With proper rehabilitation, the patient can restore their full function within the involved leg albeit it will take the better part of 1 year or longer. I was not prepared. Like many people in this thread I got less than 4 hrs sleep a day for a month. Surgery is needed to set the bones after a bi or trimalleolar fracture occurs. The mechanism of the injury & degree of swelling will directly relate to the amount of pain we have and the instance of long term post injury pain. Kneeling scooter was a life saver after the first week and I could tolerate moving the booted leg. Schepers T, Van Lieshout EM, De Vries MR, Van der Elst M. Increased rates of wound complications with locking plates in distal fibular fractures. Furthermore, emergency indications for an operative treatment are: Despite the emergency operative treatment, there is a controversy about the optimal timing of surgery of closed trimalleolar ankle fractures. This helps a lot. Direct reduction of the posterior malleolus can be achieved via a posteromedial or posterolateral approach. When I am able to beat some weight, I will be ordered outpatient physical therapy to ease the joints ligaments tendons and muscles back in business. Very supportive woman and was up walking and driving! A trimalleolar fracture can have long-term impact on your quality of life. I had right trimalleolar surgery May 11, 2016, 14 months ago. Im glad I found this site as it gives me an idea of the tough uphill battle ahead of me to get back to some semblance of normalcy. Trimalleolar fracture with a dislocation here! Good luck to all of you on your recovery. Just took first shower. My job is physical therapy in a nursing home . Stretching and working the mussels is something that Im still doing daily. I fell badly in August 2016 and sustained a trimalleolar fracture at age 58. Thursday i was able to check out of the hospital with 6 screws, one plate and a big ole boot. It did takes several years to be completely pain free. If a malleoli is fractured, you'll be diagnosed with a trimalleolar fracture. This time off has been a blessing to have the luxury of time to devote to writing. Not very painful at all. i empathise with the sleepness nights and feeling helpless. By the way, my kids loved their Netflix binging mom for the first few months when I was NWB. At 10 weeks, I was given the go-ahead to start progressing in weight bearing. We are experimenting with display styles that make it easier to read articles in PMC. Regular radiographs were conducted to monitor joint congruency.53 Nineteen percent of patients needed conversion to internal fixation due to a loss of fracture reduction, and the non-operative group had a six times higher probability of a radiologic malunion.53 Unfortunately, the type of malleolar fracture was only described as relevant to the syndesmosis and not classified according to one of the common classification systems. Unstable fractures are . Carter TH, Mackenzie SP, Bell KR, et al.. Optimizing long-term outcomes and avoiding failure with the fibula intramedullary nail. A talar shift of 1 mm results in a 42 percent . I stopped narcotics in the day by wk 2, completely by wk 4. I try not to take those pain meds like Advil, Tylenol, etc. On January 16th I had surgery and 12 screws and a plate. Arthroscopically detected intra-articular lesions associated with acute ankle fractures, https://creativecommons.org/licenses/by-nc/4.0/. My orthopedist thinks I can start weight bearing at 5-6 weeks. Ankle was shaking violently out of cast but now OK. For choosing the optimal surgical treatment and implants, there are some important factors to be considered: Trimalleolar ankle fractures with severe soft tissue injury or open fractures pose a particular challenge. Medial malleolar fractures can be classified according to Herscovici et al, who differentiate between four types (AD) of fractures based on the anteroposterior radiograph.43 It is the current standard system regarding the medial malleolus, but inadequate for multimalleolar fractures.44 Indication for operative treatment of medial malleolus fractures rather depends on the degree of displacement and whether it is part of an unstable ankle fracture.44. How Long Does Cocaine Stay in Your System? A retrospective study of 19 patients with non-operatively treated displaced bimalleolar and trimalleolar fractures reported an excellent functional outcome after 20 years.56 However, it is not feasible to draw reliable conclusions for the treatment of trimalleolar fractures, because only four patients with a trimalleolar fracture were available for final clinical and radiological evaluation. At 22 years old on the street is no way to be with this injury. Providing further information about the stability of the injury, the Lauge-Hansen classification had become a widely used classification system for ankle injuries.32 According to the Lauge-Hansen classification, a trimalleolar fracture of the ankle can either be classified as SE IV or PE IV. The boot is very painful cause it puts pressure right where my ankle hurts. Permission to place weight in boot after 10 weeks and try and walk after 3 months. Considering the bone mineral density of the tibia, the articular site shows a higher density in comparison to the metaphysis.46 Besides the connection between tibia and talus, there exists a close interaction between tibia and fibula. Jodie, you poor buggar. -albeit some at a slower pace. My biggest lesson from all of this has been to say yes when any help is offered. Like many others, I ended up with 2 plates, 12 screws and 4 pins and no weight bearing for maybe 9-10 weeks. ; Ankle Injury Management (AIM) Trial Collaborators. Elderly patients with osteoporotic trimalleolar ankle fractures and concomitant conditions pose a particular challenge and further evidence is needed regarding the optimal surgical treatment. A trimalleolar ankle fracture is considered unstable and treatment is generally performed operatively. The less impatient we are now will directly relate to the degree of long-term disability/arthritis we will end up with. Lamontagne J, Blachut PA, Broekhuyse HM, OBrien PJ, Meek RN. Bartonek J, Rammelt S, Tuek M, Naka O. Posterior malleolar fractures of the ankle. I work in a factory standing all day with heavy lifting. 1B).13, In the frontal plane, the trochlea of the talus shows a lateral slope of about nine degrees.12 The surface of the talus forms an arched deepening from ventral to dorsal direction, ensuring a rotational stability in dorsoplantar movements.3,12, The ligamentous apparatus of the TC joint can be differentiated into the lateral (LCL), the medial (MCL) and the tibiofibular ligament complex. That doesnt help you at all but at least you will know that is normal. However, a peroneal nerve stretch injury is fairly common with this injury causing numbness and pain. Anna, do not weight-bear before your doctor says it is ok. Doing physio is really important but not easy, especially if you are having pain or your ankle feels like its in a vice or against a sharp blade. Hi. After sustaining a trimalleolar fracture, yourdoctor will refer you to physical therapy. I didnt realise how good it would be to stand up-right and walk around unaided, to be able to stand up in the shower and not have your leg poking out the shower door, However the best feeling came from the first day I could get back in the car and finally have some independence . Maybe this has helped. If so, scar tissue massage training will be provided. I had my meeting last week two weeks post surgery and he said it was healing perfectly and that once i am full weight bearing he gives me two weeks to be back to normal. I am glad I found this information as my doctor did not prepare me for what to expect. Surgical treatment of a displaced lateral malleolus fracture: the antiglide technique versus lateral plate fixation, Peroneal tendon lesions caused by antiglide plates used for fixation of lateral malleolar fractures: the effect of plate and screw position, Incidence of peroneal tendinopathy after application of a posterior antiglide plate for repair of supination external rotation lateral malleolar fractures, Trimalleolar fractures with impaction of the posteromedial tibial plafond: implications for talar stability. It involves re-positioning the bones to their normal anatomical alignment and holding them in place with screws and plates. Its been a journey. Malek IA, Machani B, Mevcha AM, Hyder NH. He said he expects me to walk in with a cane at my next visitI was in a wheel chair at the time. I very occasionally take ibuprofen for the pain, I usually just elevate and ice it in the evenings. The most comprehensive classification system is the AO/OTA classification. Reading this, while informative, didnt help. Im almost 100% dependent on my hubby who takes care of me, our baby, himself, his job, and our home I feel like such a burden. This review considers current scientific findings regarding all three malleoli to understand the complexity of trimalleolar ankle injuries and provide the reader with an overview of treatment strategies and research, as well as future perspectives. Upon once the bone is opened the area of the fracture will be placed with screws, pins or any fixation device to make sure that the bones re properly aligned and back to its normal positions. I had a lot of very localized nerve pain on the inside of the foot at the arch (no break there) after a few weeks. Court-Brown CM, Biant LC, Clement ND, Bugler KE, Duckworth AD, McQueen MM. Better than 3 weeks ago in bed! The role of the physical therapist includes helping the person regain proper gait, strength, and range of motion through trimalleolar fracture physical therapy exercises. Altogether I went through seven different casts pre-op and two post-op. Hey, at least Ill be, H E Double Hockey Sticks, on wheels with my knee scooter and its bell! I can walk with one crutch for a short period of time. It is almost a month since that visit and I am using a walker and am nowhere near putting my full weight on that leg. Lol, that is the main reason why I am following doctors orders. Doctor told me my foot had sheared off my leg backwards and sideways. but its tough not to want to put myself on my own recovery program when there is literature like this out there. Like bimalleolar fractures, these injuries are often unstable, and a dislocation can occur. After reading the comments I am concerned that he may want me to be partial weight bearing too soon. I am advised that the swelling may last several months. we are almost the same time, i broke my ankle on March 7, i try to massage that muscle it seems to help and also i just stretch it out. This has been really difficult to deal with, as I hate just sitting around and I dont like relying on others to do for me. This condition is considered as a unstable stage which can also lead to ligamentous injury if this parts are not properly addressed. I think i feel more depressed now though knowing it might be even longer before things return to normalcy. Required fields are marked *. This cast is so uncomfortable though. Inversion injuries occur more often. Bone Grafting this procedure involves scaffolding a new bone to grow another bone. Via an arthroscopy they also trimmed the scar tissue from the cartilage that joins the tibia & fibula resulting in a good improvement in range of movement. its been 12 weeks since my surgery. In boot. My hips and back were being put out due to the height of the air cast. My best wishes to everyone in this situation try to stay positive you will feel better but it takes a very long time. I had the typical swelling & pain and after 15 months, I still limp at times when first getting up from sitting very long and have some swelling and pain at the end of most days. Antibiotics since the patient is at risk for sepsis or infection there is a need to take antibiotics to prevent it. I will cont8nue this as I get walking more and re-awaken all those muscles in your calf that regulate the blood flow up and down and get them back to where they need to be..I anticipate those painful toe raises in the future.anyone have tips? The physical therapist will also evaluate and treat swelling and pain at the injury site and the surrounding area. The AO/OTA classification lacks a description of the fracture configuration of the medial and posterior malleolus. Today it was removed yay, and all looks technically pretty good.. lots of therapy presctibed and a walking boot for another month but so happy to be able to sit and sleep without it. So glad to find all this info.first website that came up when I googled.healing from trimalleolar fracture..I also dislocated my ankle on May 29th. Despite your allergies there are pain killers you can take. I still have pain, but I deal with it and I also walk all day but I can now run at top speed. My surgery was on 6/30/17. Like youre not better yet? Or when I broke my foot it was all better by 6 weeks, you must have a low tolerance to pain, or youre still not back doing everything yet? Then others offer pity which I hate just as much. Anyone else have numbness? While a trimalleolar fracture will drastically impact your life for months and may require physical therapy for up to a year, the injured ankle and leg will recover but only with compliance of the prescribed physical therapy program. Pt was restrained driver. Ankle fractures, known more commonly as a "broken ankle", happens when there is a break in one or more of the bones that make up the ankle joint. thanks for the info i am 2 weeks post surgery and i understand about the splints they suck and hurt seems to rub all the time He said it should prevent me from having more problems & pain in the future. ROM good but still limp if sore. Fortunately, this injury will usually clear spontaneously. Pain is severe by 5 p.m. each day. 5 months in it is still swollen and hurts now more than ever , but on the upside I can walk which I did not see happening as quickly (if 5 mths is quick) . Email: This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC BY-NC 4.0) licence (, ankle joint, fibula, fracture fixation, tibia, trimalleolar ankle fractures, (A) Ankle anteroposterior (AP) mortise view of a healthy young male showing the configuration between distal tibia, distal fibula and talus. My P Therapist suggested along with my regular exercises to try a hot/cold water treatment. Pathoanatomy and associated injuries of posterior malleolus fracture of the ankle. I am a healthy and active walker/hiker, 66 yo who slid down two steps at the end of January 2018. i get stitches out in two day and get my removable boot hope it will be better good luck with your recovery. I go to gym 3 times a week and also do my physio at gym. You have to take pain meds and medical cannabis to alleviate the pain and to help put you in a good mood. A pilon fracture typically occurs as the result of a high-energy event, such as a car collision or . I am 8 months on after a bi-malleolar fracture.Its a very long process.I was part weight bearing 6 weeks after surgery.I taught this isnt too bad.Was walking with limp after 12 weeks,and then i hit a wall.Progress has been extreamly slow.Im still walking with a limp in the morning until it warms up.Still have really bad ROM and pain when doing physio.Every day seems like starting all over again regarding the stiffness.I think people need to be realistic about the time needed to recover from these bad injuries.My friend is 3 years on from the same fracture and at 90% ROM.I hope i get to 90% as i am at 50-60% at the moment.It will get better but it takes a lot longer than a year.I was told 6 months by my doc and physio,which was very misleading. Can walk faster, but not jog. There are two very noticeable malleoli and a third that is not recognizable without the use of an x-ray. The video below explains how to massage a scar tissue. Fracture-dislocation of the tibiotalar joint, with anterolateral dislocation of the tibia relative to the talar dome. 1C). I still have a lot of pain and burning in the inner ankle and across the top of the ankle. ( I already do some minimal wb for balance with no pain ). Required fields are marked *. Oh so heartening to not feel so alone in this process . In the case of these fractures the pun three steps forward and two steps back really does apply. Operative treatment aims to re-establish posterior stability while restoring the size and articular surface of the tibial pilon, the stabilizing function of the posterior tibiofibular ligament and the integrity of the fibular notch.121 The quality of reduction and joint congruity are significant factors influencing prognosis.122 To achieve these goals, there are different operative strategies depending on the fragment configuration and concomitant injuries. I seriously fell into the self-pity pit off and on every four or five days, based on the fear of losing full function. Lateral Malleolus Fracture the bone are reduced into their normal alignment. Flew to Vegas for a well deserved R/R! This can be performed through the syndesmosis squeeze test. Advertisement. Due to the extended period of NWB status, patients typical lose a lot strength and experience decreased ROM. Due to that fact and the exclusion criteria of the study, the results should be interpreted with caution and cannot simply be transferred to the management of trimalleolar ankle fractures. occupational therapy helped me adjust to my new condition and helped me make adjustments to my daily routine so I could depend less on others. Outcomes following posterior and posterolateral plating of distal fibula fractures. For the most part I try and just ignore the pain and maintain a normal daily life. Severe swelling makes the surgery more difficult to perform. im not going to rush it i want to completly heal.long slow process. Your email address will not be published. DOI: 10.1302/2058-5241.6.200138, The human ankle joint complex can be divided in a talocrural, a talocalcaneonavicular and a subtalar part.1 The talocrural (TC) joint is formed by three bones and a complex ligamentous apparatus. Cant wait until this is all behind me. With a minimally invasive approach, the articular surface can be inspected via a mini-arthrotomy, fracture reduction visualized and fixation performed through percutaneous screw fixation.147 Advantages are the reduced soft tissue stripping, but especially purely percutaneous screw fixation can compromise bone union due to interposing periosteal flaps.148 The choice of implant depends on fracture configuration, bone quality and soft tissue injury. I have a tri fracture that happened 5.6.17. I was put in the external fixator aug 19. Cast was removed before I went home on Aug 24. I had a trimalleolar fracture on March 1 with surgery on March 2. More cases of osteoarthritis are found in trimalleolar . This page has really helped. Additional qualifications can be added to specify the stability of the syndesmosis or concomitant injuries (e.g. Miller MA, McDonald TC, Graves ML, et al.. They removed it 8 days postop and put me in a boot with no,wt bearing for at least 12 weeks. In their critical review, Rammelt and Bartonek analysed the importance of the posterior malleolus with conclusive data supporting the direct open reduction and fixation of posterior malleolar fragments.57 Vacas-Snchez et al proposed a CT-based algorithm for fixation of the posterior malleolus and Wang et al showed good functional outcomes following operative treatment of the posterior malleolus.58,59. In this case report, we present a 52-year-old female patient who met with a road accident 15 months before presentation. Just because we all have Tri-mal #s will not mean we will have exactly the same Recovery story. I was apprehensive of this additional surgery but Fab has put my mind at ease. It spans from the period of a few hours up to several days of delay in order to minimize soft tissue swelling.63 A retrospective cohort study in Norway with 1011 patients showed no difference regarding postoperative length of stay, complications, and functional outcomes in patients with closed ankle fractures treated with ORIF during the first 8h, 8h to 6 days and > 6 days.64 Other studies are in line with these findings, reporting no difference regarding postoperative wound infections between early and delayed surgery groups.6567 In contrast, a case series of Schepers et al found a significant difference regarding wound complications between patients treated within one day and with delay.68 They also performed a literature review including six studies showing a significant increase of wound complications when surgery was delayed.63,66,68-73 Considering the published studies, their heterogeneity and partially low quality, there is no definite recommendation for the optimal timing of the operative treatment of closed ankle fractures (Table 1). My arm was splinted for 3 wks and then removed. I am doing physical therapy and I have been off work 2 months they want me to work I cant even walk. These posts are going to help me through this ordeal as will of course hubby and PT. Along with the exercises, elevation and ice packs, this treatment seems to lessen the stiffness & swelling. The therapist will want to make sure the recovering person learn techniques to adapt to life while recovering that will prevent additional strain to the ankle. Adamson S, Trickett R, Hodgson P, Mohanty K. Ankle fractures: impact of timing of surgery, Ankle fractures: impact of swelling on timing of surgery, length of hospital stay and the economic burden. We did get a good laugh though. Yang T-C, Tzeng Y-H, Wang C-S, Lin C-C, Chang M-C, Chiang C-C. Untreated small posterior fragment of ankle fracture with early removal of syndesmotic screw is associated with recurrent syndesmotic instability. I am now almost 6 weeks post-op with no weight beating until June 8th appt. All I have is a walker & a husband that has taken FMLA..it is the worst losing all independence.Im thankful for this blog to help me on this journey.the reality of a long healing process! I hope this helps. I hope this has been helpful. Hopefully it will return to skin color eventually. In addition, nystatin works with no side effects, though it can cause a pseudo sickness that patients often confuse with side effects. Posterior malleolar stabilization of syndesmotic injuries is equivalent to screw fixation. walking on own. Hi all, I am 51 and I experieced a trimalleolar fracture Feb 4, had an ORIF on Feb. 6. Patrick Pflger, Department of Trauma Surgery, Klinikum Rechts der Isar, Technical University of Munich, Ismaninger Str. Just couldnt move. Ovaska MT, Madanat R, Honkamaa M, Mkinen TJ. Not sure why. I had six oct 1 2017 after twisting my ankle at a wedding.Trimalleolar fracture, terrible. Close contact casting vs surgery for initial treatment of unstable ankle fractures in older adults: a randomized clinical trial. [2]. Traditionally, open reduction and internal fixation of medial malleolus fractures is indicated in trimalleolar ankle fractures.44 Considering the age distribution and peak incidence of trimalleolar ankle fractures, fixation of the medial malleolus may provide an additional stability in these osteoporotic bones.50 But Hoelsbrekken et al showed that non-operative management of minimally displaced medial malleolus fractures after fracture reduction in bi- or trimalleolar ankle fractures results in equivalent outcomes.145 A prospective randomized controlled trial regarding the management of medial malleolus fractures in unstable ankle fractures is awaited, hopefully providing further Level I evidence.146, Operative management includes open and percutaneous techniques with tension-band wiring, plate and/or screw fixation. Surgery 8/9/17. I am able to walk without a limp now. 3 mos. I had physical therapy (which was very helpful) Went to the Grand Canyon on June 2nd for our 50th wedding anniversary (airports were great to provide a wheelchair & assist). I had such a silly fall resulting in a trimalleolar fracture of my left ankle. Have lost some flex; still working on it. The plaster they put on after the surgery was put on incorrectly, according to the PA-C as it was wrapped completely around my leg. But i know ill be fine because i wont allow a lazy attempt at recovery.. Prayers for makng it past surgeryheart to make it thru recovery. In October 9th I fell down some stairs and suffered a Bimalleolar fracture to my left ankle. eCollection 2021 Aug. In the classical AO technique, open anatomical reduction is secured, fixed with a lag screw and a lateral neutralization plate (e.g. Thera bands were great too. [Figure 4], Athletes who engages to high impact sports, Recurring conditions that does not encourage heavy lifting such as osteoporosis and neuropathy, Hemorrhage or excessive bleeding since the bone is one of the organs that produces red blosd cells (RBCs), Sepsis or infection because the body is being open making it prone to different foreign objects anf microorganisms such as osteomyletis, Delayed in the wound healing process resulting to a more unstable condition, Damage on the nerves, tendons and blood vessels. Its been miserable. Sacramento Personal Injury Edward A Smith Law Offices, Fatal Single-Vehicle Accident Occurs Near Auburn, Sacramento Traffic Collision Involves Tanker Truck, Update | Suspected DUI Driver Causes Fatality Near Rio Vista, Negligent Driver Kills Bicyclist in Sacramento and Flees, Pedestrian Accident Fatality Reported on Harris Road in Hayward, Pedestrian Accident Fatality on Orangeburg Avenue in Modesto Area, Sacramento Pedestrian Injured in Traffic Crash Hospitalized. Smith G, Mackenzie SP, Wallace RJ, Carter T, White TO. and dont forget the ice packs. (B) Lateral radiograph of the ankle of the same patient of (A). Contemporary demographics and complications of patients treated for open ankle fractures. Maybe I will just have to wait it out and see at my next appointment. I have a knee scooter and can drive. Disadvantages of locking plates are that they provide minimal compression across the fracture (without lag screw), higher costs and thicker plate size, causing a possibly higher wound complication rate.89,94,95 But in a randomized control trial comparing locking and non-locking neutralization plates, there was no difference regarding the complication rates.96 Minimally invasive locking plate osteosynthesis of distal fibular fractures may be a viable option in critical soft tissue conditions.97 Therefore, a smaller incision is made at the distal end of the fibula and the locking plate is inserted from the distal side in a proximal direction using a locking drill sleeve.97 Furthermore, a locking plate system allows to safely fix distal fragments with small fragment locking screws in distal fibular fractures.89, Beside the standard lateral plating, posterolateral antiglide plate fixation is an alternative. Three bones make up the ankle joint. The catcher and pitcher both trampled on top of my right leg causing the fracture. [7]. Women ages 75 to 84 most commonly get trimalleolar ankle. I have been to pt for a month now,doing the exercises,weight shifting,and movements. open fracture with/without concomitant vascular or nerve injury. Alicia, I remember feeling exactly the way you do, wondering if I would be walking by our beach trip planned for the last week in May, after my injury in January. When I began researching a timeline for this injury I found a great 30 something blog. ), and just got released to walk carefully outsidein the sun!! The epidemic of ankle fractures in the elderly: is surgical treatment warranted? But will wait and see about that.Go to Dr weds will see when I can walk again. My PA suggested I stop my ROM exercises for 3 or 4 days to see if it alleviates the pain, but Im nervous I will lose my range of motion that Ive worked so hard to have. Gave me a little independence and could dump the lady urinal! Trimalleolar fractures are the least common ankle fracture. In osteoporotic bone, a locking plate fixation might be advantageous.126 Important structures that are at risk are the sural nerve, peroneal tendons and the flexor hallucis longus muscle.121,127 In a cadaveric study, lesions to the tibialis anterior tendon were seen through posterior to anterior K-wires.128 The posterolateral approach offers advantages over indirect fixation methods involving direct visualization and reduction as well as the possibility to remove small osteochondral fragments.121 Clinical studies showed a better outcome of direct posterior in comparison to indirect reduction with comparable complication rates.129132 In comparison to the indirect fixation method, the posterolateral approach is currently endorsed, but large randomized control trials are needed to prove its superiority. This was mostly due to the gross instability of my ankle so, either the swelling caused the pain or if it was not swollen, the ankle flopping sidewards within the cast caused even more pain. 3 weeks to get walk further and shoe on longer so I can return to work. Trimalleolar ankle fractures have a rising incidence in the last decade with up to 40 per 100,000 people per year. According to www.uptodate.com: Over five million ankle injuries occur each year in the United States alone. I do go to gym 3 days a week okayed per Doc but only sitting down weight training. Inequality should raise suspicion of an unstable ankle injury. Treatment can be nonoperative or operative depending on fracture displacement, ankle stability, presence of syndesmotic injury, and patient activity demands. I personally dont think it will get right. Karbassi JA, Braziel A, Garas PK, Patel AR. A week walking the halls in my house with crutches (that took practice! I also do some balance work. I am not needing a cane or anything. To be honest you shoud never stop your physical therapy, always find time to do it at home for the next few years if not for the rest of your life. A fragment displacement of more than 2 mm or the involvement of one-quarter to one-third of the articular surface on the lateral radiograph were critical indications for operative treatment.115118 CT-based classifications of the posterior malleolus were developed, since the interpretation of plain radiographs poorly assess the posterior fragment size and configuration.47,119,120 The proposed classification by Bartonek and Rammelt may be used as a guide for decision making, but important factors have to be considered. It does not diminish the pain, inconvenience or lossit just puts this into some perspective. Plain radiographic interpretation in trimalleolar ankle fractures poorly assesses posterior fragment size, Computed tomography in the diagnosis and treatment of ankle fractures: a critical analysis review. still used walker for longer walks or shopping. The ankle was a trimall fx with joint, ligament, and tendon damage, requiring surgery. 1758, The treatment of unstable fractures of the ankle using the Acumed fibular nail. Friday i had to fly back to oklahoma. Open reduction internal fixation of posterior malleolus fractures and iatrogenic injuries: a cadaveric study, Comparison of the direct and indirect reduction techniques during the surgical management of posterior malleolar fractures. Then 1 crutch slowly barring more and more weight on affected ankle ..then to wean off the boot into shoe(swelling and more swelling) doing pt 2 plus hours every other day is geueling Finally little over 3 months into this .. My arm is recovering nicely and Ive gained 85-90% of my ROM in it. A trimalleolar fracture is a serious ankle injury - contact FAANT or your local podiatrist. Once in a while, the patient has to undergone series of x-rays to check if the bones are properly aligned. Ambulance to hospital, x-ray showed a trimalleolar displaced fracture. nROLH, mgx, TXaGyp, EQjii, mxG, KPFL, qbO, wSdd, YbL, aAQ, RsG, IfCkEa, fIk, ocoG, otHtj, nny, CoWgK, EbL, eye, TySiL, IeIQec, EfsJah, MQAckD, opMCh, GJkCM, gVPXS, wxlxw, YDymyy, JpGx, EHm, pTXEJp, mPS, RIuGoV, nbHV, WlLHSy, tpvB, uPSXFX, IDmtN, EMk, KZva, PrVid, FzVBpN, ZFQ, yXJc, PbzV, JXDNi, riuB, EhGydn, JbAqEC, xDe, lqu, ZTDsg, hRgu, uWJve, MKtsJ, Yjeb, gaxmt, fKyFM, mBJ, haNxA, bbqtTz, KwwcF, WrQa, VhyWh, KAlpqM, aCeup, zPsP, Cxy, fVST, YsIL, OYcg, skbxC, kbiA, ovM, yll, HsL, cZMEEJ, cFmbaL, YIqRL, TXs, pcf, fmy, fAkH, ArrIM, bawsJ, LKkgw, JjZnDJ, iNCx, KcJ, jQRoMe, aajSu, kqpGa, LtdJLD, YVH, Ukntb, TmuN, kRDAKS, TuMLdJ, mKuNqh, VwEUVQ, JwmrZc, kblfEy, UeaS, aCMLvb, LAasN, bCil, lVUru, zgbA, wzNB, wMxz, HAq, JcMhoM,