Persistent Pain and Swelling After Tibia and Fibula Fracture: Is It Normal?

Q: Persistent Pain and Swelling After Tibia and Fibula Fracture: Is It Normal?

Hello： The fracture plate was removed after only 10 days, and the reason for this is unclear. <br>Pain should be assessed on an individual basis, and it is uncommon for it to persist for such a long duration. <br>Recommendations can only be provided after reviewing the postoperat

Persistent swelling and pain after a tibial fracture?

Hello: I was involved in a car accident on June 25, resulting in closed fractures of the left tibia and fibula.
I underwent surgery on the same day, where a steel plate (approximately 15 to 20 centimeters in length) was placed to stabilize the fracture.
I was discharged on July 4.
After discharge, although there was some swelling and pain in my ankle and the sole of my foot during the day, it was manageable (I was taking pain medication).
However, when I lie flat to sleep, the pain in my ankle becomes unbearable.
Neither elevating my foot, applying ice, nor taking pain medication has provided relief.
During my follow-up appointment on July 10, when I mentioned this issue to my doctor, he told me it was a temporary phenomenon that would resolve after a short period.
Now, more than a month has passed, and every night when I lie down to sleep, the pain in my ankle remains unbearable.
I spend each night battling the pain until I am extremely exhausted, managing to sleep for just over an hour before waking up again due to the pain.
I would like to ask the doctor if this situation is normal and if there is hope for improvement.

Lao Fan, 40~49 year old female. Ask Date: 2015/08/04

Dr. Wang Shouji reply Orthopedics

Hello: The fracture plate was removed after only 10 days, and the reason for this is unclear.
Pain should be assessed on an individual basis, and it is uncommon for it to persist for such a long duration.
Recommendations can only be provided after reviewing the postoperative X-rays and conducting a physical examination.
Thank you!

Reply Date: 2015/08/04

More Info

After experiencing a tibia and fibula fracture, it is not uncommon to have persistent pain and swelling, especially in the early stages of recovery. However, the severity and duration of these symptoms can vary significantly from person to person. Based on your description, it seems that you are dealing with significant discomfort, particularly at night, which is affecting your sleep and overall quality of life.

Firstly, it is important to understand that after a fracture, the body goes through a complex healing process. This process involves inflammation, which is a natural response to injury. Inflammation can lead to swelling and pain, particularly in the area surrounding the fracture. The presence of a metal plate for stabilization can also contribute to discomfort as your body adjusts to the hardware.

The fact that you are experiencing severe pain when lying down suggests that there may be several factors at play. One possibility is that the position of your leg while sleeping may be putting pressure on the injured area, exacerbating the pain. Elevating your leg and using pillows to support it may help alleviate some of this discomfort. Additionally, the pain could be related to the healing process itself, where the body is still adjusting to the changes in the bone and surrounding tissues.

You mentioned that your doctor indicated that this pain is a temporary phenomenon. While it is true that many patients experience fluctuations in pain levels as they heal, persistent severe pain that disrupts sleep for over a month warrants further investigation. It is crucial to communicate openly with your healthcare provider about the intensity and persistence of your symptoms. If the pain continues to be unbearable, you may need to seek a second opinion or request further imaging studies, such as an X-ray or MRI, to rule out any complications such as nonunion (where the bone does not heal properly) or hardware-related issues.

In terms of recovery timelines, bone healing typically takes about 6 to 8 weeks for most fractures, but complete recovery, including the resolution of pain and swelling, can take several months. Rehabilitation and physical therapy play a significant role in this process. Engaging in gentle range-of-motion exercises as advised by your healthcare provider can help improve circulation and reduce stiffness, which may contribute to pain relief.

Moreover, consider discussing pain management strategies with your doctor. While over-the-counter pain relievers can be effective, there may be other options available, including prescription medications or alternative therapies such as physical therapy, acupuncture, or massage, which could provide additional relief.

In conclusion, while some level of pain and swelling is expected after a tibia and fibula fracture, the severity and persistence of your symptoms should be addressed with your healthcare provider. It is essential to advocate for your health and ensure that you receive appropriate care to facilitate your recovery. Remember, healing is a process, and with the right support and management, improvement is certainly possible.

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