Numbness After Intramedullary Nail Surgery for Leg Fractures

After two weeks of having steel pins inserted for a tibia and fibula fracture, the sole of the foot began to feel numb?

Hello, I would like to ask about my condition.
On March 15th, I was hit by a car, resulting in both legs being crushed and an open fracture.
The next day, I had intramedullary nails inserted in my right leg.
A few days later, I started experiencing nerve pain, which eventually subsided, but now the soles of my feet have been numb for two months and the numbness does not stop.
It is very uncomfortable, and I am worried about whether this numbness will last a lifetime.
What could this symptom indicate?

Peng Xiansheng, 20~29 year old female. Ask Date: 2016/06/22

Dr. Hong Ximing reply Orthopedics

Open fractures of the tibia and fibula were stabilized with intramedullary nailing; however, the injury may have affected the nerves.
It is advisable to consult the attending physician for a nerve conduction study to determine the location of nerve damage and facilitate early intervention.

Reply Date: 2016/06/22

More Info

Experiencing numbness after intramedullary nail surgery for leg fractures can be concerning, especially when it persists for an extended period. It’s essential to understand the potential causes and implications of this symptom in the context of your recent surgery and recovery.

Firstly, it’s important to recognize that numbness in the foot following surgery can be attributed to several factors. The most common reason is nerve irritation or damage that may occur during the surgical procedure. In your case, since you had an open fracture and subsequent surgery, the surrounding tissues, including nerves, may have been affected. The trauma from the accident itself could also have contributed to nerve injury, leading to sensations of numbness or tingling.

The numbness you are experiencing could be a result of several underlying issues:
1. Nerve Compression or Injury: During surgery, if the nerves in the leg were compressed or inadvertently damaged, this could lead to persistent numbness. The fibular nerve, which runs along the outside of the knee and down the leg, is particularly susceptible to injury during such procedures.

2. Post-Surgical Swelling: After surgery, swelling can occur in the surrounding tissues, which may compress nerves and lead to numbness. This is often temporary and can improve as the swelling subsides.

3. Scar Tissue Formation: As you heal, scar tissue can develop around the surgical site, potentially leading to nerve entrapment. This can cause ongoing numbness or tingling sensations.

4. Circulatory Issues: Sometimes, after a significant injury and surgery, blood flow to the extremities can be affected, leading to numbness. This is less common but can occur if there are vascular complications.

5. Complex Regional Pain Syndrome (CRPS): In some cases, patients may develop CRPS, a chronic pain condition that can occur after an injury or surgery. It can manifest as pain, swelling, and changes in skin color and temperature, along with numbness.

Given that your numbness has persisted for two months, it is crucial to follow up with your healthcare provider. They may recommend imaging studies, such as an MRI or ultrasound, to assess the condition of the nerves and surrounding tissues. Additionally, a nerve conduction study may be beneficial to evaluate the function of the nerves in your leg.

In the meantime, there are several strategies you can employ to manage your symptoms:
- Physical Therapy: Engaging in physical therapy can help improve mobility and potentially alleviate some symptoms associated with nerve compression or irritation. A physical therapist can provide exercises tailored to your recovery.

- Pain Management: Over-the-counter pain relievers or prescribed medications may help manage discomfort associated with nerve pain.

- Nerve Gliding Exercises: These exercises can sometimes help relieve nerve compression and improve symptoms. A physical therapist can guide you through appropriate techniques.

- Monitoring Symptoms: Keep a record of your symptoms, noting any changes or patterns. This information can be valuable for your healthcare provider in determining the best course of action.

In conclusion, while it is understandable to be concerned about the possibility of lifelong numbness, many patients experience improvement over time as healing progresses. However, it is essential to maintain open communication with your healthcare provider to address your concerns and ensure appropriate management of your symptoms. Regular follow-ups will help monitor your recovery and any potential complications that may arise.

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