Recovery After Ligament Screw Removal: Walking Tips and Pain Management

Recovery after ligament screw removal..?

Hello, Doctor...
I suffered a fracture in my right ankle on June 23 of this year and underwent surgery at Peace Hospital for internal fixation with screws.
I have been in a cast since then.
The doctor mentioned that my ligaments were also torn and were fixed with screws.
Last week, the doctor arranged for me to return to the hospital to remove the screws that were fixing the ligaments and said that I can now put weight on my foot and walk, but I still need to keep the cast on.

I started practicing walking over the past two days, but I feel a dull ache in my heel and around the area where the screws are located inside the bone.
The doctor said it’s okay, but I still feel apprehensive...
Is it really safe to put weight on my foot and even walk without a walker? The doctor mentioned that walking is necessary to prevent the ligaments from becoming stiff, which is also why the screws were removed first.

Are there any restrictions on how much I can walk? Why do I still feel swelling in my foot?

Wánzi mā, 20~29 year old female. Ask Date: 2004/08/16

Dr. Shi Qiming reply Orthopedics

Dear Sir/Madam,
On June 23, 1993, you underwent surgery for a right ankle fracture and ligament tear, with the use of metal screws for fixation.
Based on your current description, it is difficult to fully understand the specific location of the fracture and which ligament is torn, making it challenging to provide treatment recommendations.
Regarding whether to use a walker or cane while practicing walking, I generally recommend using a cane or walker for assistance.
Whether you can put weight on your foot or use a cane depends on the specifics of the fracture.
Typically, it is advised to start with partial weight-bearing.
It is common to experience swelling when first practicing walking, so you should gradually increase your activity level over time.
Orthopedics Department, Hsinchu Hospital, Department of Health, Executive Yuan

Reply Date: 2004/08/16

More Info

Recovery after a ligament screw removal, especially following a fracture and surgical intervention, can be a complex process that requires careful management and understanding of your body’s signals. It’s great to hear that you are on the path to recovery after your ankle fracture and the removal of the screws. Here are some insights and tips regarding your concerns about walking, pain management, and the overall recovery process.

Understanding Your Recovery
After a fracture, especially one involving ligaments, it’s common to experience discomfort as you begin to put weight on the affected leg. The pain you’re feeling in the heel and around the area where the screws were removed is not unusual. This discomfort can be attributed to several factors:
1. Healing Process: Your body is still in the healing phase. The bone and surrounding tissues are adjusting to the stress of weight-bearing activities. This adjustment can lead to soreness and discomfort.

2. Scar Tissue: After surgery, scar tissue can form around the surgical site, which may contribute to feelings of tightness or pain when you start moving.

3. Muscle Weakness: After being immobilized in a cast, the muscles around your ankle may have weakened. As you begin to walk, these muscles are re-engaging, which can lead to soreness.

Walking Tips
1. Gradual Weight-Bearing: Start by putting minimal weight on your foot and gradually increase as tolerated. Listen to your body; if you feel pain, it’s a signal to ease off a bit.

2. Use of Assistive Devices: While your doctor has indicated that you can start walking without an assistive device, it might be wise to continue using crutches or a walker for additional support until you feel more confident. This can help prevent falls and further injury.

3. Footwear: Ensure you are wearing supportive footwear that provides stability. Avoid walking barefoot or in flip-flops, as these can increase the risk of slipping or twisting your ankle.

4. Practice Balance: Engage in balance exercises to strengthen your ankle and improve stability. Simple exercises like standing on one leg (with support if needed) can help.

5. Short Distances: Start with short distances and gradually increase as your comfort level improves. This will help your body adapt to the new demands being placed on it.

Pain Management
1. Ice Therapy: Applying ice to the ankle can help reduce swelling and numb the pain. Make sure to do this for 15-20 minutes several times a day, especially after walking.

2. Elevation: Keep your foot elevated when resting to help reduce swelling. This can be particularly helpful after you’ve been on your feet.

3. Pain Relief Medications: Over-the-counter pain medications, such as ibuprofen or acetaminophen, can be helpful in managing pain. Always consult your doctor before taking any medication.

4. Physical Therapy: If you haven’t already, consider working with a physical therapist. They can provide tailored exercises to strengthen your ankle and improve range of motion, which can alleviate pain over time.

Addressing Swelling
Swelling is a common occurrence after surgery and can persist for some time. Here are a few reasons why you might still experience swelling:
- Inflammation: Your body is still healing, and inflammation can cause swelling.

- Activity Level: Increased activity can lead to temporary swelling as the body responds to the new demands.

- Fluid Retention: Sometimes, the body retains fluid in response to injury, which can contribute to swelling.

Conclusion
In summary, while it’s normal to experience some discomfort and swelling as you begin to walk again, it’s crucial to listen to your body and proceed cautiously. Gradually increasing your activity level, managing pain effectively, and considering physical therapy can significantly aid your recovery. Always keep an open line of communication with your healthcare provider to address any concerns or changes in your condition. Remember, recovery is a journey, and it’s okay to take it one step at a time.

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