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How long does it take a broken ankle to heal? I have been in a cast for nearly six weeks after having ORIF and have been cut on both sides of my ankle and have had plates and a lot of screws fixed in. Also suffered dislocation as well which I had to have a plate in also. I am due to go back next week to have cast removed. Have noticed by searching on the internet that alot of people get transferred to a boot. This wasn't mentioned to me. Is this the case. Your help would be very much appreciated.
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First Helper User Profile Gaelic

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replied December 2nd, 2011
Especially eHealthy

It sounds like you had a bimalleolar fracture-dislocation of the ankle. Also, since the surgeon elected to cast you for 6 weeks, he/she probably felt that the fixation was not secure enough to allow early motion.

In some cases, patients are allowed to weight bear immediately, within a boot or cast. Some are allowed to do early range of motion, which is one reason that an ORIF (open reduction and internal fixation) is done (the main reason is to get the bone back together of course).

But, every fracture has its own personality and thus has to be treated a little differently. It appears that your fracture pattern was significant enough, that even after it was fixated with the hardware, the surgeon wanted to be cautious. As such, you were placed in the cast for extra support.

You do not say if you have been allowed to weight bear in the cast of not.

As to how long it takes for an ankle fracture to heal, it varies. You have had a very significant injury, and the soft tissue injuries around the bones are probably just as significant, if not more, than the injury to the bone. And, it takes the soft tissues much longer to heal and be rehabilitated than it does to get the bones to unite.

The bones will usually unite around 6 to 8 weeks in an ankle injury. But, again, that is just the first step in recovering from a fracture. Once the bones are healed enough to withstand some stress, then activity is advanced, both in terms of weight bearing and in range of motion (ROM).

Total recovery from this significant of an injury may take as long as a year. You will not be totally laid up for that long, but it may take that long before you know you final result.

So, at your next visit, depending upon how the bones are healing, you could be placed into a fracture brace (boot) or be placed back into a cast. Some surgeons will continue with a cast, but allow the patient to start weight bearing in the cast. Others, will go to a boot, allow the patient to remove the boot and do ROM, but not weight bear. Some, will allow the patient to weight bear and do ROM.

It all depends upon how YOUR fracture is healing. Every patient will have a different post-op recovery. So, it is not a good idea to compare what happens in your case to others. You have had a very significant injury and, of course, will have a different course of recovery from someone who just broke the fibula.

So, whatever happens at your next visit, go with it. If you are allowed to start ROM, try to really work on getting that motion back. Don't weight bear any more than you are allowed.

With your injury, getting your ROM back is going to be the hard part. With the amount of soft tissue injury in an ankle fracture-dislocation, you are going to have a lot of scar tissue to stretch out. So, again, when you are allowed to start moving, really work on that aspect.

Good luck. Hope your ankle heals well.
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