Hawaiian Airlines









Additional Pages

Timalleolar Fracture Two Years Later

March 30, 2006


It's been two years since that other March 30 so full of events. A wedding for Linda & Wayne, morphine and an ambulance ride for me, and a test of physical endurance for Dutch, my then 83 year old hanai mother. Looking back on that era from this two year vantage I can say I've learned many things I didn't really want to know.

The big bone on the left ankle on the left side of the foot is the lateral malleolus.
The big bone on the inside of the left ankle is the medial malleolus.
Malleolus is singular (one); malleoli is plural (two or more); malleolar means pertaining to the malleolus/malleoli.

Whether it's a unimalleolar, bimalleolar or trimalleolar fracture, it's a broken ankle.

Uni  means one: unimalleolar pertains to one malleolus;
Bi refers to two: bimalleolar pertains to the two malleoli, the lateral and medial;
Tri means three: trimalleolar pertains to three malleoli. Technically, there are two malleoli, and the big bone at the tip of the tibia counts as the third.

My surgeon several times told me about the classes of broken ankles. Most broken ankles are unimalleolar, and heal much like other fractures. A bimalleolar fracture is a less common than a unimalleolar, is serious, and presents complications. And as my surgeon would relate each time he saw me: a trimalleolar fracture is severe. Trimalleolar fractures are not often seen, as several in the profession have told me.


This is a good time to close this two year chapter in life, and be truly pau (finished). I last updated the ankle page with my six month review, a year and a half ago. I have been steadily replying to email from visitors to my ankle pages at, people asking questions or relating their experiences. Most want to know what to expect in their trek to walk, or to allay fear. Many ask how I'm doing now, for a picture of their future. And our shared experience has been the spring of friendships.


You'll find most of my experience related on the original ankle pages. Today I look back, and consider those events that dominate, and have changed my life. The excruciating pain, the resulting shock from the doctor's telling me the severity of my injury, and the helplessness, surely are at the top of the list. The doctor didn't tell me what to expect beyond the coming few weeks, and available information was depressing enough to make me believe I'd not walk again, at least not without great pain. This is the second reason the broken ankle pages at exist. The first reason the first ankle page, the Staple Contest, was born was for my children.




As related on the Staple Contest page, my children, all grown and on the mainland, wanted to know how their mother (unfortunately not named Grace) was faring. Until the day the surgical staples were removed ten days after surgery, I had convinced myself that only a badly broken leg was attached to me. I could handle that. But when the surgeon, an ankle-specializing orthopedist, explained different types of ankle fractures, and stressed the severity of my injury, I wanted to deny my condition. I hurt badly, isn't that bad enough? Well, my foot was still attached, and I was grateful for that. My surgeon came with high accolades from Darlene, a nurse friend who looks for the very best doctors. My husband was encouraging. Dutch is an excellent caretaker, with a handicapped prepared home, including adjustable bed. (Did I mention she's not in her 30's?) And I had a PowerBook named Tinkerbell (hey! it's a Mac!) who does all kind of things for me.


Dutch took pictures of my stapled ankle and the xrays while at the doctor's office, and my keiki (children) would want to see them. But when I later saw those pictures, with the horrid, stapled gouges on my ankle that had looked much smaller from on the doctor's table, I wanted only to cry. The situation loomed larger than my ability to control. While I cannot always control my emotion, I can choose to direct my actions. (My mother used to tell me that.) My only option was to present the pictures with humor, thus the Staple Contest was born. Those pictures were compiled for a Flash movie …I'm so glad Tinkerbell knows how to do that stuff!


The second reason for the Staple Contest, for updating it, anyway, was the unexpected response from other looking for information on this injury, as I had.

I had searched the internet for information of what to expect. Oh, there's lots available: very tecinical, describing the pros and cons of open fixation (surgery) or closed, and orthopedic charts indicating this bone and that tendon. While I learned about ankle bones and surgical proceedures, I learned nothing of what to expect. Other websites related experiences of others with trimalleolar fractures, every bit depressing. While broken ankles (unimalleolar) are common and much like other fractures, every bit of information I found about trimalleolar fractures was not the least bit encouraging, not even helpful. It was quite a disheartening find.


Now, how was I to update my children with a discouraged, distressed, angered, helpless, pained, fearful, depressed outlook dominating the gloom of reality? Behind every grey cloud the sun is brightly shining, even when we can't see it. Let everyone else see only the clouds, I'd set my sight on the shining sun on the other side, thank you very much! Like the staples themselves, I could only discuss this injury by finding the angle that showed the absurdity of the situation, where the sun is shining. I intentionally used discordant, wild colors on a dark background to reflect discordant emotions, breaking all design rules.







One question I'm commonly aksed: How are you doing now? Well, I can walk without a limp, mostly pain free. The bone at the back of my ankle (the third malleolus, the tip of the tibia) hurts the deepest, and the area on the top of my foot is still shoots sparks — nerves take a long time to heal. There is still a little bit of occasional swelling on the inner screw area. The lateral malleolus side (outside) is mostly fine, but it does sometimes feel like the plate is bent. The fear of a misstep still grips me, and I don't know if ever I will again mangage to confidently walk on uneven terrain.


I ran across a forgotten file: a diary of sorts from before the Staple Contest, theFirstDiary.

My motherly friend, Dutch, breathing challanged with emphysema and subsequent 1/3 of her lungs surgically removed; heaing challenged, noises barely coming in from one ear only; mobility challenged, with a handicapped placard and new knee; and old age challenged, with her friends my age rather than hers (and we all love her dearly) wrote her observation of that memorable, unwanted event at Dutch's Story.


Linda's Staple Contest is PAU.




©2006 WindwardWahine all rights reserved