Orthopaedic Surgery - Discharge advice following Simple ankle fractures

We are sorry to hear you had an injury. This advice is designed to help you get better as quickly as possible. During your recovery we may contact you to improve the service for future patients.

What have I done?

You have had a small break in your ankle bone. This injury is common and because your ligaments have remained intact, your ankle is still stable, so although it is likely to be painful for 6-8 weeks, it should heal without any surgery or further medical treatment.

You can return to all daily activities as soon as you feel comfortable.

Please contact us if:

• You are worried about anything in this plan or have any questions
• If you do NOT want to be contacted about your injury
• If you are having pain or swelling in a different part of your body
• The pain is getting worse, not better after two weeks
• You experience numbness or pins and needles that are not improving
• You do not trust your ankle, or if it feels unstable
• The pain has not improved by 6-8 weeks
• If you develop a hot/red/swollen/painful calf – this could be a blood clot and you should attend The Emergency Department

Helpline - 0161 206 4892. You can leave a message anytime. We will aim to return your call within 24 hours (except weekends).

Your ankle may be very painful, stiff and/or swollen. Therefore, you should follow the procedure known as “PRICED”.
P = Protect. Use any walking aids provided – this will offload the joint. Use a walking stick in the hand opposite the painful ankle.
R = Rest. Partial rest is often recommended, but you should move the ankle as pain allows. This will aid your recovery
I = Ice. A bag of ice/frozen peas/ice pack wrapped in a towel can be applied for 15 minutes, every 2 hours, to reduce pain and swelling.*
C = Compression. The boot provided will help with this. You may choose to wear a support under your boot or instead of as it heals.
E = Elevation. Elevating the ankle above the heart level will help reduce any swelling.
D = Drugs. Sensible use of simple painkillers, e.g. paracetamol, will reduce pain and allow you to start moving. Check it is safe for you to take any anti-inflammatories.**

* Warning: Check the area after 5 minutes for ice burn. Do not use if you cannot feel the sensation of hot/cold.

** Warning: Follow patient information advice leaflet found in all medicines.

You will be given a boot for 4-6 weeks protection, but it is important to take this off to regularly stretch your ankle.

Regular movements within comfortable limits will prevent it from becoming stiff, this will aid recovery.

Exercises

Week 1-2: Elevate and do small movements of your ankle (out of boot) every 2-3 hours.

Week 2-6: Progress exercises gradually.

Week 6 -12: Full movement and strength work or until you have returned to normal activity.

Important information about smoking

FACT - Smoking affects healing rates. In extreme cases it can stop healing altogether.

GOOD NEWS - Stopping now will make the difference and give you the best results.

HELP - Go to www.smokefree.nhs.uk or https:// www.salford.gov.uk/health-and-social-care/health-services/quit- smoking/ or have a chat with your GP.

Physiotherapy

If you live in Salford, you can refer yourself online to our physiotherapy department using this website www.northerncarealliance.nhs.uk/go2physio

If you do not live in Salford or have no internet access, then ask your GP to refer you.

Osteoporosis

If you’ve fractured a bone AND are over 50 years you may be at risk of having Osteoporosis (weakening of bones). You may be contacted separately by letter from Salford Fracture Liaison Service offering you a telephone risk assessment; if you live outside of Salford please speak to your GP.

What is osteoporosis?

Bone is a living tissue, but as we get older it’s not able to renew itself as well and our bones start to weaken.

This happens to everybody to some degree, but when the bones become fragile it’s called osteoporosis.

How can I help myself?

The following will help to reduce your risk of developing osteoporosis:

• Get plenty of calcium and vitamin D as part of a well-balanced diet
• Exercise regularly, especially activities that involve walking or running
• Stop smoking
• Don’t drink too much alcohol

Nutrition tips

• You can help your body to recover by eating the right food
• Drink lots of water
• Protein, calcium and vitamin D work together to help your body to repair
• Food high in protein: Seafood, meat, dairy, eggs, beans, and soya
• Food high in calcium: Dairy, almonds, seeds, oily fish, beans and lentils
• Dark leafy greens like kale, broccoli and cabbage also help calcium absorption
• Food high in vitamin D: Oily fish, milk, cheese and eggs
• Eat less sugar and alcohol, as sugar reduces calcium absorption

Work

You can return to work once you feel comfortable performing your duties. If your work involves manual duties such as lifting or operating heavy machinery, then this may take up 6 weeks.

Sports

You should not play any contact sport until you are symptom free. You can exercise your upper body or uninjured leg as soon as you feel able to.

Driving

It is important that you contact your insurance company to tell them about your fracture. You may be able to drive when you feel safe to perform an emergency stop and fully operate your vehicle. You may not be insured if wearing a boot or cast of any kind.

Alcohol

Try to minimise the amount of alcohol you drink whilst your ankle is recovering. Excess alcohol can reduce the ability for injuries to heal and it can cause you to have further injury.

Remember...

• Ankle fractures can be very painful
• The majority of these injuries will recover within 6-8 weeks
• Gentle exercises will aid your recovery and reduce the risk of re-injury