Post-Surgery Concerns: Will Screws Shift After Ankle Ligament Repair?

Fracture of the bone above the left ankle joint with ligament tear?

Hello, doctor! I would like to ask you about my condition.
I have a sports injury that caused a separation of the bone above the joint on the outer side of my left foot, along with a ligament tear.
After observing for six weeks, the doctor decided to perform a screw fixation surgery.
The surgery was completed on April 17th in the afternoon.
Three days later, the pain was not as severe.
However, my left foot has been moving and I have been putting weight on it.
Will the screws that were just inserted shift or come out due to my movement or weight-bearing?

Liu Xiaojie, 10~19 year old female. Ask Date: 2022/05/22

Dr. Chen Bochen reply Orthopedics

Hello, ordinary screws are not that fragile.
If the screws are loose, it usually accompanies an increase in pain, and there would be noticeable pain at the moment of injury.
If you are still concerned, you can return for a follow-up appointment and ask your original surgeon to perform an X-ray.

Reply Date: 2022/05/22

More Info

After undergoing surgery for an ankle ligament repair, it is understandable to have concerns about the stability of the screws used during the procedure. The surgery you described, which involved the use of screws to stabilize the bone and repair the torn ligaments, is a common approach to treating such injuries.
To address your primary concern: it is unlikely that the screws will shift or displace due to normal movements or minor weight-bearing activities shortly after surgery. Surgical screws are designed to provide strong fixation and are typically placed in a manner that allows for stability during the healing process. However, there are several factors to consider regarding your recovery and the integrity of the surgical repair.

1. Healing Process: After surgery, the body begins a healing process that involves inflammation, tissue repair, and remodeling. During the initial weeks, the ligaments and surrounding tissues are particularly vulnerable. While you may feel less pain after a few days, it is crucial to follow your surgeon's post-operative instructions regarding weight-bearing and activity levels.
2. Weight-Bearing Restrictions: Most surgeons will provide specific guidelines on when and how much weight you can put on your ankle. If your doctor has advised you to avoid putting weight on the ankle for a certain period, it is essential to adhere to those recommendations to ensure proper healing and avoid complications such as screw displacement or failure of the repair.

3. Physical Activity: Light movements, such as gentle range-of-motion exercises, may be encouraged to prevent stiffness, but more vigorous activities or weight-bearing should be approached with caution. If you accidentally put weight on your foot or move it in a way that causes discomfort, it is advisable to consult your surgeon to assess the situation.

4. Signs of Complications: Be vigilant for any signs of complications, such as increased pain, swelling, or instability in the ankle. If you notice any of these symptoms, it is crucial to contact your healthcare provider immediately. They may recommend imaging studies, such as X-rays, to evaluate the position of the screws and the overall integrity of the repair.

5. Follow-Up Appointments: Regular follow-up appointments with your surgeon are essential to monitor your recovery. During these visits, your doctor will assess the healing process and may perform imaging studies to ensure that the screws remain in the correct position and that the ligaments are healing properly.

6. Rehabilitation: Once your doctor gives you the green light, engaging in a structured rehabilitation program is vital. Physical therapy can help restore strength, flexibility, and function to your ankle. A physical therapist will guide you through exercises that are safe and appropriate for your stage of recovery.

In summary, while it is normal to have concerns about the stability of screws after ankle surgery, following your surgeon's advice and being mindful of your activities will significantly reduce the risk of complications. If you have any doubts or experience unusual symptoms, do not hesitate to reach out to your healthcare provider for guidance. Your recovery is a process, and being proactive about your care will help ensure the best possible outcome.

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