Managing Swelling and Pain After Tibial Fracture Surgery: A Patient's Journey

Swelling five months after tibial fracture surgery?

I apologize for the intrusion, Doctor.
I was in a car accident on March 1st of this year, resulting in a fracture of the left tibia, which was repaired with plates and screws.
I also fractured my coccyx, and my attending physician mentioned that the coccyx would gradually heal over time, which requires patience.
It has now been five months! My leg still experiences swelling, although it is not as severe as initially, but there is a noticeable difference between my legs.
The surgical site is just below the knee joint, and whenever I bend the joint for a while and then try to straighten it, I experience sharp pain on the inner side of the knee joint.
Additionally, my ankle feels tight and stiff when walking, almost as if I have twisted my foot, making it difficult to walk, and sometimes it hurts! After standing for long periods, the joints in my toes also hurt.
During the fall, my left foot's big toe and little toe directly impacted the ground, so the joints still hurt and I cannot exert force on them! Currently, due to the injury, my left knee can bend without any issues in terms of angle, but I cannot squat down; the joint feels very tight.
If I force myself to squat, my heels naturally lift, and this also affects my right side, making it inconvenient to squat! I would like to ask the doctor: I am currently working hard on rehabilitation every day and receiving acupuncture treatment from a traditional Chinese medicine practitioner.
While there has been some improvement, due to my job requiring long periods of standing, along with the swelling, walking feels stiff, and I keep going through this cycle of rehabilitation and Chinese medicine treatment! Furthermore, regarding the pain on the inner side of the knee joint, the Chinese medicine practitioner said it is related to the ligaments, while I thought it was a muscle strain.
How should I treat this? Where is the swelling issue coming from? How should I address the pain in my toe joints? By the way, the surgical wound has healed well, but there are still areas that hurt; is this because the tissue has not fully recovered?

applebigsister, 50~59 year old female. Ask Date: 2020/07/19

Dr. You Dianqi reply Orthopedics

Hello, regarding these questions, in order to provide accurate information, it may be necessary to review the imaging and physical examination from the time of your injury as well as your current recovery status.
Additionally, these questions should be addressed by your attending physician for the highest level of accuracy.

Reply Date: 2020/07/19

More Info

Managing swelling and pain after a tibial fracture surgery can be a complex journey, especially when multiple injuries are involved, as in your case. It’s important to understand that recovery from such injuries is often gradual and can be influenced by various factors, including the nature of the injury, the surgical procedure, and your overall health.

Firstly, regarding the persistent swelling in your leg, it’s not uncommon for patients to experience edema (swelling) for an extended period after surgery. This can be due to several reasons, including inflammation from the surgical site, fluid accumulation, and the body’s natural healing response. The fact that your swelling has decreased from the initial post-operative phase is a positive sign, but it may take time for the swelling to completely resolve. Elevating your leg, applying ice, and wearing compression garments can help manage swelling. Additionally, staying active within your limits and performing recommended exercises can promote circulation and reduce edema.

You mentioned experiencing sharp pain on the inner side of your knee when bending and straightening your leg. This could be related to several factors, including irritation of the soft tissues around the knee joint, such as ligaments or tendons, or even residual inflammation from the surgery. It’s essential to communicate these symptoms to your healthcare provider, as they may recommend imaging studies to rule out any complications, such as scar tissue formation or joint issues.

The tightness and discomfort in your ankle and toes, particularly after standing for long periods, may indicate that your body is still adjusting to the changes following your injury and surgery. The tightness could be due to muscle stiffness or weakness, which is common after immobilization. Regular physical therapy can help address these issues by focusing on strengthening exercises and improving flexibility. If you’re experiencing pain in your toe joints, it may be beneficial to consult a podiatrist or orthopedic specialist to assess for any underlying issues, such as joint inflammation or misalignment.

You mentioned that you are undergoing acupuncture and traditional Chinese medicine treatments. These can be beneficial for pain management and promoting healing, but it’s crucial to ensure that these treatments complement your rehabilitation program rather than replace conventional physical therapy. Consistent communication with both your orthopedic surgeon and your alternative medicine practitioners can help create a cohesive treatment plan.

As for the healing of your surgical site, it’s normal for some tenderness to persist as the tissues continue to recover. The healing process can take several months, and factors such as age, nutrition, and overall health can influence recovery. If the pain at the surgical site worsens or if you notice any signs of infection (such as increased redness, warmth, or discharge), it’s essential to seek medical attention promptly.

In summary, managing your recovery involves a multifaceted approach that includes physical therapy, pain management strategies, and regular communication with your healthcare team. It’s essential to remain patient and committed to your rehabilitation exercises while also listening to your body and adjusting your activities as needed. If you have specific concerns about your symptoms or recovery process, don’t hesitate to reach out to your healthcare provider for personalized advice and support. Your journey to recovery may be challenging, but with the right strategies and support, you can work towards regaining your mobility and reducing pain.

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