Ankle and Heel Pain After Fracture Recovery - Orthopedics

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Hello, 阿陳. It sounds like you’ve been through quite a challenging recovery process after your ankle fracture. Let’s address your concerns regarding the ongoing pain in your ankle and heel after the fracture has healed.

1. Duration of Immobilization and Its Effects: It’s quite common for patients who have been in a cast for an extended period, such as a month, to experience stiffness, discomfort, and pain in the ankle joint after the cast is removed. When a limb is immobilized, the surrounding muscles and joints can become stiff due to disuse. This condition is often referred to as "joint stiffness" or "ankle stiffness," and it can lead to pain when you attempt to move the joint. The pain you feel when sitting or standing for long periods may be due to this stiffness, as well as potential inflammation in the joint.
It is essential to gradually reintroduce movement to the ankle joint. Physical therapy can be beneficial in this regard, as a therapist can guide you through exercises that promote flexibility and strength in the ankle. If you haven’t already, I recommend consulting with your healthcare provider about starting a rehabilitation program tailored to your needs.

2. Potential for Osteochondral Issues: You mentioned the possibility of osteochondral lesions, such as osteochondritis dissecans or cartilage softening. While it’s difficult to diagnose these conditions without imaging, they can occur after fractures, especially if there was significant trauma to the joint. The pain and limited range of motion you’re experiencing could be indicative of such issues, but they are not the only possibilities.
If you suspect that your symptoms may be related to cartilage issues, it’s crucial to discuss this with your doctor. They may recommend advanced imaging techniques, such as an MRI, which can provide a more detailed view of the cartilage and other soft tissues in the ankle.

3. Diagnostic Approaches: Since your X-rays show no abnormalities, further evaluation may be necessary to understand the underlying cause of your pain. An MRI is often the next step for assessing soft tissue injuries, including cartilage damage. Additionally, your doctor might consider other diagnostic tests, such as a CT scan, if they suspect complex fractures or joint issues that X-rays might not reveal.

In summary, the pain and discomfort you are experiencing in your ankle and heel are likely related to the immobilization period and could be exacerbated by stiffness or potential soft tissue injuries. It’s essential to engage in a structured rehabilitation program to regain strength and flexibility in your ankle. If your symptoms persist or worsen, I strongly encourage you to follow up with your healthcare provider for further evaluation and management.
Remember, recovery from a fracture can take time, and it’s important to be patient with your body as it heals. With the right approach, you should be able to regain function and reduce pain in your ankle. Best of luck with your recovery!