Re: How can I reduce ankle and foot swelling (broken leg)

On 17 Mar 2007 13:51:45 -0700, starved@xxxxxxxx wrote:

Hello all.

47 y/o male, 6'1" 250. 11 days ago I broke my leg, a few inches above
the ankle. Fractured distal fibula; SE2 supination with external
rotation. Closed break, nothing major, minimal soft tissue damage. Had
a hard cast (fiberglass) put on. 1 week later saw the doc and he said
recovery is right on schedule, so he was able to take the cast off and
replace it a removable boot. With the boot I'm now able to put weight
on the leg and walk on it - still using crutches. I should be able to
gradually put more and more weight on it over the next few weeks,
eventually going from two crutches down to one, then to a cane, etc.

What I'm wondering is how to reduce the swelling in my ankle and foot?
I'm trying to keep the foot elevated throughout the day as much as
possible, but that's not always practical - I have to walk around
quite a bit. I'm also wearing Jobst 15-20mmHg Compression Support

Is there anything else I can do to reduce the swelling?
Deep heating rubs like Tiger Balm or Ben-Gay?
Exercising the ankle through range of motion - more or less
Tightly wrapped Ace bandage?

Any suggestions would be greatly appreciated. Thanks in advance.

- Dave

As Ozzie would say, here's my folklore:

I broke my left fibula at the malleolus on October 8. When there is
a fracture, the first step toward healing is internal bleeding. The
hematoma clots around the break and new bone forms as new blood
vessels grow through the hematoma. I was truly amazed at the extent
of the dark purple "bruising" along the top of my foot to the base of
the toes, and along both sides of the heel -- basically all the
interstices filled up with a puddle of blood.

The increase in size of your ankle is due to the "clot" and the callus
on the bone, first of all. Plus, the circulation through that area is
diminished by the hematoma etc. -- so until new blood vessels grow
through the mass and move fluids through there efficiently, you're
going to experience secondary swelling: a.) any time the injury is
below heart level; b.) any time you use / over-use muscles in that
leg; c.) maybe even with certain foods. Only this "secondary"
swelling (as I call it) responds to ice and elevation.

Lots of thoughts: Make sure the boot is not too tight. Use
improvised footstools -- pull out a desk drawer near your desk, or use
inverted wast basket, etc. Massage? -- only the muscles that connect
to the tendons that go through the ankle, NOT the ankle itself. Have
the boot off when you can safely elevate the leg at home -- and wiggle
your toes, gently move the ankle (not to full range of motion) just to
get the juices flowing.

So to a great extent, the swelling is the healing process. My
understanding is that anything that impairs circulation (compression
bandage, smoking cigarettes...) is going against the healing process
at this point.

What an orthopedic surgeon means when he says minimal soft tissue
damage is, "Damn, no chance to wield my surgical tools on *this* guy!"
Face it, even when the bone is knit, what's left is a bad sprain. The
worst thing for a sprain is immobilization. But you have to
immobilize this one so the bone can knit. So you're basically screwed
whether they open you up and put a physical screw in the bone or not.

Forget the "one crutch" method. Crutches suck and get in the way. As
soon as they will let you, move to an adjustable cane, in the hand
opposite the injured leg.

Good luck!
Daniel ( deltaechomike@xxxxxxx )

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