Trimalleolar ankle fracture

Do: Listen to your doctor's advice.

Don't: Follow the advice of Vitards.

That being said, How old are you? What's a Trimalleolar fracture? 
I just spent almost a year recovering from my Malleolus break, but I'm 55. The ankle is a hard one to heal. 

Have a foot an ankle surgeon do it

Surgery 

I crushed my navicular as well as some other bones in my foot in my early 20's.  I don't know about Your specific injury. This is more general advice about how to make sure You are able to get the best Dr. to advise You.  

 Not all Dr.'s are good, even less are great .  If you have only been seen by an ER Dr. Get to an orthopedic DR. ASAP and confirm what the ER said.  I've seen ER's get things wrong , and time can often impact the recovery. As in if it needs to be operated on, doing that ASAP can sometimes make the recovery more successful and the surgery less involved. You start healing almost right away, and if You heal without everything lined up properly, they sometimes have to rebreak stuff. And that extra trauma can make it harder to heal certain bones in Your foot and ankle. Some bones have really fragile blood supplies  and the less invasive the surgery the better chance of a successful recovery. 

If possible take the time to find the best possible surgeon if surgery is suggested. Just like everything in life, some are just more skilled than others.  I had  a couple failed attempts at fixing my foot, then insurance change resulted in me not being able to go back to the high profile Dr. and as a result I had many visits with other orthopedic surgeons who all heard the past Dr's name and told me there was nothing they could do. Took 6 months of seeing a dr every 2 weeks or so before I found 2 Surgeon's that were both willing to try and fix my foot and thought that they could fix it. 

 I've had an OK orthopedic surgeon and some of the best. It makes a difference no matter how bad the injury is. 

 If something doesn't feel or sound right, get another opinion before settling .

 And one other thing I would say is to take more time off the bike than the dr. says. Even if they understand the demands of MX.  Get the rest of your body back into shape before riding again. and take it really easy as You get back into it.  

I regret rushing , and taking advice from a Dr. who did not really understand the demands MX puts on Your body. I just heard that I could ride again, that the Dr. said it was ok. And as a result I now have a fused foot, with almost no movement. just a tiny amount in my ankle. And I'm lucky to have that, and to have my foot and lower leg. Some tiny mistakes made multiplied each other and caused serious complications that likely would not have happened if I had gone directly to the best Dr. I could find. I have gone through the basic  PT after an injury and also gone through the extensive PT that a specialized sports orthopedic Dr. offers. They got my body as a whole back into shape. while the average PT is all focused on the injured body part/area.  

So obviously ONLY listen  to YOUR Dr's, but also find the best You can, and get another opinion if something feels wrong.  I'm sure there are a lot of people on here that know a lot about medical stuff. But only the Dr.s that have all the specific info on you and  Your injury really have enough info to provide specific advice.  So many factors outside of the injury can impact what will work for some and not others. Only a Dr. with access to all of Your info is going to have enough of the picture to guide You . But there are a lot of people on here with real world experience that can offer some good advice, and bad advice. Just remember that we all have much less info to  go off than Your Dr.s will. But there could be some really good advice from people on here about how to shower, or tips for getting around easier or some non medical advice. That is where I have found people with experience recovering often had some better more helpful advice. Dr.s may have never recovered from an injury and  may be less helpful in the basic day to day life of recovering from an injury. Still a good idea to run any of those suggestions by Your Dr.  before trying them.    

I did something similar including separation of the ankle. My only regret is not removing the hardware. I use to love running for my cardio but no chance I can run with how the plate and screws are. I was also amazed at how much strength I lost during the non-weight barring weeks. I was only off the bike for 13 weeks but took a year before I felt normal. 

Absolutely find the best surgeon and cash based PT you can afford. Forget insurance based PT they do cookie cutter exercises - you need someone who will spend the full hour working with you and intimately understands foot and ankle biomechanics. I’m 2 years out from a bimaleolar fracture and continue to make progress but that is because I found the best foot and ankle surgeon in SoCal and PT combined with functional trainer who knows how to progressively load the foot and ankle to regain mobility and strength. The ankle is one of the most poorly rehabbed joints because it’s so closely connected to the foot function and has 33 joints that impact ankle function. Feel free to message me if you want some one on one advice. 

Things to also look at that will cost you a fortune as they are not covered by insurance but if you want to get back to full function they are a must do and I did them. 
1 - hyperbaric chamber the next day after surgery for at least 2 weeks everyday 

2- shockwave therapy once your incisions heal up once a week for 6 weeks to help breakdown any scar tissue 

3- Class 4 laser to help with post surgery swelling also once a week for 6 weeks 

4- peptides BPC 156 and TB 500 start they day after surgery and run for 12 weeks. 

Do all this and you will stack the deck in your favor. 

At age 50, you'll have a long recovery time, just like I did. Longer than we used to experience as kids, at least. 

I like Jettsonator's advice about the peptides and the hyperbaric chamber, even if they are a little over the top. Can't be too careful. 
My doc recommended taking lots of calcium supplements and vitamin D to help it absorb. 

Keep the thing elevated nonstop until you see surgeon, like annoyingly elevated laying on couch foot the highest part of your body kind of elevated. Helps to keep swelling down and prevent facture blisters which will make your surgeon's life easier and help wounds heal after surgery. Bad enough swelling will delay your surgery. Find fellowship trained foot and ankle orthopedic surgeon. Most big ortho groups should have a guy. I'd rather have tri mal than talus facture. Do the PT afterwards. Lot of people who claim PT didn't help didn't do most of what their PT told them to do..... 

I second the out of pocket PT … the one i found had me back mobile and training pretty quick (not ankle injury) but i had two orthopedic surgeons tell me i needed lumbar fusion and i could never lift anything over 20lbs again last year …. so yeah im riding as good as ever, gym 5 times a week including squats and deadlifts! I may need a fusion at some point but they wanted to do it last year, and it hasn’t been this year and i sure hope it isn’t next year but i’m going to keep doing what he told me to do until i can’t move anymore! 

I have some Experience on this subject LOL.

Coming up 7 years ago age 49.

I recommended letting it heal properly (I was 4 months NW .

Ankle Dorisflexion is now around 50% but riding is all good and I think it was two years to get to the best point -lots of leg weight training and calf work etc.

I can relate to Jett Lawrence’s  issues and amazed tjat he’s riding so soon on his break.

Good luck man ! 

I had one 10 years ago on left ankle at 51 YO.  My bike fell over on me and twisted my foot.  ER gave me the options to cast it or have surgery.  The bottoms of both my tib and fib were pointed out which the doc said could lead to premature arthritis (among other things), so she strongly recommended surgery for it to heal in the proper place.  Didn’t think of getting a second opinion – TBH, never even thought of it – but the ER orthopedist was the surgeon and a runner, so I trusted her recommendation.  Two screws up the tib, plate and about 6 screws on outside of fib.

To echo Truck…KEEP IT UP!  And up high, above your heart as much as humanly possible…now and at least 10 days after surgery (or when stitches come out).  It’s a PITA, but the swelling leads to edema which takes forever to go down. 

I was told 6 weeks non-WB and given the option to begin PT after stitches came out at 10 days.  Didn’t do the then and that was a mistake!  It would’ve helped with the flexibility and edema immensely.  Aside from the minute flexibility exercises, there are also “anti-gravity“ treadmills (not every PT place has these; I wasn’t aware of them until months later) that suspend the body and allow you to regain your gait.  Walking is the #1 thing that helped work out the edema and could’ve begun weeks sooner.  C’est la vie.  My PT was through insurance and was really good (athletic, took time with me and listened well), but had others along the way who weren’t nearly as good.  I was around 75-80% flexibility after 12 weeks when PT ended; around 85-90% since then.

I was told that hardware removal was not covered by insurance and not needed, but after 7 years, one of my fib screws was visibly popping out, so plate and screws were removed.  Felt better as there was a tendon that crossed over the plate.  Tib screws were already well-covered with bone, so they were left in.

Just my story and $0.02.  Best of luck and please update us!

Looks like a friend of mines X rays. Hes was a compound fracture and that complicated things. He was in his 30's when it happened.  He's not riding dirtbikes anymore , but has really into Mountain bikes and has good range of motion. 

He had infection issues since it was open and got dirt inside.  So he had an extended length to his recovery.   Because of the infections he had to have skin grafts and   then had to have some hardware removed after it was  causing problems.  But its been  more than 10 years since the injury and  its still something that can bug him, but overall he's doing well. 

Because of my size, I have a plate in my foot normally used on a lower leg , I broke the first plate and a couple screws. So they beefed everything up. And its been good for a while now. I'm still limited in range of motion.  Shifting is super difficult , but it healed and my only limits are range of motion now. After having 10 years of pain, and issues with bones dyeing and infections. I'm happy to have  it as good as it is. 

Crazy how we all break ourselves  and keep coming back for more.  Hope Yours healed up well and Your 100%   

This is some absolute vitard advice but one thing I’ve found that helps with the healing process is lots of chlorophyll, and I’m not really talking the supplement but moreso your diet filled with Zucchini, Microgreens, Arugula, etc

If you mean a podiatrist, god no don’t do that. If you mean an actual orthopedic surgeon that specializes in foot/ankle, then yes. 
I broke my ankle, open tibial dislocation and fractured fibula and shredded (in my surgeons words) my ligaments. I was non weight bearing for 3 months due to the ligament repair. But the best advice I got, from the ortho surgeon, was to start moving my ankle as soon as the stitches were out to lessen the build up of scar tissue. No weight or PT with it, but stretching and movement of the joint. And take your PT seriously and do what they tell you to do. They are the experts. 

Thanks man,its healed up pretty good-can still ride a dirt bike so no stress.

Good to hear. My buddy could probably still ride but he has had too many injuries and finds riding MTB's  safer for him. He has an Xr 200 or 250 that he takes on trail rides that another buddy puts on every year. But they are slow and involve everything from golf carts to adventure bikes, 3 wheelers, just about anything that  that is a powersports vehicle.  

I had to stop riding back when my foot was refusing to heal,  I had been cleared to ride and rode through the pain for a while. I thought it would go away after I got back into riding and it just got worse. To the point I couldn't ride to the level  I enjoyed riding at.  I have not tried really riding since it has healed completely. The lack of range of motion I have from the fusions  will make shifting much harder.  It took about 11 years total to get to the point I'm at now.  I fought non unions and infections for many years after I got an infection during a surgery. I'm lucky I still have a lower leg and foot. 

 I tried a Stark Varg after not riding for about 15 years or so . And The lack of a shifter made me feel like a new rider. My foot wasn't an issue. I want to get an electric MX bike, or build my own at some point soon. I'll run a hand rear brake too. My height has always made it difficult to adjust shifters and brake pedals. I'm 6'9" with a size 16 boot.    For me, I felt more confident on that bike during the 20 minutes I rode it, than I have on any dirtbike I've ridden. And I noticed I had my feet where they should be on the pegs and wasn't trying to have them in the compromised position just to reach the shifter or brake.  

Anybody stopped riding because of an ankle or foot fusion and the reduced range of motion But  they do not have pain that prevents them from riding, A Stark Varg or other electric is worth trying out if You have the bug to ride again.