Post-Surgery Recovery: Addressing Color Changes and Swelling After Ankle Fracture

Post-operative condition after fracture surgery?

Hello Dr.
Chen,
I had surgery for a left ankle fracture due to a car accident in early July, and my condition seems to be quite good so far.
The surgical wound is fine, and I don't feel any pain.
However, I have a concern: the skin color of my entire foot below the ankle appears to be a purplish-black due to poor blood circulation (it's not an alarming shade of purple-black, just darker compared to the normal color of my right foot).
Besides some bruising on the outer side of my foot, everything else looks fine, but my foot is still slightly swollen, and I feel mild pain when pressing on it.
Is this situation normal? Are there any ways to improve this condition, such as using heat therapy? I originally planned to return for a follow-up appointment in mid-August; should I consider going back earlier given this situation? Thank you, Dr.
Chen.

Chen, 20~29 year old female. Ask Date: 2006/07/24

Dr. Chen Xingyuan reply Orthopedics

Dear Reader,
After surgery for an ankle fracture, it is common to experience some swelling or bruising in the foot.
This phenomenon is due to poor peripheral blood circulation resulting from the injury and the surgery.
Typically, this condition improves within about three months.
However, engaging in exercises for the leg and foot muscles and elevating the leg can help promote blood flow and reduce swelling.

Applying heat can aid in local blood circulation and rehabilitation of the ankle joint.
However, it is normal for local tissue to experience slight swelling after heat application; as long as it is not severe or causing significant discomfort, it should not be a concern.
Since your surgery was only three to four weeks ago, some swelling and pain are to be expected.
As long as there is gradual improvement in the swelling and pain, there should not be any major issues.

If the swelling and pain do not improve, worsen, or if there are signs of re-injury, it is best to return for a follow-up appointment as soon as possible.
You should plan to return for your follow-up visit as originally scheduled.

Significant functional improvement is typically observed six months after ankle fracture surgery.
One year post-surgery, 88% of patients report no pain or only mild discomfort, 90% have no restrictions on activity or only limitations in recreational activities, and 90% of patients achieve over 90% functional recovery.
Wishing you health and safety!
Sincerely,
Dr.
Chen

Reply Date: 2006/07/24

More Info

After an ankle fracture surgery, it is common for patients to experience changes in skin color and swelling in the affected area. The purple-black discoloration you are observing in your left foot is likely due to a combination of factors, including blood circulation issues and the natural healing process following your injury and surgery.

When a fracture occurs, especially in the ankle, there can be damage to the surrounding soft tissues, including blood vessels. This can lead to bruising (ecchymosis) and swelling as blood and fluids accumulate in the area. The discoloration you see is a result of blood pooling under the skin, which is a normal response to trauma. The fact that the color is not alarmingly dark suggests that it is within the expected range of post-injury changes.

Swelling is also a common occurrence after surgery. It can be exacerbated by gravity, especially if you are not keeping your foot elevated. Elevating your foot above the level of your heart can help reduce swelling by promoting venous return and decreasing fluid accumulation in the tissues. Ice therapy can also be beneficial in the initial stages post-surgery to reduce swelling and numb any pain. However, after the first few days, heat may be more appropriate to promote blood flow and healing, but it should be used cautiously and not directly on the skin.

As for your pain upon pressing the swollen area, mild discomfort can be expected as your body heals. However, if the pain intensifies or if you notice any signs of infection (such as increased redness, warmth, or discharge from the surgical site), you should contact your healthcare provider immediately.

Regarding your follow-up appointment, if your symptoms are stable and you are not experiencing any concerning changes, it may not be necessary to return to the clinic earlier than planned. However, if you have any doubts or if your condition worsens, it is always best to err on the side of caution and consult your physician. They can provide a thorough evaluation and determine if any adjustments to your recovery plan are needed.

In summary, the discoloration and swelling you are experiencing are common after an ankle fracture surgery and are usually not a cause for concern. Continue to follow your doctor's advice regarding elevation, ice, and activity levels. If you have any persistent concerns, do not hesitate to reach out to your healthcare provider for further guidance. Your recovery is a process, and being attentive to your body’s signals will help ensure a smoother healing journey.

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