astro123,
If you have been nonweight bearing for 3 months, do not expect to walk out of the surgeon's office.
You will have very significant ankle stiffness and atrophy of the calf muscles. When the surgeon allows you to start weight bearing, you will need to start ambulating with crutches. Then, as you regain ankle motion and strength, you will be able to go to a cane and finally, walking on your own.
You will also notice that you will have some discomfort in the ankle when you first try to move it. So, once the cast comes off, you are going to have to really work on getting your ankle motion back. Some surgeons will allow the patient to start moving the ankle, before they allow weight bearing. But, that all depends upon the fracture pattern and how the fractures are healing.
You also have to remember that getting the bones to unite is just the first step in recovery from a bimalleolar fracture on the ankle. Three months is a little on the conservative side to remain totally nonweight bearing and not moving the ankle at all after an ORIF of a bimalleolar fracture. One of the reasons for fixing an ankle fracture, is so that the patient can be allowed to move the joint very early on. The range of motion (ROM) of the ankle helps the articular cartilage inside the joint smooth out and heal with fibrocartilage. ROM also helps reduce the chances of developing stiffness and atrophy. But, that is now a moot point.
Once the bones have united, you will have quite a bit of therapy ahead of you. Again, getting the bones to unite is just the first step. You now have to rehabilitated all of the soft tissues around the ankle. It is not uncommon for it to take as much as a year or so to fully recover from an ankle fracture. That is not to say that you will not be able to to anything for a year, but, that it can take that long before the final outcome is known. We used to tell the athletes, that for every day they were out of practice for an injury, it would take two days of rehab to get back to their prior condition. So, just for a ballpark figure, if you have been in a cast for 3 months before starting rehab, it may take about 6 months of rehab to get back to your preinjury condition. Some patients can do it faster, some slower, every patient is unique.
So, make sure you take your crutches with you when you go to your next appointment. Also, be prepared to see a very skinny calf and very dry, scaly skin. Do not scratch, even if you really want to, your skin is going to be very sensitive and easily damaged. You will have to take a good shower and use a ton of hand lotion on the skin.
Oh, also take your other shoe, just in case the surgeon takes the cast off and lets you go free. Sometimes, the surgeon will elect to transition from a nonweight bearing cast, to a weight bearing cast. Other times, the transition will be to a fracture brace (Air-Cast, Cam-Walker, etc), with advancement of weight bearing as tolerated in the brace, and allow the patient to take the brace off for ROM. In other cases, the surgeon just lets the patient advance weight bearing as tolerated without anymore immobilization. Every case is different, so be prepared for all possibilities.
Good luck. Hope you do well with your rehabilitation.
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