ankle injury rehab schedule

[alpie]

Had a fracture of lateral malleolus, Weber Type B I think. Unstable on stress xray so it was fixed with ORIF. Turned out that there was no need to repair syndesmosis, so the only hardware put in was plate and screws to hold the fracture in place.

I've been reading a lot about rehab and there are a lot of studies that suggest early weight bearing is beneficial for this, or at least not harmful. N Dehghan et al in a randomized study in Toronto comparing weight bearing in boot as tolerated and limited range of motion at 2 weeks vs no motion and no weight bearing until 6 weeks is a recent study, there are older ones too.

But when speaking to the surgeon before the procedure, he wanted to do 6 weeks non weight bearing, then Xray at 6 weeks, 2 more weeks non-weight bearing but with ROM exercise, and then 50% wt bearing at 8 weeks and full wt bearing at 10 weeks. From my reading, this is seeming a bit conservative, though at the time I think he thought he'd need to repair the syndesmosis.

So, I'll talk to him for the followup (2 weeks after surgery) soon. I know he knows a lot more, and he's got a very good reputation, but what if this is just one of these things that some surgeons like to do one way and some like to do another, rather than being based on specific details of my case? Any suggestions for how to proceed if he still wants no wt bearing till 8 wks? Is it reasonable to ask another doctor for additional opinions? Again, I know the guy is an expert, I'm not going to argue with him or ignore instructions; I just want to understand if this is more a matter of preference of the surgeon or what.

[edgery]

Didn't see any replies to this but thought I'd share my experience. Dislocation and bimalleolar break in left ankle on 7/19, surgery 10 days later (waited to get the swelling down). My surgeon kept me at non-weight bearing for 13 days after surgery, with fiberglass cast and walking boot at day 13. He told me to start conservatively in terms of amount of time up and about but definitely wanted me walking on it and building up time as possible. I won't have my post-surgery x-rays for another 3 weeks, so I don't know the outcome yet but I'm sure glad I wasn't hopping around any more than I had to be.

Basically, it seems like your guy uses the go-slow approach while mine is the up and at 'em style. Hope you're doing well