Broken legs and ankles heal better if you walk on them within weeks

I had a bad pilon fracture of my ankle a couple of years ago with both a break on Tibia and Fibia.

I fell off a ramp whilst pushing a wheelbarrow full of rubble into a skip (should've stuck to building code instead of building a house!).

Normally that type of injury is associated with car crashes when someone instinctively puts all their force on the brake and the shock of the crash travels up the pedal into the ankle.

It was a really scary time for me as the doctors were trying to manage expectations and plan how to fix my ankle. There was a possibility of my foot being fused to my leg permanently at 90 degrees angle.

Fortunately I had an awesome team of orthopaedic surgeons who managed to do ORIF surgery with about £70,000 worth of titanium inside my leg.

6 weeks later I was out of my plaster cast and into a "moon boot" with my physio starting and doctor telling me to put weight on it already as the titanium was holding it together effectively. Always pushing me to break the mental barrier of protecting my broken leg.

Long story short, physio, putting weight on my toes meant my ankle is about 95% back to how it was, just a small limitation in dorsiflexion and plantarflexion.

Can run, cycle, Jiu-jitsu etc.

NHS emergency care - great!

NHS physio care - poor, had to go private.

Here's a photo of the damage - https://photos.app.goo.gl/z8J8RfhnZ2jnVHFYA

I suffered a very similar break playing soccer. ER surgeon asked if I fell off a roof. 3 metal plates and 15 screws later I was non-weight bearing for 14 weeks. I lost almost 5 inches in circumference from my left thigh while waiting to put weight back on that leg.

My post-break recovery has not been as good as yours sounds. Almost 3 years later and I rate my ankle at 75% of what its sibling is capable of. I had follow-up surgery to remove one of the plates and clean up scar tissue, and _that_ surgeon was appalled at how long I was immobilized.

Anecdata and all that, but my personal experience says waiting for weight ain’t it.

What's your leg circumference at, now?

Mine is also smaller, due to patella tendinopathy.

Sorry to hear about the outcome on your leg, I am sure you've tried lots of things to beef up your muscle. Just looking at my two legs I can still see a slight difference in calf thickness.

One thing I didn't appreciate is that in a break the bone is the easy part, but getting the muscle back or preserving it is the hard part.

I’m going through a very similar process after breaking my ankle in a motorcycle accident. Tibia and double fibula fracture with dislocation and open wound, an ugly one which needed 2 titanium plates and 18 screws.

I was out of my plaster after week 2 so that I could start moving the ankle, and started physical therapy on week 5. I'm currently on week 7 and have already started _walking_ with the "moon boot".

I can stand on the brokenish ankle with 90% of my weight on it. It's kind of scary to be doing all this to the ankle when the bone is still not fully fixed, but it improves the recovery time and final outcome. I will probably be out of the boot on week 10-12. I'm 10 degrees away from full dorsiflexion range, and apparently it will still take some time and effort to get to the full range, if at all.

Treatment for these kind of injuries have definitely come a long way, this is a massively different experience from breaking my ankle 20 years ago playing football in the US and being on a cast forever, plus dealing with ankle pain for a year after the injury as I didn't get any physical therapy

EDIT: some of the parts for the curious

- https://www.arthrex.com/foot-ankle/titanium-ankle-fracture-s...

- https://www.arthrex.com/products/AR-9943H-03?objectID=human....

I also broke my ankle about 20 years ago. Once I was out of the cast, I regained all function, and only recently has my ankle been starting to ache. The doctor I saw about it even commented that it was as clean of a fix as he'd ever seen!

I also didn't do much physio, but that was mostly due to me being a 23 year old moron (which, believe it or not, also had a lot to do with me breaking my ankle in the first place!)

I wonder how and when they choose to remove plates, vs. leaving them in. They left mine in, and when I originally asked them, they mentioned that there was significantly more risk in removing it than leaving it in.

20 years on, and it's still hanging in there.

I asked to have them removed because my physical therapist believed they were impinging on a nerve, preventing me from regaining mobility in my toes. They didn’t want to but I kept insisting.

For sure! Not to mention all the tendons and nerves. My recovery continues, as I’m sure yours does too — I’m back to my pre-injury PRs for most weight lifting, and my goal for this year is to match my pre-injury mile time.

All things considered I’m still pretty lucky. This could have happened when I’m much older and been debilitating for life.

They are within 1 inch of each other, which is fine with me. I haven’t measured in over a year, I know there’s still a strength imbalance but that’s not what feels limiting to me anymore.

I can relate, 21 year old moron in my case. No surgery needed and clean fix. The problems were gone after a year when I decided to get some help in the form physical therapy. It never hurt again until recently when I broke it again

That's much more serious than the break I had in 2023. Slid and fell on an icy ramp coming off a river boat in Regensburg, Germany. Snapped the fibula in the middle, but didn't get it x-rayed until I was back in the US. Walking around Newark Airport wasn't fun. After that, wore a boot for four weeks, no cast was needed.

I crushed my leg a few years ago, my wife and I dropped a bridge on it, and I suddenly had 200kg of steel and wood grind down the back of it, and the front slammed into a concrete footing.

Internally degloved my calf, broke my fibula, and took a chunk out of my tibia - and being me, decided to ice it, strap it, look out for compartmentalisation and rhabdomyolysis, and hobble around on it until it was better. Took about two months before I could walk normally.

I only know what I did to it because I dislocated my knee last year skiing, and they were thoroughly confused as to what they were looking at - had to explain that I mashed my leg and couldn’t be bothered wasting my time sitting in A&E for a few days.

Either way, it healed just fine with zero intervention. My calf is a slightly funny shape from the fascia still being bunched up around my ankle, but it doesn’t seem to do any harm, and the break to the fibula healed almost perfectly - slightly offset but works just fine.

Having recently walked away from that exact situation miraculously unscathed (the teenage drunk drivers also managed to walk away somehow), that’s an interesting insight into the type of injury I avoided. Grim, scary, but very interesting. Glad you recovered.

If it's not an articular injury and they fix all the bones, you can more or less walk on these immediately. I've read about protocols like two weeks, and even immediately (albeit that has issues with wound healing)

Unless we have a clear indication, plates are not meant to be removed. For example, plating children we usually remove the plate as to not interfere with growth, or in some cases a fibula plate can irritate the tendons and should be removed, or in cases of infection.