Ankle ORIF - 32 weeks pregnant
This forum has been super helpful to me over the last few weeks so I wanted to share my own experiences in case they help anyone else along the way!
On 4/12 I tripped on the last step of our patio at 30 weeks pregnant and pretty well flipped my foot backwards (oops). An ambulance ride and an initial closed reduction later, I was in a splint for a week and a half waiting for ORIF surgery for a trimalleolar fracture of my ankle. Thankfully, I instinctively prioritized protecting my big preggo belly when I fell so the baby was completely unaffected. We had done a few labor classes ahead of my fall so when in the ER I knew I could accept medications like fentanyl which helped a lot with the initial closed reduction.
After consulting with maternal fetal medicine and OB anesthesia, alongside my Ortho team, we elected to proceed with full general anesthesia for the operation. I also consulted a trusted friend who is an OB who advised on the VERY minimal risks of general anesthesia at this state in pregnancy. So to any other pregnant women suffering a traumatic orthopedic injury, hopefully this is reassuring to you. The OB team monitored fetal heart rate through the entire operation on 4/22. A nerve block was also administered to my affected leg and OB opted to put me on a magnesium drip early on in the operation as well. Surgery was successful and I had 2 plates and a total of 13 screws installed. Baby was a champion and according to the OB nurse was visibly dancing around in my belly during most of the operation so that's fun. The surgical team did elevate me via one glute prior to putting me under so I was not fully prone during the operation.
For pain management following the operation, I am allowed to utilize oxycodone and Tylenol. My OB also preemptively put me on Lovenox to minimize any risk of DVT so if you're undergoing a similar operation, worth discussing this with your OB. The first night home was fine but the second night the nerve block wore off fully and I was in intense pain (far more than the pain of the initial break). This subreddit was really helpful in informing me how rough coming off the nerve block could be, so I want to echo those comments but also say "it gets better". My discharge papers gave me a number for the on call surgical resident who I called at 10 pm the night of my extreme pain and it was nice to just have some reassurance on things going to plan. I told him I'd been wiggling my toes every so often to keep blood moving and he advised me to stop that until the nerve block pain had dispersed. He said to focus on elevation and rest and I could worry about toe wiggling in a few days once the pain has subsided. That helped a lot because the next day I more or less laid perfectly still with my foot as high as I could get it for the majority of the day and the pain all but went away. So I had about 20 hours of ick and now I'm definitely on the other side. If you're going through nerve block hell, it will end. 3 days post op and I'm down to only taking Tylenol for pain.
Through all of this, I've learned a fun statistic that 8 % of pregnant women experience some sort of traumatic Ortho event - so if you find yourself in this boat as well, you can survive this!!! Not a fun club to join, but go easy on yourself and allow yourself to rest. My friends keep reminding me that even though I'd rather be in full nesting mode right now, all baby really needs when they come home is the bassinet, a few diapers, and to be fed. So take care of yourself and heal so you can take care of baby when they arrive!
Sending well wishes and thoughts of recovery to everyone else going through this right now. ♥️