Ankle Pain After Surgery: Is It Normal?

Ankle fracture

At the end of July, I sustained a closed fracture with dislocation of both ankles in my right calf and underwent surgery, during which steel pins and plates were inserted.
By the end of August, I stopped using a walker, and I began rehabilitation in early September.
However, starting Thursday night of this week, I experienced pain on the right side of my ankle that made it difficult to walk.
On Friday, I went to the hospital for an examination, and the doctor said that I had been walking too frequently, causing my foot to become overloaded and leading to a rebound effect.
I rested until Saturday, but the pain did not decrease and showed no signs of improvement.
Prior to this, I had not fallen; I only had to walk longer distances between classrooms at school.
Is this level of pain considered normal?

Xiao Xue, 20~29 year old female. Ask Date: 2022/09/24

Dr. Chen Bochen reply Orthopedics

Hello, Xiaoxue.
Generally, after more than 1.5 months, there should not be severe pain when walking.
If there is no improvement after taking medication and resting for three days, it is important to seek medical attention for further examination as soon as possible.

Reply Date: 2022/09/24

More Info

Experiencing pain after ankle surgery, particularly following a closed fracture and the placement of hardware such as screws and plates, is not uncommon. In your case, it seems that you have undergone a significant surgical procedure, and the recovery process can be complex and variable from person to person.
Firstly, it is essential to understand that post-operative pain can arise from several factors. After surgery, the body goes through a healing process that involves inflammation, tissue repair, and sometimes nerve irritation. The pain you are experiencing could be attributed to a few potential causes:
1. Post-Surgical Inflammation: After any surgical procedure, inflammation is a natural response as the body begins to heal. This inflammation can lead to swelling and pain around the surgical site, which may be exacerbated by increased activity levels.

2. Overuse or Strain: You mentioned that you resumed walking without the aid of a walker and that your school environment requires you to walk between classrooms. This increased activity may have placed additional strain on your healing ankle, leading to pain. It is crucial to gradually increase activity levels and listen to your body’s signals. If you push too hard too soon, it can lead to a setback in your recovery.

3. Hardware Sensitivity: The presence of screws and plates can sometimes cause discomfort, especially as the surrounding tissues heal. Some patients report pain related to the hardware, particularly if the hardware is prominent or if there is any irritation of the surrounding soft tissues.

4. Potential Complications: While less common, it is essential to rule out complications such as infection, hardware failure, or issues with bone healing (nonunion or malunion). If the pain persists or worsens, it is crucial to follow up with your healthcare provider for further evaluation.

Given that you have already consulted with your doctor, it is good that they have assessed your situation. However, if the pain does not improve with rest, or if you experience increased swelling, redness, or fever, you should seek medical attention promptly.
In terms of management, here are some recommendations:
- Rest and Ice: Allow your ankle to rest and apply ice to reduce swelling and pain. Avoid putting weight on the affected ankle until you can do so without significant pain.

- Gradual Increase in Activity: Once the pain subsides, gradually reintroduce activities. Consider physical therapy to help guide your rehabilitation and ensure you are strengthening your ankle appropriately without overdoing it.

- Pain Management: Over-the-counter pain medications, such as ibuprofen or acetaminophen, can help manage pain and inflammation. Always consult with your healthcare provider before starting any medication.

- Follow-Up: Keep regular follow-up appointments with your orthopedic surgeon or physical therapist to monitor your recovery and make any necessary adjustments to your rehabilitation plan.

In conclusion, while some pain after ankle surgery can be normal, especially with increased activity, it is essential to monitor your symptoms closely. If the pain persists or worsens, further evaluation may be necessary to rule out any complications. Remember, recovery is a process, and it is vital to be patient with your body as it heals.

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