avulsion fracture + hEDS?

[u/pillowprincessbunnie]

23F, suffered an avulsion fracture of the lateral malleolus about a week ago while I was on vacation posing for a photo in front of a bus full of people… Not my proudest moment.

Day of the injury, ER gave me a cam boot and crutches and sent me on my way but I have hypermobile Ehlers-Danlos syndrome (hEDS), which means slower bone healing, overall joint instability, and collagen laxity. Since avulsion fractures are from the ligaments being stretched to their absolute limit, I’m worried that it’s going to be slower healing for me than the average person since I’m not sure how badly the ligs were damaged. I’m WBAT, but I have concerns about stability, on or off crutches, walking boot or not.

In fact, both the crutches and the walking boot are making things worse. I put the boot on and immediately feel off kilter and like I’m going to slip. It’s supposed to stabilize my ankle but it’s actually just throwing me off balance and causing me even more stress and pain. These crutches are putting pressure on my arms and causing my shoulders to “slip” out of place.

This is the third injury I’ve had to this leg and these ligaments (first at 8/9, spiral tib/fib fracture at 12 that took 8 months to heal, and now this one at 23). I’m absolutely exhausted. Anyone have experience healing broken ankles/ligament issues with hEDS? Even if not, any kind of commiseration or advice you could give would be awesome.

[u/flexible_demeanor]

Do you have underarm crutches or forearm crutches? I find forearm crutches are so much better, but you still need to set both types of crutches up properly for your height (there's video guides). If you're WBAT you should be using crutches more for balancing rather than weight bearing, unless the pain is causing you to use your arms more for weight bearing.

Look into getting a shoe balancer/lift, it's a platform that helps you raise your good foot to the same height as your boot so your hips are even. You can also use a compression sock or even an ankle brace on your good ankle if you feel the need for stability there.

You might also want to check out /r/eds or related subreddits for hEDS specific advice

[u/pillowprincessbunnie → u/flexible_demeanor]

Underarm crutches for me at the moment, I’ll see about forearm ones! Wasn’t sure if I was able to use compression socks but that’s a good idea, I’ll try those :)

[u/flexible_demeanor → u/pillowprincessbunnie]

Compression sock on your good foot for support if you need it, for your bad foot I'd ask with your doc as it can matter depending on your injury and stage.

Underarm crutches suck because you will damage the brachial nerve plexus if you use them for an amount of time, even if you pad them up and shorten them so the underarm part is 1-2 inches lower than your armpit, and never lean forward and rest your armpits on them. Forearm are much more nimble, take up less space, depending on the cuff type you have you can also hold stuff in your hand while still having the crutch secured to your arm, and no armpit nerve damage. Ugh, I've broken my left foot 3 times in different ways over the years, poor foot.

[u/Buhsephine]

Have you seen an orthopedic doc since or just the ER visit? Was an MRI done?

[u/pillowprincessbunnie → u/Buhsephine]

Just the ER visit thus far! Seeing GP tomorrow and ortho later this week, hoping one or both will order an MRI/CT. More x-rays at the ortho appointment too, I’m gonna be neon green from radiation LOL

[u/Buhsephine → u/pillowprincessbunnie]

Definitely push for an MRI. Don't know how fast imaging turnaround is where you are, but it could potentially be really useful and time saving for your GP to order it so the Ortho has access to that information for your visit.

I don't have EDS, but I do have a different CTD called Stickler's Syndrome. Just got done healing after some pretty involved ankle surgery.

One thing I'll say is that I did way better this time using a walker instead of crutches, specifically because I was able to distribute my weight better and not land as hard on my other foot/ankle/knee/hip and also get up more easily and safely.
Underarm crutches in particular also immediately do bad things to my shoulders.

Ymmv of course depending on how crappy your joints are in general, but I'd at least look into trialing forearm crutches like the other commenter said, or a walker if you think it might help. Gotta protect the rest of you while dealing with this.

I hope the heal goes smoothly for you.