Post-Screw Removal Recovery: Pain and Weakness After Lisfranc Fracture

Issues related to the removal of metal screws and recovery?

Doctor, I have a question.
I had a Lisfranc fracture in my right foot, specifically in the first and second metatarsals, on August 4th of last year, and I had three steel pins inserted.
The pins were removed on September 22nd, but I currently feel some weakness when walking, and I experience pain and sudden sharp pains at the site where the pins were removed.
Is this normal? Do I need to return for a follow-up? (I am currently using a cane for support because I am afraid of falling again.) I have noticed that walking barefoot is less painful, but wearing shoes causes pain after a short time.
What kind of rehabilitation should I undergo? Given my current condition, is it safe to drive or ride a motorcycle, considering it has not yet been three months since the injury?

Xue, 30~39 year old female. Ask Date: 2023/11/15

Dr. Wang Shouji reply Orthopedics

Hello, if the description is accurate, it has been over a year since the surgery, and most walking activities should cause only mild discomfort.
If there is still discomfort, an orthopedic outpatient examination is necessary to check for any abnormalities.
Changhua Hospital cares about your health.
Dr.
Wang Shou-ji.

Reply Date: 2023/11/15

More Info

After undergoing surgery for a Lisfranc fracture, it is not uncommon to experience pain, weakness, and discomfort in the affected foot, especially after the removal of screws. The Lisfranc joint complex is crucial for maintaining the stability and function of the foot, and injuries in this area can lead to prolonged recovery times and complications.
The symptoms you are experiencing—weakness, pain at the site of screw removal, and sudden sharp pains—are relatively normal in the post-operative phase. After the removal of hardware, the body needs time to heal and adapt. The pain you feel when wearing shoes compared to walking barefoot may be due to several factors, including the pressure from the shoe on the healing tissues, the fit of the shoe, and the overall strength and stability of the foot as it continues to recover.

In terms of recovery, it is essential to understand that healing from a Lisfranc fracture can take several months, and the timeline can vary significantly from person to person. The fact that you are still experiencing discomfort nearly three months post-screw removal suggests that your body is still in the healing process. The presence of weakness and pain can be attributed to muscle atrophy from immobilization, inflammation, or even nerve irritation in the area surrounding the surgical site.

Regarding your question about whether you should return for a follow-up appointment, it is advisable to consult your orthopedic surgeon or healthcare provider. They can assess your healing progress, rule out any complications such as infection or improper healing, and provide tailored advice based on your specific situation.

As for rehabilitation, physical therapy is often recommended after the removal of screws to help regain strength, flexibility, and function in the foot. A physical therapist can design a program that includes exercises to strengthen the muscles around the foot and ankle, improve range of motion, and enhance balance. It is crucial to start with gentle exercises and gradually increase intensity as tolerated.
In terms of activities like driving or riding a motorcycle, it is essential to ensure that you have adequate strength and control over your foot before engaging in these activities. If you are still experiencing significant pain or weakness, it may be best to wait until you have improved further. Always prioritize safety and consult with your healthcare provider before resuming such activities.

In summary, while your symptoms are common after Lisfranc fracture surgery and screw removal, it is crucial to monitor your recovery closely. Engage in physical therapy, follow your doctor's advice, and do not hesitate to seek further evaluation if your symptoms persist or worsen. Healing takes time, and with appropriate care and rehabilitation, you should see gradual improvement in your condition.

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