photograph courtesy shara clark
In the hospital, the first stage of treatment involved stabilizing the fracture, with “transfixing pins” drilled directly into the bones.
Until this spring, although I’m probably the clumsiest person I know, I prided myself on never having broken a bone. All my structural pieces were intact and in working order, aside from some likely weak tendons from many ankle sprains through the years.
Today, I’m turning the corner into month five of recovery from an April fall that broke the ends of both bones in my lower left leg. You may relate because of an experience of your own (I’m sorry). Or (heavens forbid) you may find yourself in a similar predicament. Unfortunately, the answer to “what happened?” is boring, but here I am — confessing that I was simply walking around. Some of us are more prone to tripping over things, more likely to take a tumble from time to time.
I am one of those people. And on this particular evening, my stylish but ill-fated platform boots were my ankle’s undoing. Perhaps there was an uneven bit of pavement, a tree root peeking through as I walked along the sidewalk, but suddenly I found myself lying on the concrete. It hurt — a lot. I couldn’t manage to stand. There was no broken skin, but when I removed the heavy boot, my foot plopped down and dangled at the end of my leg.
photograph courtesy shara clark
X-rays clearly reveal the “deep hardware” — a steel plate attached to the fibula.
A Trip to the E.R. (and a Hospital Stay)
After an X-ray, a CT scan, and some time in a room, I was dizzy with pain and medicated by the hospital staff so they could attempt to shift my ankle in place using bare hands and force. That was a no-go (ouch!), so I was prepped for emergency surgery. The next part was a blur, of course, and I awoke from anesthesia with metal pins jutting from my shin and heel, all bolted to a brace strapped to my leg.
From the surgeon’s report: “Attention was first directed to the left lower extremity where manual reduction was performed and I could feel the ankle slipped back in the joint. … a calcaneal transfixing pin was then placed across the calcaneus under the guide of intraop fluoroscopy. Attention was then directed to the proximal tibia where two 5mm half pins were placed sequentially proximal and distal … the ankle was distracted and the coupling mechanisms were tightened down, securing the ankle into near anatomic alignment.”
I spent one week laid up in the hospital, with another surgery and (among other things) the removal of that horrid external metal contraption on day five. The technical terms on that procedure: “Open reduction internal fixation left trimalleolar ankle fracture; Syndesmotic stabilization … Deltoid ligament repair … Removal of deep hardware.” And then came what I guess you could call an internal fixator, with the installation of “arthrex anatomical fibular plate with locking and nonlocking screws, syndesmotic screw.”
All of that is a fancy way of saying I’m now the proud owner of a titanium plate and several screws — lined up along the outside of my bone like nails in a board.
Road to Recovery
Two days following that surgery, I was discharged. I’d acquired borrowed essentials: a shower chair, a walker, a four-wheeled walker with a seat, a knee scooter (this was too difficult to maneuver for me; do not recommend), and a wheelchair. It was those first few weeks that were the toughest. On a plethora of pain and anti-inflammatory prescriptions, I was still aching and restless. At first, I couldn’t even get out of bed on my own. But with time I learned to navigate the house with one good leg and the rolling walker/chair — although my narrow door frames suffered. Outings were only for the many follow-up medical appointments — wound cleaning and redressing, more X-rays — weekly at first, then biweekly.
Looking back, the worst part might have been the frustration of feeling helpless, trapped in my body with its limitations. Proper healing doesn’t happen standing up with such an injury, so a lot of time was spent in bed — my leg elevated, required rest — waiting, waiting, waiting. Longing for my daily neighborhood walks.
It was around month two when I was given the green light to bear weight, wearing an orthopedic boot. An exciting moment indeed after all that lying around, but I found myself having to relearn to walk.
In the early weeks, I struggled with uncomfortable swelling that sometimes made it impossible to sleep at night. About a month in, the 30 staples lining my leg were removed — at a follow-up in the clinic with no numbing (just don’t watch and it feels like little pricks). This was followed by a stubborn incision that refused to close. At every appointment, I paid close attention to the doctor’s suggestions. Compression socks, even more ice and elevation, betadine, B-12 complex, collagen supplements, frequency of changing bandages, no weight bearing at all!
Eight weeks in, I had a final surgery to restitch the stubborn wound and have an internal pin removed. (That particular pin could later limit flexibility of the ankle. It could also, I was told, eventually break and a person would have the split pieces in there until … forever? No thanks.)
Walking Again
It was around month two when I was given the green light to bear weight, wearing an orthopedic boot. An exciting moment indeed after all that lying around, but I found myself having to relearn to walk. It wasn’t just that it felt funny — and scary — after what I knew my bones had been through, but I had to rewire my brain, too, and build back muscles in my calves, thighs, and even my back.
My foot felt tingly, as if it had just awoken from a months-long slumber (it had), burning as the nerves reignited to do the job they’ve done for decades. Just like riding a bike, I suppose, but accompanied by strange lightning strikes of pain and a brain that didn’t want to cooperate. You don’t realize what it takes to stand up and walk around on two legs until you haven’t done that for a while.
This journey has been a lesson in patience and gratitude. In trusting that our miraculous bodies, which know what to do, can and will mend.
Heading into month four as I write, the top of my foot still burns and tingles, and there is still swelling if I’m upright too long, but I’m walking (hobbling) now in supportive shoes without the boot. Short distances, but it’s a start. Last week, I completed my first two sessions of physical therapy. I wasn’t sure what to expect, but during the initial assessment, I realized how far I still have to go to get my foot working correctly — and my brain firing with my foot again to work on balance, rebound, and recovery while walking.
We’re working on stretching and strength now, a little at a time and at a comfortable pace for me. A few minutes on the recumbent stepper, toe raises, sit-down reps with a circular balance board (standing on a balance board comes later). Between sessions, I’m doing exercises at home (which might be good to do even without an ankle injury) — working on the ABCs, but with your feet, holding your leg out and “writing” each letter in the air with your toes to improve flexibility.
These few months felt like time both stood still and moved quickly. In the thick of it, those painful days went on and on. But now that I’m more mobile, it seems to have happened in a flash. I’m reflecting on the stories I heard from strangers while out with the boot or in the wheelchair. After asking what had happened, they’d share a similar injury story. From one woman who fell while roller-skating with her kids to another woman who dropped a large can of pie filling on her foot in the grocery store, and many more, I learned I’m not alone in what I’ve been through. And it’s often not some daredevil move that lands you in a predicament.
This journey has been a lesson in patience and gratitude. In trusting that our miraculous bodies, which know what to do, can and will mend. But it takes baby steps. And I took more of those recently, on my first neighborhood walk since April. It was less than a mile, but I’ve never been so thankful for sidewalks and trees and clouds and light breezes and passing cars and the houses full of people living full lives — while I stroll, stronger and smiling, the finish line in clear view.
Shara Clark is the editor of the Memphis Flyer.
