Posterior Malleolus Fracture

Patient Information Leaflet

Healing

• This is a break to the bone on the back of your ankle.
• This normally takes approximately 6 -12 weeks to heal.
• Smoking will slow down your healing.
• We would advise that you stop smoking while your fracture heals.
• Talk to your GP or go to www.smokefree.nhs.uk for more information.

Pain and swelling

• Your ankle may be swollen and painful.
• Swelling is often worse at the end of the day.
• It is normal to have mild pain and swelling for three to six months after your injury.
• Taking pain medication, elevating your ankle and using ice or cold packs will help.
• More information about this can be found below.

Walking and your boot

• The boot protects your ankle and will make you more comfortable.
• Wear the boot when you are standing and walking for the first two weeks. You can take it off at night and at rest.
• Please let us know if you are diabetic as you may need a special boot.
• You are allowed to put weight through your foot.
• You may find it easier to use crutches in the early stages.

Exercises

• It is important to start exercises as soon as possible. Exercise instructions are later in this leaflet.

Follow up

• There is a small chance that the broken bone could move out of place. If this happens, you may need an operation.
• You will have an X-ray while standing or putting weight on your leg.
• You will also see a specialist, usually about 2 weeks after your injury.
• The specialist will explain the results and what happens next.

Any questions?

• If you are worried about your symptoms, cannot follow this recovery plan or have not received your appointment letter please contact us.

Caring for your injury: Week 1-6

• Remember to wear your boot whenever standing and walking for the first 6 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

• Moving your ankle and foot early is important. It helps your blood flow and lowers the chance of getting a blood clot.
• Do these exercises 3 to 4 times a day. Start them straight away. Stop if they cause pain.

Caring for your injury: Week 6-12

• You should now stop using your boot, if you haven’t already.
• Start by walking without the boot around your own home.
• Build up to walking without it outside or for longer walks.
• You should no longer need the boot or crutches by 8 weeks after your injury.
• It is normal to still have mild discomfort and swelling.
• This may continue for 6-12 months.

Activity and Exercise

• Slowly increase how much activity you do.
• Avoid activities that put a lot of impact on your ankle for 3 months. This includes running, jumping and dancing.
• You can now progress your exercises.

Stretches

Balance

Level 1: These exercises are for people who couldn’t stand on one leg before their injury.

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

Frequently Asked Questions

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

• The boot has a thicker sole; 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 have diabetes, please contact us to talk about your boot.
• This is especially important if you have skin problems or cannot feel sensations in your foot.
• We may give you a special boot made for people with diabetes.

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.

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

• We cannot use the boots again, so please do not return your boot to the hospital.
• You can return your crutches to the Fracture Clinic or Accident & Emergency department.

I haven’t received my appointment letter. What do I do?

• Your first appointment will be made by the Virtual Fracture Clinic team.
• If you have not received your appointment letter, please contact us.
• If you need to book a follow up appointment, please contact the booking hub on 020 7288 3310.

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.