Post-Surgery Pain After Removal of Ankle Fracture Plate: What to Expect?

Q: Post-Surgery Pain After Removal of Ankle Fracture Plate: What to Expect?

Hello： Were you diagnosed with a fracture of the calcaneus? If so, this type of fracture is indeed considered to have a poorer prognosis. <br>Additionally, during your treatment, did you experience any signs of infection? It is quite unusual for symptoms to worsen nine months aft

Pain after removal of the plate following a fracture of the left calcaneus?

Hello Dr.
You: In January of this year, I fell from a 3-meter ladder, resulting in a closed comminuted fracture of my left heel.
I had a steel plate and artificial bone implanted.
My recovery has been relatively normal, but before the plate was removed, I experienced swelling and pain, which the doctor attributed to the body rejecting the steel plate.
In October of this year, the doctor felt that the bone had healed sufficiently, so I underwent surgery to remove the plate.
For the first week after the surgery, I used crutches, but the swelling and pain have not subsided.
It has now been over two weeks, and the swelling and pain are actually worse than when the plate was still in place.
Is this normal? Besides returning to the orthopedic clinic, should I consult other specialties due to the severity of the fall? (I am unsure how to upload X-ray images for you to review, so I can only describe my situation verbally.) Thank you, Dr.
You.

Aji, 40~49 year old female. Ask Date: 2019/10/04

Dr. You Dianqi reply Orthopedics

Hello: Were you diagnosed with a fracture of the calcaneus? If so, this type of fracture is indeed considered to have a poorer prognosis.
Additionally, during your treatment, did you experience any signs of infection? It is quite unusual for symptoms to worsen nine months after the removal of the bone screws and plates.
I recommend returning to the clinic for further evaluation, as this is the best way to identify the underlying causes and answers.
As for whether you need to see other specialists, the current discussion primarily focuses on the condition of the fracture, so it would be advisable to continue consulting with an orthopedic specialist.
Wishing you a speedy recovery.

Reply Date: 2019/10/04

More Info

Post-surgery pain and swelling after the removal of an ankle fracture plate can be concerning, especially when the symptoms seem to worsen rather than improve. It's important to understand that while some discomfort and swelling are expected after such a procedure, the intensity and duration of these symptoms can vary significantly among individuals.

Firstly, it is not uncommon to experience increased pain and swelling after the removal of hardware, such as plates and screws, from a fracture site. This can be attributed to several factors:
1. Soft Tissue Trauma: The surgery to remove the plate involves manipulating the surrounding soft tissues, which can lead to inflammation and swelling. The body may react to this trauma, causing pain and discomfort as it heals.

2. Bone Healing Process: Even though the plate has been removed, the underlying bone may still be in the process of healing. If there was significant trauma, such as a comminuted fracture, the healing process can take time, and the removal of the hardware may temporarily disrupt the stability of the area, leading to increased pain.

3. Scar Tissue Formation: After surgery, scar tissue can form around the surgical site. This tissue can sometimes cause discomfort as it develops and matures, leading to sensations of tightness or pain.

4. Increased Activity: After the removal of the plate, patients often feel encouraged to increase their activity levels. If you have started to put more weight on the affected leg or engage in more physical activity, this could also contribute to increased pain and swelling.

Regarding your specific situation, it is essential to monitor your symptoms closely. If the swelling and pain persist or worsen, it would be prudent to follow up with your orthopedic surgeon. They may want to conduct imaging studies, such as X-rays, to assess the healing of the bone and ensure that there are no complications, such as infection or improper healing.

In some cases, if the pain is severe and not improving, your doctor may consider referring you to a pain management specialist or a physical therapist. A physical therapist can help you with rehabilitation exercises that can improve mobility and strength while managing pain effectively.

As for your question about whether you should consult other specialties, it depends on the nature of your symptoms. If you experience signs of infection (such as fever, increased redness, or discharge from the surgical site), or if you have persistent pain that does not respond to standard pain management strategies, it may be beneficial to consult a pain specialist or even a rheumatologist if there are concerns about underlying conditions affecting your healing.

In summary, while some pain and swelling after the removal of an ankle fracture plate can be normal, the severity and duration of your symptoms warrant a thorough evaluation. Keeping an open line of communication with your healthcare provider is crucial for ensuring a smooth recovery process. They can provide personalized advice based on your specific situation and may recommend further imaging or referrals if necessary.

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