy, what an ordeal! I think gymnastics is probably how all of my trouble started-I was in gymnastics before I started cheering. You have have such a positive outlook...I wish you all the best!
i know how you feel i was in a motorcycle wreck and my ankle was crushed after it was ran over i spent a week in the hospital not allowed to eat or drink because they never knew when i would be ready for surgery after i week i called my wife had her come get me i left the hospital after 2 months of waiting with a broken ankle just hangen round i finally got a call for a cheek up they then said ill be ready for surgery....in a month so i had spent one more month with a broken ankle then i had my surgery and i still cant walk for 3 more months so i spent 6 months not being able to walk or even stand up they wanted me to go longer without walking but i had all i could take and i started with little baby steps and just standing for as long as i could and this how time the only pill they would prescribe me is percocet 5mg so idk but i wish i had went to your hospital
What an ordeal, Glenn! I hope you continue to improve! Almost 18 months post op for me and I still have some problems-I don't think my ankle will ever be as strong as it was, but it's better than it was before surgery. Thanks for coming by and sharing your story!
Wow, it's been great to read about others experiences.
I had a simple fall 10 months ago where I sustained bilateral ankle injuries. No fractures, just ligament damage. After lots of physio the left ankle healed and right improved a lot but I continued to have pain when walking up and down stairs and any distance. The ortho surgeon said had an impingement in the joint (tissue in joint) which could be fixed with an arthoscopy. This was done at six months post injury. Seemed to help a little, but continued to have problems.
My ankle started to give way more constantly shortly after surgery. Stress xrays showed an unstable ankle. I was booked in to have a plate and two screws put into the tib and fib and to have the ligaments on the outer side of ankle all tightened. I had a long wait for the surgery and had to stop work as was too painful and giving way all the time.
I have just had the surgery. Surgeon said it was worse than they thought and definately needed to be fixed. I spent nearly 4 days in hospital. Now have to be non weight bearing on the right leg for three months. It hasn't been long since surgery and I am finding it very overwhelming. I don't like wishing time away, but at this stage I am.
Hello Peddles, I wish you a quick recovery! I didn't have to have hardware put in, but I'm beginning to wonder if my problems are not completely fixed. I'm having pain and stiffness and every once in awhile is gives way as well. It's amazing how a simple fall can cause so much damage! As time goes on it gets easier to function with just one leg, but definitely frustrating. Good luck!
I had a surgery similar by the sounds of it to yours in feb 2010 and have just had to go back for another MRI because of intense pain and swelling after rolling it again. its so frustrating having so much surgical intervention and still dealing with the pain.
Kimberley, I agree, it is so frustrating! I actually fell last week on an uneven sidewalk because my ankle gave out on me. Luckily, my ankle seems to be ok, but my knee on the same side is another story. Never ending! Best of luck to you :)
In June 2009, while playing soccer I snapped 3 ligaments in my ankle, that is what I found out nearly 4 months after the fact when ER doctors just called it a sprain. Now its April 2011 i am finally due to have my ankle reconstructed, which I cant be happier for. one dilemma is that my wife will be due to have our 3rd baby while I will still be in a cast.should be interesting
Holy moly Mick, your family will be in my prayers! The recovery sucks, but it's worth it. I have problems with my ankle still, but I think alot of my issues can be attributed to arthritis...it's awesome to hear your doc talk about how much arthritis he cleaned out of your ankle when you're the ripe old age of 23! Good luck to ya!
Just thought that I would do an update. All has been well. I've had sutures out and plaster change at two weeks. It is now 3 1/2 weeks post op and I find myself back in hospital as I have a DVT. A clot in my leg . .. . Hopefully only in for a few days . . . . Definately a complication that I was hoping not to get
Thanks for updating, Peddles! DVTs are a pain, but definitely not something to mess with. I hope they get it dissolved and under control soon so you can get back to recovering :)
I am recovering from my second ankle surgery. I had a split tear of the peroneal brevis. Easy enough-long recovery though. non-weight bearing for 8 weeks. P/t helped a lot, but about 6 months after surgery I stepped in a small divot in a parking lot, had a small bobble with my ankle (didn't turn it) about an hour later I could hardly walk. Then, my ankle locked up and I KNEW I had done some damage. Went to the orthopaedic. Not much they could do for me. I was sent to another in their practice-whom I will never go back to after the MRI showed damage to all the ligaments in my ankle and on my peroneal brevis. He said the MRI was inconclusive and my ankle appeared stable. He told me that he could do surgery if I wanted, but it would be made worse by that. I found a new guy. He did brostrum-harper lateral ligament reconstruction, peroneal brevis repair with tenosynovectomy , peroneal longus to brevis tendon transfer subluxation repair-as well as worked on the sural nerve and removed a piece of bone in my ankle. This was March 28th 2011. I just started P/T. My pain was fairly moderate for the first 3 weeks, but now i'm back to that familiar ache-mostly due to swelling. My foot and ankle are HUGE! I do know your pain to a degree! I'm hoping that I will be back to doing normal physical activity soon. I've got a vacation with beach time planned next month! That's my goal. Maybe I'm too optimistic, but I am going! Good luck and take care!
Wow Kristina, in a word, that sucks. I hope the PT brings some relief! And I hope you get to go to the beach and enjoy yourself! Thanks for coming by :)
We'd all be so much luckier to have broken a bone! Bones heal so much better and easier than this soft tissue damage garbage! It takes longer to get the dx necessary for fixing it. Mine took 9 years for the first dx of a torn tendon. I dealt with the pain and instability for a long time-probably doing more damage each time it gave out on me or locked up! I'm a large woman, and caught in the catch 22 of severely arthritic knees and a bad ankle-it's hard to lose weight with no exercise, but exercise is painful! I'm hoping to deal with the knee pain and get moving again once my ankle is healed! I'm really looking forward to that. Thankfully, I'm not dealing with a lot of pain in the recovery! My ankle will be stiff because of all the repairs! As long as it's stable, and doesn't hurt.....I don't care about a little stiffness! :-) Good luck to all going through this. patience is what i'm learning from all of this!
I hope your healing fast. I recently just injured my knee and was on crutches for quite some time, its amazing how much you start to value the privilege of walking when you just cant walk for a temporary amount of time.
Hello Entourage, thanks for coming by. I hope your knee is doing well! You truly do begin to realize how much you take for granted on a daily basis!
I feel your pain. Glad to hear you are healing well.
I had the same surgery back in '98. They stitched me inside, stapled outside. I had an allergic reaction to the stitches, eventually causing an infection in my ankle. I was almost 4 months non weight bearing. By the time I finally started p/t I literally had to learn to walk all over again. Its been pretty good through the years, nothing more than the joys of arthritis, aching, stiffness.. ect..
3 weeks ago I fell walking my dog, and sprained it again. X-rays at the ER said nothing was broken, gave me some crutches and an air splint and sent me home. After a week of bruising, swelling, severe pain and still not being able to bear weight, I went back to the ER. This time they put me in a plaster splint (this thing weighs a TON) Judging by the swelling, bruising and pain, they think I may have damaged my Achilles tendon as well, as I have a sharp pain the shoots from the back of my foot and up the back of my leg, as well as the pain down the side of my foot. I go to see the orthopedic doctor on Wednesday. Im just praying its not going to turn into another surgery..
I have had multiple surgeries on my ankles
I have "cadaver" (hope I spelled it right) ligaments in one ankle and have for about fifteen yrs now - no problems with that ankle other than it lockl up often and will soon be cleaned out and tightened as the surgeon has said
I obviously have wrecked ankles from all kinds off injuries from cars running over them(accidentally) to severe breaks
my curiousity is since i have chronic ankle instability no matter how much I work them out should I ask about joint replacement or would that only solve the joint problems and not the ligament/tendon problems
Anyways for all those out there suffering ankle problems don't be scared if surgery is indicated
I have had many and still work ten hours a day as a construction electrician all over the world in war zones with a brace on both and do ok not great but ok
the surgery and rehab is the easy part
the part where you know you've done it again and try and wait out the pain until i have the time for recovery is the hard part
Hi Jason,
Sounds like quite a history of ankle problems! I'm not sure I can adequately answer your joint replacement question. It seems as if that may help some aspects of the problem, like locking up, but I feel like the tendon and ligament issues would be the main part of the instability problem. Definitely something to ask your ortho doctor about! I still have problems with rolling my ankle and some days it locks or gives out too. There's been more than once I've been walking down the hallway at work and have had to catch myself on the railing to keep from falling! My saving grace has been finding an awesome pair of tennis shoes to get me through my 13 hour shifts at the hospital!
Thanks for commenting :)
Am set to have ligament reconstruction on February 29th. Possible creation of a tendon, with possibilitiy of biocork anchor screws....so nervous. The orthopaedic surgeon didn't explain what would happen, but I have sural nerve problems, medial talar dome problems, and other problems that haven't quite been explained to me. All I know is the doctor said the ankle is "extremely loose." I am hoping that the surgery is not too painful and for a good outcome. I find your story and the following comments inspiring and mind-easing. Thanks so much!
I'm six weeks out of my 3rd ankle surgery in 8 months, 3 different surgeons 2 different hospitals. My advice is to ask lots of ? And get a pt that you like and trust.
I cannot thank you all enough for sharing your stories. I am scheduled for Lateral Ligament Reconstruction and Peroneal Tendon Transfer in my left ankle on March 29th. It has been a really long journey to reach this point beginning with not even knowing where my injury came from or where it happened in September 2009. Originally told it was a sprain, I iced it, elevated it and kept on doing what I was used to (gym 6-7 times a week and with a trainer 1-2 times a week) until I couldn't do it anymore. Everything just started to fall apart so much that I couldn't walk. I'm a teacher so that was difficult.
I went to the chiropractor, went repeatedly back to my MD who requested the first x-ray at the beginning of 2010. I've had x-rays, ultrasounds, MRIs, PT, and wore a night brace. I waited 9 months to see my surgeon who confirmed that I would need surgery to search for loose bone, attach the ligament to the bone with 2 screws, and suture the tendon together.
My fears have been many in that I basically crashed into a wall and stopped all activity. I've gained a lot of weight and know that if it was my right ankle I could not drive a vehicle. My foot, leg, and thigh continue to feel frozen and go numb.
I am getting married in mid-August and am very concerned about how it will go. I attempted post-poning the surgery last week as I've been doing acupuncture with a phenomenal doctor for 6 weeks and have been seeing some positive results. The wait if I postpone is 2 years. I cannot live with this for over 4.5 years.
Thank you again for all your stories... I wish everyone Godspeed with their personal struggles and recoveries.
I had the same surgery on March 9, 2012 after years of increasing pain and swelling due to repeated injuries. Ankle roll-overs obviously became more frequent due to weakness. I waited almost a year to have the surgery performed. (I waited for cool weather and to complete some work obligations because I knew it would be a long recovery)I got myself mentally prepared for the ordeal of forced rest and inactivity. And adjustment of your eating habits is essential if you are prone to weight gain. I am 48 years old and also have neck and back fusions that complicate locomotion. Crutches are important and must be used correctly or you can cause a whole new set of problems! Remember good posture; chin up! My doctor stressed this: Immediately after surgery and for at least 2-3 weeks REST and ELEVATE! Swelling is the enemy. Swelling begets more swelling, so you must take it very easy initially and be patient! This will help you get good results later in healing and recovery. My surgeon used steri-strips on the skin rather than sutures or staples and that seems to reduce incision line reaction. My fiberglass cast comes off in 1 week (yippee!!)and I get my long walking boot until he gives me the "ok". I am feeling pretty good and very encouraged but must CONSTANTLY remind myself to "take it easy". I own a farm and have horses and the temptation to overdue is powerful, so this confinement is nearly driving me mad!!! I don't want to do this again... So remember-Early rest and elevation of the foot is most important after ankle reconstruction.
Hi
My step dad had an orif of bi malleolar fracture almost 4 weeks ago....should he really still require oral opitaes for pain management? Just wondering. Thanks so much.
Joanne, glad you're coming along well after your surgery! Wishing you a speedy recovery :-)
Conknee, it is certainly possible! I took them-though not around the clock-even after I was in the walking boot. If they are taken as prescribed, recovery will be more tolerable, less painful and therefore faster. It is important not to let the pain get ahead of you. That doesn't mean you'll always be pain free, but it needs to be maintained at a tolerable level. We tell patients (I'm a trauma RN) that everyone experiences pain differently and that it is easier to control pain if it is not allowed to get unbearable. What is a tolerable level for me may not be for you. So while it seems that 4 weeks post-op is a long time to still be taking pain meds, it may not be at all. If they are being taken as prescribed there shouldn't be much to worry about. Bone pain can be excruciating! Just be sure he is continuing to elevate and take it easy along with taking pain meds as prescribed.
I am considering this surgery, but my pain right now is nothing compared to your pre-surgery description. I walk and my ankle will roll once every few weeks. I have just finished PT and it seems a little better and I can wear a low heel. I am going to wait, but worried that the arthritis will be far worse and complicate recovery.
It's may 11th 2012 and I had my surgery 4 weeks ago . I've got 1 more week of a cast and it seems as if we had the same surgery, my scar looks identical to yours and I'm nervous about the rehab.. Thanks for the story..
Putz Ballard 2 years ago
Bless your heart girl,this had to be painful. So glad your on the mend and take care of that ankle.