Misstep leads to broken ankle

You can bet the next time Jeralyn Westercamp goes outside "just for a couple of minutes" in the middle of winter - she'll take the extra time to put snow boots.

"I had just come home from all day classes at the University of Iowa," recalled Jeralyn. "I thought I would take a quick trip outside, walk the dogs and fill the bird feeder."

It was a cold day. Cedar Rapids recorded a high of three degrees around 6 p.m. on January 31, 2013. With the wind chill it felt more like 20 below zero. The National Weather Service had issued a wind chill advisory that day.

"It was very cold," said Jeralyn. "All I remember is one minute I am walking the dogs and the next minute I am down on the ground. It didn't initially hurt but I couldn't put weight on my right leg. I noticed it was at a bad angle and I heard a pop. I tried to get up but couldn't. At first
I thought my whole leg was broken."

Jeralyn had been wearing flats but no socks. The slick shoes, combined with snow and ice on the ground caused her fall. Thankfully she was wearing a coat and fished gloves out of her pockets. Her cell phone had been left inside the house.

No one else was home. Both of her parents were away at meetings.

"I knew I had to do something," recalled Jeralyn. "Our house isn't in a busy area so the chances of someone finding me were remote. I knew I had to get inside and call for help. I couldn't stay outside and wait. It was too cold."

Jeralyn managed to crawl back to the house. She was able to drag herself up the steps and open the door.

"I called my parents and reached my Dad who rushed home to help me," said Jeralyn. "We went to a doctor where it was determined my ankle was broken and surgery was needed the following morning."

Frost bite damage

"When I first saw Jeralyn's ankle I was surprised with the amount of blisters I saw," said Sandeep Munjal, MD, Physicians' Clinic of Iowa orthopedic surgeon. "The blisters were indicative of the severity of soft tissue damage to her ankle. It was cold-induced for sure. It was a type of frost bite. It's not uncommon to see fracture blisters in displaced fractures but in her case it was more of an injury from exposure to the cold."

"We needed to wait for the soft tissues to heal before we could talk about fixing the broken ankle," said Scott Ekroth, MD, Physicians' Clinic of Iowa orthopedic foot and ankle surgeon. "To facilitate healing of the damaged skin we needed to give her ankle some stability."

It was decided Jeralyn would need two surgeries at St. Luke's Hospital to fix her injuries. In the first procedure Drs. Munjal and Ekroth placed her ankle in an external fixator, which is a surgical treatment used to stabilize bone and soft tissues.

Collaborative team

"We were thankful for this great team of healthcare professionals at St. Luke's who came together for Jeralyn and devised a plan to get her back on her feet," said Barbara Westercamp, Jeralyn's mom. "The external fixator was used to allow time for the skin to heal around her ankle. It gave us such comfort to know she was well cared for."

After about four weeks the skin around Jeralyn's ankle had healed enough to have the second surgery to repair her broken bones.

"The challenge of operating on a fracture that is several weeks old is you have to break up some of the healing that has already occurred and then move the bones where they should be. It takes a bit of work to get things shifted where they needed to be and put the screws and plates in place for the healing process to start over again," said Dr. Ekroth.

"Jeralyn's surgery went well and her ankle fracture healed nicely," said Dr. Munjal. "Unfortunately there was nerve damage with the break and the recovery has been a bit of a challenge so we've worked with a collaborative team of health professionals, which include therapy and physiatry to help her fully recover."

Excellent care in Cedar Rapids

"We felt confident in our choice of St. Luke's," said Barbara. "We knew if we had any questions or concerns they had it covered. Everyone from the doctors, nurses, cafeteria workers and housekeepers provided great care. We are fortunate to have such an excellent team right here in Cedar Rapids."

Today Jeralyn is back for her final year at the University of Iowa where she is pursuing a triple major in management, marketing and political science.

"It has been a long recovery but I am thankful for Drs. Munjal and Ekroth for their exceptional care," said Jeralyn. "I can't imagine what might have happened if I didn't have them and the fabulous team at St. Luke's to help me get back on my feet."