Postoperative care after metatarsal osteotomy with screw removal?
Hello, I had a car accident on February 16, resulting in fractures of the 1st, 2nd, and 3rd metatarsals in my right foot.
There were no open wounds, and the following day I had three metal pins and a cast placed.
I had the pins and cast removed on May 1, but now, nearly two weeks later, my right foot tends to swell easily after walking a short distance, and there are still many bruises.
The temperature of my right foot feels higher than that of my left foot, though not to the point of being hot.
When I press on the areas of the 2nd, 3rd, and 4th metatarsals, I experience pain.
The doctor mentioned that I can start rehabilitation walking, but I still have difficulty walking, and my right foot hurts a bit, with noticeable stiffness in the joints.
How long will it take for the swelling and pain to subside? Is the warmth I feel due to ongoing inflammation? Is this normal after two weeks?
Cindy, 20~29 year old female. Ask Date: 2013/05/13
Dr. Shi Guozheng reply Orthopedics
As time progresses, the condition you described will gradually improve.
The slight inflammation is a response of the tissue following surgery, and the swelling should subside in approximately two to four weeks.
Reply Date: 2013/05/13
More Info
Post-surgery recovery, especially after a metatarsal fracture, can be a challenging process. It's common to experience swelling, bruising, and pain during the initial weeks following surgery. Based on your description, it appears that you are experiencing typical post-operative symptoms, but let's break down your concerns and provide some guidance.
Firstly, swelling is a normal response to surgery and injury. After a metatarsal fracture, the body goes through a healing process that involves inflammation, which can lead to swelling in the affected area. The fact that your right foot swells after walking is not unusual, especially considering that you had surgery just a couple of weeks ago. The swelling can be exacerbated by gravity when you are on your feet, so elevating your foot when resting can help reduce this swelling.
Bruising is also a common occurrence after fractures and surgical procedures. The discoloration you see is due to blood pooling under the skin as a result of the injury and the surgical intervention. This bruising typically resolves over time, but it can take several weeks to fully disappear.
Regarding the temperature difference between your right and left foot, it is not uncommon for the injured foot to feel warmer due to increased blood flow and inflammation in the area as part of the healing process. However, if you notice significant warmth or redness, or if the swelling worsens, it would be wise to consult your physician to rule out any complications such as infection.
The pain you are experiencing when pressing on the metatarsal bones is also expected. Post-operative pain can persist as the tissues heal, and it is not unusual for pain to be present when you begin to mobilize the foot. Your doctor has indicated that you can start walking and rehabilitating the foot, which is a positive step towards recovery. However, it’s important to listen to your body. If walking causes significant pain, you may need to adjust your activity level and gradually increase your walking distance as tolerated.
Stiffness in the joints is another common issue following immobilization due to a fracture. The joints can become stiff when they are not used for an extended period. Gentle range-of-motion exercises, as advised by your healthcare provider or physical therapist, can help improve flexibility and reduce stiffness over time.
As for your question about when the swelling and pain will subside, recovery timelines can vary significantly from person to person. Generally, you can expect swelling to gradually decrease over the first few weeks to months, depending on the severity of the injury and your adherence to rehabilitation protocols. Pain should also diminish as healing progresses, but it may take several weeks to months for complete resolution.
In summary, while your symptoms are consistent with the post-operative recovery process, it is essential to maintain open communication with your healthcare provider. They can provide personalized advice based on your specific situation and may recommend additional interventions if necessary. Continue to follow their guidance on rehabilitation exercises, and don’t hesitate to reach out if your symptoms worsen or if you have any concerns about your recovery.
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