Displaced Trimalleolar Ankle Fracture Treated With ORIF

What is Displaced Trimalleolar Ankle Fracture Treated With ORIF

In a displaced trimalleolar fracture, there are three breaks (fractures) in the bones that make up your ankle. These fractures are in the bone that you feel as the bump on the outside of your ankle (fibula) and the bone that you feel as the bump on the inside of your ankle (tibia).

Displaced means that the bones are not lined up correctly. The bones will be put back into position with a procedure called open reduction and internal fixation (ORIF).

Tell a health care provider about:

  • Any allergies you have.
  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
  • Any problems you or family members have had with anesthetic medicines.
  • Any blood disorders you have.
  • Any surgeries you have had.
  • Any medical conditions you have.

What are the risks?

Generally, this is a safe procedure. However, problems can occur and include:

  • Excessive bleeding.
  • Infection.
  • Posttraumatic arthritis.
  • Failure to heal properly, resulting in an unstable or arthritic ankle.
  • Stiffness of the ankle after the repair.

What happens before the procedure?

  • Ask your health care provider about:
    • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
    • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood.Do nottake these medicines before your procedure if your health care provider asks you not to.
  • Do not eat or drink anything after midnight on the night before the procedure or as directed by your health care provider.

What happens during the procedure?

  • An IV tube will be inserted into a vein in your arm. Medicine will flow directly into your body through this tube. You may be given antibiotic medicine and medicine for pain through the IV.
  • You will be given one of the following:
    • A medicine that makes you fall asleep (general anesthetic).
    • A medicine injected into your spine that numbs your body below the waist (spinal anesthetic).
  • The skin over your ankle will be cleaned with a germ-killing (antiseptic) solution.
  • The surgeon will make an incision through your skin to expose the areas of the fracture.
  • The broken bones will be put back into their normal positions. The surgeon will use a combination of screws, screws and a metal plate, or different types of wiring to hold the bones in place.
  • After the bones are back in place, the surgeon will close the incision using stitches or staples.
  • Then a bandage (dressing) and a cast or supportive boot will be placed over your ankle.

What happens after the procedure?

  • You will stay in a recovery area until the anesthetic wears off. Your blood pressure and pulse will be checked often.
  • It is normal to have some pain. You will be given medicine to control the pain.
  • While in the hospital, you will be helped out of bed so you can begin moving around. It is important for you to start moving around several times a day.

Care After Displaced Trimalleolar Ankle Fracture Treated With ORIF

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

  • Pain.
  • Swelling.
  • A small amount of fluid from your incision.

Follow these instructions at home:

If you have a splint or boot:

  • Wear the splint or boot as told by your health care provider. Remove it only as told by your health care provider.
  • Loosen the splint or boot if your toes tingle, become numb, or turn cold and blue.
  • Keep the splint or boot clean.
  • If the splint or boot is not waterproof:
    • Do not let it get wet.
    • Cover it with a watertight covering when you take a bath or a shower.

If you have a cast:

  • Do not stick anything inside the cast to scratch your skin. Doing that increases your risk of infection.
  • Check the skin around the cast every day. Tell your health care provider about any concerns.
  • You may put lotion on dry skin around the edges of the cast. Do not put lotion on the skin underneath the cast.
  • Keep the cast clean.
  • If the cast is not waterproof:
    • Do not let it get wet.
    • Cover it with a watertight covering when you take a bath or a shower.

Bathing

  • Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you can take showers.
  • If your splint, boot, or cast is not waterproof, cover it with a watertight covering when you take a bath or a shower.
  • Keep the bandage (dressing) dry until your health care provider says it can be removed.

Incision care

  • Follow instructions from your health care provider about how to take care of your incision. Make sure you:
    • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
    • Change your dressing as told by your health care provider.
    • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do notremove adhesive strips completely unless your health care provider tells you to do that.

Check your incision area every day for signs of infection. Check for:

  • Redness.
  • More pain or swelling.
  • Blood or more fluid.
  • Warmth.
  • Pus or a bad smell.

Managing pain, stiffness, and swelling

  • If directed, put ice on the affected area.
    • If you have a removable splint or boot, remove it as told by your health care provider.
    • Put ice in a plastic bag.
    • Place a towel between your skin and the bag or between your cast and the bag.
    • Leave the ice on for 20 minutes, 2–3 times a day.
  • Move your toes often to avoid stiffness and to lessen swelling.

Raise (elevate) the injured area above the level of your heart while you are sitting or lying down. To do this, try putting a few pillows under your leg and ankle.

Driving

  • Do not drive or use heavy machinery while taking prescription pain medicine.
  • Ask your health care provider when it is safe to drive if you have a splint, boot, or cast on your foot.

Activity

  • Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
  • Do exercises as told by your health care provider or physical therapist.
  • Do notuse your injured limb to support (bear) your body weight until your health care provider says that you can. Follow weight-bearing restrictions as told. Use crutches or other devices to help you move around (assistive devices) as directed.

General instructions

  • Do notput pressure on any part of the splint or cast until it is fully hardened. This may take several hours.
  • Do notuse any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay bone healing. If you need help quitting, ask your health care provider.
  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • If you are taking prescription pain medicine, take actions to prevent or treat constipation. Your health care provider may recommend that you:
    • Drink enough fluid to keep your urine pale yellow.
    • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
    • Limit foods that are high in fat and processed sugars, such as fried or sweet foods.
    • Take an over-the-counter or prescription medicine for constipation.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • You have a fever.
  • Your pain medicine is not helping.
  • You have redness around your incision.
  • You have more pain or swelling around your incision.
  • You have blood or more fluid coming from your incision or leaking through your cast.
  • Your incision feels warm to the touch.
  • You have pus or a bad smell coming from your incision or from your cast or dressing.

Get help right away if:

  • The edges of your incision come apart after the stitches or staples have been taken out.
  • You have numbness or tingling in your foot or leg.
  • Your foot becomes cold, pale, or blue.
  • You have chest pain or difficulty breathing.

Summary

  • After the procedure, it is common to have some pain and swelling.
  • If your splint, boot, or cast is not waterproof, do notlet it get wet.
  • Contact your health care provider if you have severe pain or swelling, or if you have fluids coming from your incision or leaking through your cast.
  • Get medical help right away if you have numbness or tingling in your foot or leg, or if your foot becomes cold, pale, or blue.
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