Pain and Recovery After Ankle Fracture and Dislocation

Questions regarding suspected fracture and dislocation of the left ankle?

Hello Dr.
Yeh,
I would like to ask you about my husband.
On November 9th, he suffered a fracture and dislocation of his left ankle while playing basketball.
On November 10th, he underwent surgery for fixation and reduction of the dislocation.
On December 3rd, he had a fiberglass cast applied.
Throughout this month, he frequently complains of pain (sharp pain, aching, etc.), and during his weekly follow-up visits, the doctors have not provided clear answers to his questions (only advising him to elevate his leg and apply ice).
This has left us quite puzzled, and we are unsure how to proceed.

On December 7th, he experienced pain at the surgical site on the outer side of his left ankle (a 2 cm incision), and the doctor mentioned inflammation inside.
Why is this happening? How long until he feels no pain? Can the fixation hardware cause inflammation? Additionally, on December 9th, he accidentally stepped on his left foot with crutches, resulting in a sudden tingling pain.
What should we do? Could this lead to another dislocation? We are really worried.
Thank you for your response!

Tinna, 20~29 year old female. Ask Date: 2005/12/09

Dr. Ye Qingnian reply Orthopedics

After orthopedic surgery and casting, there should generally not be significant pain.
If there is severe pain, it may indicate issues such as wound infection or poor circulation (swelling).
A wound infection can cause a damp sensation inside the cast due to secretions and compromised circulation.
Swelling is often exacerbated by prolonged sitting or standing, leading to poor blood return and pain from the swollen limb.

In cases of wound infection, the cast may need to be opened at the surgical site for dressing changes.
To manage swelling, it is important to actively elevate the limb and engage in gentle movement.
If swelling persists, the cast may need to be removed.
Until the fracture has healed, full weight-bearing on the affected limb should be avoided.
If there is concern about displacement, an X-ray can determine if there has been any shift in the fracture.

Reply Date: 2005/12/09

More Info

After an ankle fracture and dislocation, it is common for patients to experience significant pain and discomfort during the recovery process. Your husband's situation, where he sustained an ankle fracture and dislocation while playing basketball, followed by surgical intervention, is not uncommon. The pain he is experiencing can be attributed to several factors related to the injury and the healing process.

Firstly, the pain he describes, such as sharp or stabbing sensations, is typical after such injuries. This pain can arise from various sources, including inflammation, nerve irritation, and the healing of soft tissues around the fracture site. After surgery, the body goes through a natural healing process, which often involves inflammation. This inflammation can lead to swelling and pain, particularly around the surgical site. The fact that he has a small incision (2 cm) from the surgery indicates that there was significant trauma to the surrounding tissues, which can contribute to ongoing discomfort.

Regarding the inflammation mentioned by the doctor, it is not unusual for surgical sites to become inflamed, especially if there is a reaction to the hardware (such as screws or plates) used during the surgery. In some cases, the body may react to the metal implants, leading to localized inflammation. This can cause pain and tenderness around the surgical area. The use of ice and elevation, as advised by the physician, is a standard recommendation to help reduce swelling and manage pain.

As for the timeline for recovery, it varies significantly from person to person. Generally, after an ankle fracture, patients can expect to experience pain for several weeks to months, depending on the severity of the injury and the individual's healing capacity. It is not uncommon for patients to still feel discomfort even after the initial healing phase, especially when they begin to bear weight on the affected limb.

Regarding the incident where your husband accidentally stepped on his left foot, it is understandable to be concerned about the potential for re-injury or dislocation. If he felt a sudden pain or tingling sensation after stepping down, it could indicate that the ankle is still vulnerable during the healing process. It is essential to monitor his symptoms closely. If he experiences increased pain, swelling, or instability in the ankle, it would be prudent to consult with his orthopedic surgeon promptly to assess the situation.

In terms of rehabilitation, it is crucial to follow the doctor's recommendations closely. Physical therapy often begins once the fracture has stabilized, and the patient is ready to start weight-bearing activities. The goal of rehabilitation is to restore range of motion, strength, and function to the ankle. If your husband is still experiencing significant pain, it may be necessary to adjust his rehabilitation plan to ensure he is not pushing himself too hard too soon.

In summary, pain and discomfort after an ankle fracture and dislocation are common and can be attributed to inflammation, healing tissues, and potential reactions to surgical hardware. It is essential to maintain open communication with the healthcare provider, especially if there are concerns about pain management or the risk of re-injury. Encourage your husband to adhere to the rehabilitation plan and report any concerning symptoms to his doctor. With time, patience, and appropriate care, he should gradually experience relief from pain and regain function in his ankle.

Similar Q&A

Understanding Ankle and Heel Pain After Fracture Recovery

Hello Doctor: At the end of September this year, I fell down the stairs and fractured my right foot. I have been treated with anti-inflammatory medication, calcium supplements, and a cast. The fracture has healed, and X-rays show no external damage. However, after the fracture he...

Dr. Hong Ximing reply Orthopedics
A-Chen: Hello, I'm not sure which part of the foot you are referring to as the "foot bone." However, after a fracture has healed and the cast has been removed, it can still affect the movement of the joints and ligaments. Therefore, it is important to continue with...

Understanding Talus Fractures: Recovery and Pain Management After Surgery

Hello, doctor. On August 15th of this year, I twisted my left ankle while jumping and landing during a badminton game (there was a dislocation), which resulted in a comminuted and displaced fracture of the talus (this is the diagnosis given by the doctor). I was taken to the emer...

Dr. Chen Bochen reply Orthopedics
Hello, generally speaking, if a fracture has successfully healed, you can gradually increase the intensity of rehabilitation to recover. However, whether it has healed properly must be determined by the surgeon based on imaging and clinical symptoms. Additionally, talus fractures...

Understanding Open Ankle Fractures: Recovery, Pain Management, and Rehabilitation

Hello, Doctor! I was in a car accident at the end of February this year and later discovered that I had an open fracture in my ankle with bone displacement and a crack in the ankle bone. I underwent surgery three days after the accident, where they inserted six screws and one pla...

Dr. Li Wenlin reply Orthopedics
Hello, handsome: 1. An ankle fracture can sometimes cause injury to the interosseous membrane between the tibia and fibula, leading to separation. If this is the case, a long steel nail may be placed at an appropriate position to span the fibula, interosseous membrane, and tibi...

Understanding Ankle Fractures from Car Accidents: Pain and Recovery Insights

Regarding the ankle fracture pain caused by a car accident, the accident occurred on June 23, 2015, and an X-ray confirmed a fracture of the left lateral malleolus. After the cast was removed on August 12, 2015, rehabilitation was initiated in the physical therapy department. By ...

Dr. Shi Guozheng reply Orthopedics
If a fracture is non-displaced, surgery is not necessary. Ankle injuries typically take about three months to gradually heal, while numbness may take approximately six months to fully recover.