Post-Surgery Pain Levels and Recovery After Ankle Fracture Fixation

After the fracture reduction surgery, there is a reduced sensation of pain?

Hello, Doctor.
I suffered an open fracture of the left ankle due to a car accident on August 11.
After surgery, I had a plate and screws placed for fixation.
I am unsure if my recovery is progressing well.
I was discharged a week post-surgery and have hardly taken any pain medication since then.
Three weeks after the fracture, there is still some swelling, but not much pain, so I have started to put weight on my foot.
During a follow-up appointment on September 3, the doctor said the plate was fine.
Recently, I have not felt much pain, so I have been trying to walk with a brace and a single crutch for support, and I can even stand without additional support.
However, yesterday I noticed that I could clearly feel the plate protruding at the fixation site, and it is visibly raised when my foot is flat.
I hadn't intentionally touched it before, so I'm unsure if it has shifted.
I would like to ask the doctor if it is normal for the fracture site to have little pain after surgery? Is it appropriate to start walking slowly three weeks post-surgery if there is no pain? If the plate has shifted, would that cause pain? And if it has shifted, would it have significant implications? Thank you, Doctor.

Takeda, 20~29 year old female. Ask Date: 2015/09/11

Dr. Shi Guozheng reply Orthopedics

After the swelling from a fracture subsides, it is sometimes normal to feel the metal plate beneath the skin.
If the plate has shifted, it is likely to cause pain.
During your follow-up appointment, please ask your doctor to perform an X-ray to assess the condition of the fracture site.

Reply Date: 2015/09/11

More Info

Post-surgery recovery after an ankle fracture fixation can vary significantly from patient to patient, and your experience seems to reflect a generally positive trajectory. It’s great to hear that you have been managing your pain well and have been able to reduce your reliance on pain medication. Here’s a detailed response to your questions and concerns based on medical knowledge and common practices in orthopedic recovery.

Firstly, the absence of significant pain three weeks post-surgery is often a good sign. After an ankle fracture fixation, it is common for patients to experience some swelling and discomfort, but if you are feeling minimal pain, it may indicate that your body is healing well. Pain levels can vary based on several factors, including the severity of the fracture, the surgical technique used, and individual pain tolerance. It’s important to listen to your body; if you feel comfortable and your doctor has cleared you for weight-bearing activities, gradually increasing your activity level can be beneficial.

Regarding your attempt to bear weight on your ankle, it’s crucial to follow your surgeon's recommendations. If your doctor has advised you to start putting weight on your foot, doing so with the aid of a brace and crutches is appropriate. This approach helps to ensure that you are not placing undue stress on the healing bone and surrounding tissues. However, if you experience any sudden increase in pain or discomfort, it’s essential to stop and consult your physician.

You mentioned that you can feel the plate under your skin and that it appears to be protruding. This is not uncommon after surgery, especially if the plate is placed close to the surface of the skin. However, if you notice any changes in the shape of your ankle, increased swelling, or pain at the site of the plate, it could be a sign of complications such as infection or hardware issues. Generally, if the plate were to shift significantly, it could potentially cause pain, but this is not always the case. Some patients may experience discomfort due to hardware prominence without any actual displacement.

If you are concerned about the possibility of the plate moving, it’s advisable to discuss this with your orthopedic surgeon. They may recommend imaging studies, such as an X-ray, to assess the position of the hardware and ensure that everything is in place. It’s essential to address any concerns about hardware migration or complications early on to prevent further issues.

In summary, your current recovery progress seems to be on track, with minimal pain and the ability to bear weight. However, always prioritize communication with your healthcare provider regarding any changes in your condition. They can provide personalized advice based on your specific situation and ensure that your recovery continues smoothly. Remember, while it’s important to regain function and mobility, it’s equally crucial to do so safely to avoid setbacks in your healing process.

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