Why Is My Ankle Still Swollen After a Fracture? Causes and Solutions

Swelling on the posterior lateral aspect of the ankle?

Hello, I sustained a fracture at the base of the fifth metatarsal in my left foot on February 7th, and it has been over two months now.
Why is there still swelling on the outer back of my ankle? It hurts when I walk.
Is there an issue with the bone? What should I do? Thank you for your response.
Why does my foot still swell at times?

Feng Qiu Shuang Qing, 20~29 year old female. Ask Date: 2014/04/26

Dr. Shi Guozheng reply Orthopedics

Fractures in the bones of the foot may not have healed properly, which can lead to swelling during standing, walking, or excessive exertion.
Resting with the foot elevated can promote blood circulation, potentially improving the condition.
Over time, most individuals will recover.

Reply Date: 2014/04/26

More Info

After a fracture, it is not uncommon for swelling to persist for an extended period, even after the initial injury has begun to heal. In your case, having sustained a fracture of the fifth metatarsal base on February 7, and now being two months post-injury, there are several factors that could contribute to the ongoing swelling and pain in your ankle.

Causes of Persistent Swelling
1. Inflammation: After a fracture, the body initiates an inflammatory response to heal the injured area. This inflammation can cause swelling, which may take time to subside. Even after the bone begins to heal, the surrounding soft tissues may remain inflamed.

2. Fluid Accumulation: Swelling can also be due to fluid accumulation in the tissues surrounding the fracture site. This can happen if the ankle is not adequately elevated or if there is prolonged immobility.

3. Soft Tissue Injury: Along with the fracture, there may have been soft tissue damage (ligaments, tendons, or muscles) that can contribute to swelling and pain. This damage may not heal as quickly as the bone itself.

4. Inadequate Rehabilitation: If you have not been able to engage in appropriate rehabilitation exercises, this can lead to stiffness and swelling. Gentle range-of-motion exercises are essential to promote circulation and reduce swelling.

5. Weight Bearing: If you have started to bear weight on the injured foot too soon, this can exacerbate swelling and pain. It is crucial to follow your healthcare provider's recommendations regarding weight-bearing activities.

6. Complications: In some cases, complications such as a nonunion (where the bone fails to heal properly) or malunion (where the bone heals incorrectly) can lead to ongoing symptoms. If the fracture has not healed correctly, it may continue to cause pain and swelling.

Solutions and Recommendations
1. Rest and Elevation: Ensure that you are resting your foot and keeping it elevated as much as possible. Elevation helps reduce swelling by promoting fluid drainage away from the injured area.

2. Ice Therapy: Applying ice to the swollen area can help reduce inflammation and numb the pain. Use ice packs for 15-20 minutes several times a day, ensuring to protect your skin with a cloth.

3. Compression: Using a compression bandage can help control swelling. Make sure it is snug but not too tight, as this can impede circulation.

4. Gentle Exercises: Engage in gentle range-of-motion exercises as tolerated. This can help improve circulation and reduce stiffness. Consult with a physical therapist for a tailored rehabilitation program.

5. Follow-Up with Your Doctor: If the swelling persists or worsens, it is essential to follow up with your healthcare provider. They may recommend imaging studies, such as X-rays, to assess the healing process of the fracture and rule out any complications.

6. Medication: Over-the-counter anti-inflammatory medications, such as ibuprofen or naproxen, can help reduce pain and swelling. However, consult your doctor before starting any medication.

7. Gradual Weight Bearing: If you have not yet been cleared for weight-bearing activities, follow your doctor's advice regarding when and how to gradually increase your activity level.

In conclusion, persistent swelling after a fracture can be attributed to various factors, including inflammation, soft tissue injury, and inadequate rehabilitation. It is crucial to manage the swelling through rest, elevation, ice, and gentle exercises while maintaining open communication with your healthcare provider to ensure proper healing and recovery.

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