February 14, 2021 at 9 p.m., Valentine's Day, the air is full of dog abuse. I had just been taken to the hospital by ambulance and lay in the emergency room and watched as the doctor hurried toward me.
"Happy Valentine's Day!" He said to me. "I didn't expect to be on night duty on Valentine's Day." He blinked.
I stared at my own feet that flipped outward, and for a moment I didn't know who was worse.
My left foot and calf fell out at a weird angle
At that time, I was a senior in Singapore, and there were too few classes to take. So I started thinking about how to kill time, and bouldering was my new hobby. Somewhat different from general rock climbing, bouldering is usually indoors, the walls are 4 to 5 meters high, and the bottom is paved with soft cushions and no protective ropes.
Bouldering 丨 PxHere
As a little white, although my level is not good, I am very bold. The moment I enjoyed the most was the jump after climbing to the top of the wall. On that day, I never expected that this seemingly normal action would bring me much trouble.
On the evening of February 14, while couples were busy eating candlelit dinners, I went to a climbing gym and started to bump the line. After failing several times, I finally touched the top. Exhausted, I let go as usual and began to fall freely.
"Snap!" It was the sound of my left foot touching the protective pad. When I opened my eyes, I saw the ceiling and the glare of lights.
I fell to the ground unable to get up, and the pain was faintly coming from my ankles. I barely lifted my upper body and glanced at it, and found that my left foot and calf formed a very strange angle.
"Finished calves!" I thought to myself.
Everyone gathered around one after another. A medical student at the scene helped me take off my shoes and socks and poked my toes to ask if I felt.
"This time it's really the end of the calf!" I thought again.
I don't know how many people have worn the shoes in the rock museum, if the medical student brother is smoked by my pickled socks, where will my face be.
When the anesthetic woke up, I made three phone calls in a row
Soon, I was taken by ambulance to the nearest hospital.
I didn't expect that the only person who wished me a happy Valentine's Day that day was actually the emergency room doctor. I was about to conceive a circle of friends when I saw the doctor holding an X-ray with a serious face.
"You can't climb for a long time." He said, "We're going to have a reduction operation on you first and get your foot a little more normal." ”
It wasn't until I read the diagnosis when I was discharged from the hospital that I didn't know what my injury was. There are three fractures of the left foot, the inner ankle, the outer ankle, and the posterior ankle, also known as the three ankle fractures, one of which is comminuted. In addition, there is ankle dislocation. The purpose of the reduction surgery that the doctor calls it is to restore the dislocated joint to its original position.
Then, before I could react, I was fitted with a nasal oxygen tube and an electrocardiogram. While injecting the medicine, the doctor said: You may faint after a while.
The next second, I came to a magical world. In front of my eyes, I was changing all kinds of strange patterns, as if I was looking at a kaleidoscope, and I felt that the whole person was floating up. After fully regaining consciousness, I found that my legs had been cast in a plaster cast.
I quickly asked the nurse for my mobile phone, dialed the first phone after the injury, called the owner of the shop where I worked part-time, told him that he could not go to the part-time job tomorrow, and asked him to cancel my schedule.
The second call was made to the insurance company. After asking about the principle of claims, I was relieved a lot, after all, I had heard the scary story of taking an ambulance abroad and ruining my family too many times.
The third person to contact was my homework team member, telling them that I might not be able to complete my homework in time because of my injury.
After being injured, the first contact is the boss, insurance and team members, which is probably the life of contemporary international students and workers.
Edema plus blisters large and small
As a result, the operation was postponed three times
At 1 a.m., I was finally admitted to the ward and waited for a second surgery during the day. In the morning my foot was so swollen that I was told I needed to wait until it subsided before I had surgery.
The operation was postponed, but I was not in a hurry at all, and every day I happily complained to my friends about the unpalatable hospital meals, lamented the gentleness of the nurse's sister, and chatted with my grandmother in the same ward.
Finally, it was the day of the surgery. The doctor cut open the gauze and sighed heavily: "Tension blisters, the operation is canceled." ”
I was dumbfounded, my swollen ankles densely covered with large and small red blisters.
Dense tension blisters at the ankle 丨 Author courtesy of the author
While taking a needle to extract the exudate from the blisters, the doctor explained to me the cause of the blisters - fractures caused soft tissue contusions, edema, and blisters formed by the exudate due to uneven pressure. And my blisters are just in the place where the surgery is needed, and the risk of infection will be high if I rush to surgery.
It was as if a basin of cold water had poured over my head. A few hours ago, I was happily looking forward to the operation, but now I can only silently pack up my things and prepare to go home, and then choose a day after the blisters have cleared.
Thinking of all the unhappiness since the covid-19 epidemic and the pressure to hide my illness from my family, I, who has always been a Lotte sect, shed my first tears since I was injured.
While waiting for the operation, the doctor told me to pay attention to elevating the affected limb, braking, and stressing the need to move the thigh muscles more. So I followed the physical therapist to learn some simple movements, such as sitting on the bed and alternately raising my legs, using the thigh muscles to drive the entire leg, and so on.
A week later, I went back to the hospital for a follow-up, and the wound was still not recovering well. The surgery was postponed again.
Put on my boots, I feel like A contemporary Iron Man
In the third week after the injury, I finally waited for the surgery. When I woke up again, I was already in the post-operative observation room. The doctor applied a steel plate and several nails on the inside and outside of my ankle. I also got a certificate of implants in my body.
Postoperative X-ray examination shows plates and nails. 丨 Courtesy of the author
Like many fracture patients, I also put on special protective boots. Wearing steel plates and stepping on "combat boots", I felt as if I had become a contemporary Iron Man.
The postoperative days are short and long. The doctor in the rehabilitation department taught me how to use both crutches and told me to move my joints as much as possible.
Although I was lying in a hospital bed, my heart was looking forward to the day of recovery. Finally, 4 days later, I was discharged home with a large bag of anti-swelling medication painkillers and vitamin D, and I was super happy to leave the hospital.
After the operation, I put on special protective boots and walked on crutches, and I was super happy to go home. 丨 Courtesy of the author
I didn't expect that the most difficult thing was postoperative rehabilitation
I recovered quickly. From the initial bed rest to the loss of ligations to go out independently, it took only one and a half months. Six months later, I started running again.
But I soon realized that something had been changed forever.
The first hyperplasia of scars covered the original neat beauty stitches, and the ankle joint was also thickened by the steel plate, but these were secondary.
Just removed stitches vs a year later wound comparison 丨 Author courtesy of the image
More importantly, the joint flexibility seems to be much lower than before.
The angle of the ankle joint is difficult to fully return to its original state after injury, and it can only be lifted as much as possible. However, no matter how I practice every day, the room for improvement is very small.
Other than that, my daily life seems to be no different from a normal person. But only I know that every step I take on a weekday will feel a slight pain; every step I take will be slightly hesitant; and at the same time, I can't squat as unobstructed as before. I joked with my friend that I wouldn't be "Asian squatting" and that I wouldn't be able to call myself Asian anymore. Behind the joke, there is a slight bitterness.
Fast forward a year, although the joints are still not flexible enough, although I have not yet decided whether to take out the steel plate in the future, although occasionally I will suddenly be depressed because of some small things, I am still optimistic, with the determination to recover a little bit, still insisting on rehabilitation.
Not to mention, I believe everything is the best arrangement. Because of a series of serendipitous coincidences after the injury, I met my current boyfriend. He will urge me to recover and will accompany me when I am depressed. If you break your ankle to meet him, it's a special Valentine's Day gift.
Doctor reviews
Gu Xiaodong | Attending physician of the Department of Orthopedics, Shanxi Bethune Hospital
The ankle joint is the largest weight-bearing joint in the human body, and its normal function is very important for our daily walking, jumping and other movements. Ankle fractures are common clinically, usually caused by indirect violence such as falling from height and twisting, and often require surgery. Improper treatment can lead to ankle instability and eventually lead to the development of traumatic arthritis, which seriously affects the function of the ankle joint.
The authors' three-ankle fractures are the more serious type of ankle fractures. Triple ankle fractures are posterior ankle fractures distal to the tibia in addition to medial and lateral ankle fractures, which are severe and complex intra-articular fractures, usually accompanied by ankle dislocation. For patients with triple ankle fractures with ankle dislocations like the authors who cannot undergo emergency surgery, it is usually necessary to reduce the dislocation first, cast external fixation, and then perform surgery after the swelling is reduced, which can effectively preserve ankle function.
Schematic diagram of X-ray of a fracture of the three ankle 丨Reference 1
When is the best time for surgery for an ankle fracture? Generally speaking, within 6 hours after injury, that is, before the appearance of obvious ankle swelling and blisters, it is the best time for surgery. At this time, emergency surgery, incision reduction and internal fixation of the fracture can reduce the hematoma and facilitate the closure of the first stage of the incision, thereby reducing the patient's pain and shortening the length of hospital stay.
However, in most cases, the ankle swelling is already obvious at the time of presentation, and some patients will also have tension blisters such as the author, and the operation must be postponed at this time. Tissue injury after fracture, increased local exudate, and tension blisters due to uneven tissue pressure.
While waiting for surgery, a cast is applied, strict immobilization and elevation of the affected limb is required, distal limb movement massage, local cold compresses, etc. Wait for the tension blisters to disappear and the skin folds at the surgical site to appear, and the operation can be performed.
Do steel plates and screws need to be removed after fracture surgery? Generally for young patients, we still recommend that they be removed to avoid complications such as delayed infections.
After ankle fracture surgery, it is difficult to fully restore function, which is what the authors call the joints not as flexible as before. Although joint function improves over time, there are still varying degrees of joint dysfunction. Postoperative rehabilitation is also an important part of patients with ankle fractures, and rehabilitation treatment needs to be performed under the guidance of a rehabilitation doctor to maximize joint function.
Resources:
Hu Changqing,Ju Jihui,Liu Yuefei,Zhou Rong,Xu Hao,Chen Lucheng. Posterolateral combined medial approach emergency internal fixation for triple ankle fractures[J].Journal of Clinical Orthopedics,2021,24(01):131-134.
Sharing personal experience does not constitute a diagnosis and treatment recommendation, can not replace the doctor's individual judgment of a specific patient, if you need to go to a regular hospital.
Author: Don't look at me as just a Yang
Editors: Xiao Ai, Li Xiaoqiu