Trimalleolar Ankle Fracture

1. DIET

  • Begin with clear liquids and light foods (jellos, soups, etc.)

  • Progress to your normal diet if you are not nauseated

2. WOUND CARE

  • Maintain your splint until your first post-operative appointment at 10-14 days

  • It is normal for the foot to bleed and swell following surgery – if blood soaks onto the bandage, do not become alarmed – reinforce with additional dressing.

  • Surgical dressing and splint will be removed 10-14 days after surgery at your first post-operative appointment.

  • To avoid infection, keep surgical incisions clean and dry – you may shower or bathe but be sure to keep splint dry. If it becomes wet at any point please come to the office to have it changed

  • NO immersion of operative leg (i.e. bath)

3. MEDICATIONS

Do not drive a car or operate machinery while taking the narcotic medication*, and increase the time intervals between narcotic pain medication usage

  • Pain medication is injected into the wound and ankle during surgery – this will wear off within 8-12 hours.

  • Most patients will require some narcotic pain medication for a short period of time.

  • Primary Medication Oxycodone

    • Take 1 tablet every 4 – 6 hours as needed (If pain is severe may take 2 tablets)

    • Max of 12 pills per day

    • Plan on using it for 2 to 5 days, depending on level of pain

    • Take additional Tylenol (Acetaminophen) or Naproxen (Aleve) as needed.

  • Common side effects of the pain medication are nausea, drowsiness, and constipation – to decrease the side effects, take medication with food.

  • If constipation occurs, consider taking an over-the-counter laxative such as prune juice, Senekot, Colace (or Periocolase), or Miralax.

  • You will be prescribed Aspirin 325 mg to be taken daily for 6 weeks to prevent blood clots

  • If you are having problems with nausea and vomiting, contact the office to possibly have your medication changed

  • For nausea, take prescribed Zofran / Phenergan

 

4. ACTIVITY

  • Begin exercises 24 hours after surgery (straight leg raises, quad sets, wiggle toes) unless otherwise instructed.

  • Discomfort and pain is normal for a few days following surgery – getting up and moving around with a knee scooter or crutches will help you normalize more quickly

  • Complete exercises 3-4 times daily until your first postoperative visit.

  • Wiggle toes throughout the day to reduce the possibility of a blood clot in your calf (extremely uncommon).

  • After six weeks you may be able to start bearing weight on the leg in a CAM boot if there was no syndesmotic injury

  • Formal physical therapy (PT) may begin 6 weeks after surgery if you are having stiffness

5. EMERGENCIES**

Contact Dr. Aran or the office at 305 667 8686 if any of the following are present:

  • Painful swelling or numbness

  • Unrelenting pain

  • Fever (over 101° - it is normal to have a low grade fever for the first day or two following surgery) or chills

  • Redness around incisions

  • Continuous drainage or bleeding from incision (a small amount of drainage is expected)

  • Difficulty breathing

  • Excessive nausea/vomiting

6. FOLLOW UP CARE/QUESTIONS

A member of Dr. Aran’s team will call you on your first day after surgery to address any questions or concerns. If you have not been contacted within 48 hours of surgery, please call the office at 305-667-8686. • If you do not already have a postoperative appointment scheduled, please contact the office during normal office hours and ask for appointment scheduling.