Weber A combined with dislocation?
Does anyone have experience with rehabbing a dislocated ankle in combination with a Weber A fracture? (and unknown soft tissue damage)
I fell while bouldering 2 months ago and medially dislocated my left ankle. Surprisingly, no fractures were seen on x-rays in the ER after reduction. Three days later a trauma surgeon (the ones who handle ankle fractures in the Netherlands instead of orthopedics) repeated the x-rays, which were still clean. He assumed there was extensive soft tissue damage and I got a cast for 3 weeks. At cast removal a Weber A avulsion fracture of the lateral malleolus was seen. I was allowed to start weight bearing without a cast or boot and I started seeing a physiotherapist weekly.
Since I live in the Netherlands, no MRI was made. They only do that if the rehabilitation doesn't go according to plan.
It's been 9 weeks since the accident and I'm wondering whether my ROM is normal for this stage. Dorsoflexion doesn't go any further than 90 degrees and it hasn't really been progressing the last 3 weeks, despite manipulation by the physio and lots of stretching and other exercises. There's hardly any pain on the side of the fracture, which has probably healed already, but I do feel pain above the medial malleolus. This gets worse during a syndesmosis squeeze test. I walk 3000 steps a day with crutches, although there have also been days that I walked 4500-6000 steps, because I wanted to join dog walks again. Our current hypothesis is that I have overdone it this way, so more stretching, less walking!
Anyone with experience with a similar case?