Managing Ankle Stiffness After Fracture: Surgical Options and Recommendations - Orthopedics

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Managing ankle stiffness after a fracture can be a challenging process, especially when surgical fixation has been involved. It’s important to understand that stiffness can occur due to a variety of reasons, including scar tissue formation, muscle atrophy, and joint immobilization. Given your situation, where the internal fixation has been removed but you still experience significant stiffness and inability to move your ankle, there are several considerations and potential options for management.

Firstly, it’s crucial to assess the underlying cause of your ankle stiffness. After the removal of hardware, some patients may still experience stiffness due to the prolonged immobilization of the joint during the healing process. This can lead to a condition known as joint contracture, where the muscles and soft tissues around the joint become tight and less flexible. In your case, since you mentioned that the ankle is in a state of "攣縮" (contracture), it suggests that the soft tissues may have adapted to the immobilized position.

In terms of surgical options, if conservative measures such as physical therapy and rehabilitation exercises have not yielded satisfactory results, surgical intervention may be considered. One common procedure for addressing severe stiffness is arthrolysis, which involves the surgical release of scar tissue and adhesions around the joint. This can help restore mobility by freeing up the joint and allowing for a greater range of motion. Another option could be a joint manipulation under anesthesia, where the surgeon attempts to mobilize the joint while you are sedated, which can sometimes break up adhesions and improve movement.

Before proceeding with any surgical options, it is essential to have a thorough evaluation by an orthopedic specialist. They will likely perform imaging studies, such as X-rays or MRI, to assess the joint's condition and determine the best course of action. They will also evaluate your overall health and any other factors that may influence the surgical outcome.

As for recommendations for orthopedic surgeons in Taipei, I cannot provide specific names, but I suggest seeking out a reputable orthopedic clinic or hospital that specializes in joint surgeries and rehabilitation. You may want to consider facilities that have a strong reputation for treating post-fracture complications and have experienced surgeons who are familiar with ankle joint issues.

In the meantime, while you are exploring surgical options, it may be beneficial to engage in physical therapy focused on gentle range-of-motion exercises. A physical therapist can guide you through specific exercises designed to gradually improve flexibility and strength in the ankle. Modalities such as ultrasound therapy, electrical stimulation, or manual therapy techniques may also be employed to help alleviate stiffness and promote healing.

In summary, managing ankle stiffness after a fracture, particularly following hardware removal, can be complex. Surgical options like arthrolysis or manipulation may be viable if conservative measures fail. Consulting with a qualified orthopedic surgeon in Taipei will provide you with personalized recommendations based on your specific condition. Meanwhile, engaging in physical therapy can help maintain some level of mobility and prepare you for potential surgical intervention. Remember, the goal is to restore function and improve your quality of life, so don’t hesitate to seek the help you need.