Weber A fracture

Patient information leaflet

A Weber A fracture is a break to the bone on the outside of your ankle.

Healing

• This type of broken bone (fracture) usually takes about 6 to 12 weeks to heal.
• Smoking can slow down the healing process, so it is best not to smoke while your bone is healing.
• If you would like help to stop smoking, speak to your doctor (GP) or visit the NHS Smokefree website for advice and support: www.smokefree.nhs.uk

Pain and swelling

Your ankle may be swollen and sore after the injury. The swelling is often worse later in the day.

• It is normal to have some mild pain and swelling for 6 to 12 months while your ankle continues to heal.
• You can help reduce the pain and swelling by taking pain relief medicine, keeping your ankle raised up, and using ice or a cold pack.
• You can find more information on the next page.

Walking and your boot

• The boot helps protect your ankle and makes it more comfortable while it heals.
• Wear the boot whenever you are standing or walking during the first 4 weeks.
• You can take the boot off when you are resting or sleeping.
• If you have diabetes, please let us know, as you may need a special type of boot.
• You can put weight on your foot while wearing the boot.
• You may find it helpful to use crutches at first, especially if walking is uncomfortable.

Exercises

• It is important to start exercises as soon as possible. Instructions are on the next page.

Follow up

• We usually do not arrange follow-up appointments for this injury because most people recover well by themselves.
• Please contact our team if:
  • You still have a lot of pain or swelling after 12 weeks, or
  • You are still using the boot after 6 weeks.

Any questions?

• If you are worried about your symptoms, or you cannot follow the following rehabilitation plan, or you have not received your appointment letter, please get in touch with us.

Caring for your injury: Week 1-4

• Remember to wear your boot whenever standing and walking for the first four weeks.
• You can remove the boot when resting and at night. Wear a long sock in your boot.
• Using a cold pack will help with your pain and swelling.
• You can use an ice pack or bag of frozen peas wrapped in a damp towel.
• Put this on your ankle for up to 15 minutes every few hours. Make sure the ice isn’t in direct contact with your skin.
• Try to rest your ankle, especially in the first 24-72 hours.
• Raise your ankle on a stool or cushions so that it is above the level of your hip. This will help to reduce your swelling.

Exercises

• It is important to start gently moving your ankle and foot early on.
• This helps improve blood flow and lowers the chance of getting a blood clot (called a Deep Vein Thrombosis, or DVT).
• Do these exercises three to four times a day. Start straight away, working within your pain levels.

1. Point your foot up and down. Repeat this 10 times.	2. With your heels together, move your toes apart to turn the foot outwards. Repeat this 10 times. Do this movement gently within comfort.	3. Make gentle circles with your foot in one direction and then the other direction. Repeat this 10 times

Caring for your injury: Week 4-6

• You can now stop using your boot.
• Start by walking without the boot around your own home.
• Build up to walking without it outside or for longer walks.
• You should not be using your boot after 6 weeks post injury.
• It is normal to still have mild discomfort and swelling. This may continue for six to twelve months.

Activity and exercise

• Slowly do more activity over time as your ankle gets better.
• For 3 months, avoid activities that put strong stress on your ankle, like running, jumping, or dancing.
• You can now progress your exercises.

Stretches

1. Sit with your leg straight out in front of you. Put a towel or bandage around your foot and pull it towards you. Feel a stretch in the back of the calf. Hold for 30 seconds.	2. Point your toes down as far as they go, place your other foot on top and apply some pressure. This will stretch the top of your foot. Hold for 30 seconds.

Caring for your injury: Week 6-12

• You should no longer be using your boot or crutches.
• It is now time to move on to the next stage of your exercises and start practising your balance.

Level 1: These exercises are for people who could not stand on one leg before their injury.

1. Stand with your feet as close together as possible. Hold onto a firm support in safe space. Hold your balance for 30 seconds
2. Now try removing your hand. Try to keep your balance for 30 seconds.
3. Hold onto a firm support. Put one foot in front of the other, as close together as you can. Hold this for 30 seconds. If you can, try to let go of the support and keep your balance.

Level 2: These exercises are for people who could stand on one leg before their injury

1. Hold onto a firm surface in a safe space. Try to stand on one leg. Hold this for 30 seconds. Stop if you experience pain. When you can do this comfortably, try the next exercise.
2. Try to stand on one leg without holding on to a support. Try to hold this for 30 seconds. When you can do this comfortably, try the next exercise.
3. You can try these exercises with your eyes closed. Make sure you are always in a safe environment with a support to hold if needed.

• Please contact the Virtual Fracture Clinic if you are having trouble getting your movement back or returning to normal activities. Frequently Asked Questions

I am struggling with my boot. What do I do?

• The boot has a thicker sole and this can make you feel uneven.
• Make sure you wear a supportive shoe or trainer on your uninjured foot. This will reduce stress on other joints.

If you need more advice, contact the Virtual Fracture Clinic.

I am diabetic, does this change things?

• If you are diabetic, please contact us to discuss your boot.
• This is particularly important if you have problems with your skin or sensation.
• We may provide you with a specialist diabetic boot.

When can I start driving?

You can return to driving when:

• You are no longer using your boot,
• You can walk comfortably and
• You can perform an emergency stop pain free.

Always test your ability to drive in a safe environment first.

How can I get a certificate for work?

• You can get a ‘fitness for work’ statement from your GP or the doctor at your Fracture Clinic appointment.

What do I do with my boot and crutches when I no longer need them?

• The hospital cannot reuse boots, so please do not return them to us.
• Crutches can be returned to the Fracture Clinic or A&E.

Contact the Virtual Fracture Clinic

Call us on 020 7288 3310 (Monday to Friday 9am to 5pm)
or email whh-tr.fracturevirtualclinic@nhs.net

With thanks to Brighton and Sussex University Hospitals NHS Trust for kindly sharing their information sheets with us with full permission to use contents and images.