Swelling and soreness since weight-bearing/syndesmotic screws limiting ROM?
Posted , 7 users are following.
I broke my lateral malleolus 8 weeks ago, am just over 6-weeks post-ORIF. I attended orthopaedics on Friday and had physio where they prescribed that I start weight-bearing. They did tell me to anticipate it being painful. What has surprised me is the variation in pain. One moment it can be almost unbearable to weight-bear with my crutches, and 5 minutes later I can fairly comfortably walk across the room pretty much without needing them.
My concern has been the swelling; things I've read on here have suggested that exercise can sometimes induce swelling. So I was surprised on Saturday evening, to see that for the first time since my accident my bad ankle looked pretty much the same as my good one. However, yesterday evening it was much, much worse - probably about as bad as it's been since I had my cast removed, and similarly today (although it did go down a lot overnight). Also, the shiny, peely, stretched skin on the inside of my ankle has been getting increasingly itchy and sore. Is this normal?
One more concern - the exercises the physio gave me were particularly for stretching and strengthening my tight achilles; however, for the stretching one, I don't feel any stretch because the limiting factor seems to be the stiffness at the front of the joint. I did need two syndesmotic screws through the tib and fib (which the surgeon say they now tend to leave in, although they'll sometimes snap - which it sounds like is a good result), so I'm concerned that this is going to limit my range of motion.
The physio did tell me to expect it to be painful, but essentially that it was going to be very difficult for me to cause it damage - essentially that I should limit my exercise based on not making it hurt so much that I wouldn't come back for more! I've not experienced any pain in my fibula area for weeks, it's all on the inside and top/front, which from my understanding fits with the torn ligaments (deltoid and syndemosis).
1 like, 12 replies
Magic22 matt14241
Posted
Matt:
You have many questions, however first I would say you are only six weeks post op and it's a bit early to expect no pain and great ROM ( range of motion).
I would keep working with your PT and try to find a compromise between under doing and overdoing. Don't wimp out and don't go hog wild overdoing it.
I'm five months post op for TAA (total ankle arthroplasty) with achilles tendon lengthening, spur removal and lateral tendon tightening. I'm just getting to the point of minor pain and near normal gait when walking. ( I do have a history of going overboard in recovery).
It will get better and the time frame can depend on age and effort.
Good Luck.
jessica71699 matt14241
Posted
I am one year out of having a trimalleolar fracture. I can honestly say this has been a very painful and depressing journey. I was 6 weeks non weight bearing. The swelling was a problem for a while. Physical therapist helped the swelling with massage. I would also massage ankle at home. I still have tightness and walk much better with shoes on. I was told it would take a year and that seems to be right on target. I still go down steps with one foot. It still feels very tight but never any swelling. I will have screws and plate removed at some point. As mentioned by someone else on this feed they said removal surgery was not that bad. I want to have more normal movement.
Jillaimee matt14241
Posted
you do sound very much like me - im 9 weeks today - i can walk without the crutches but its painful my pain is the outside and recently the last two toes anybody else have this with the toes ??
Magic22 matt14241
Posted
I too have some generalized numbness around the foot and ankle. This is not unusual post-op dependent upon how many incisions the surgeon had to make. It is likely to improve over time and also nerve areas not impacted by the surgery will adapt and give you reasonable sensation.
Good Luck
M
matt14241
Posted
Thanks for the replies. Things have been continuing as described, but the thing which is really getting me down is pain on the inside of my heel. It feels like a burning sensation - very much like my experience of plantar fasciitis, except very slightly higher than I've experienced, and 100 times worse. It does feel like it's a continuation on the pain on the inside of the ankle rather than PF and seems to be worst when at rest.
mark19591 matt14241
Posted
Seven month's post opp.
Not as sore as was sometimes it feals like a
Stabbing pain only for a few mins.
Can tilt it forward quite far tilt back still hurts. OK to walk down hill up hill hurts.
Generally getting better still using walking sticks. Age 53.
Fibula break two places 4 fixations.
And a dislocation.
mark19591 matt14241
Posted
Moisturising cream helped big time.
Jillaimee mark19591
Posted
ill try the moisturiser how do you think it helped ?
mark19591 Jillaimee
Posted
After the sores had healing I applyed it on me kept skin supple so when it swelled it ever got dry and cracked.
So what soothing also.
It really y works.
matt14241 mark19591
Posted
I've started moisturising it more over the past few days, as the swelling has been making it really tight and like the skin wants to pull it apart. It has really helped, but i do need to do it multiple times per day.
i also gave it a foot soak last night which at least felt nice.
One thing i have noticed is that now that i can take my boot and sock off occasionally, when i put it down on a wood floor etc, it feels freezing cold compared with the other foot. Guess it's a circulation thing.
tom92172 matt14241
Edited
I'm just starting this journey, surgery to plate the spiral fracture of my fibula is scheduled for the 21st. syndesmosis injury is tbd during surgery.
I will say this and hopefully maybe save some people in the future. After my injury i searched around the web a lot and one of the things that jumped out were syndesmotic screws and the frequent snapping of screws and additional surgery to remove, etc .
To my surprise, my orthopedist looked shocked that I was even asking about screws, told me that maybe 10 years ago they might've done that. Or that a "general" ortho might employ that technique. Apparently they (foot/ankle orthos) prefer using syndesmosis "tightrope" now. Same benefits of stabilization without the complications and potential additional surgeries.
Not to say screws don't work, just trying to put info out there for people to ask their ortho as they go through this challenging process. Knowledge is power
andy0278 matt14241
Edited
hi Matt
i am 10 weeks post Op having had a calcaneal osteotomy (heal moved) and ligament reconstruction. This is after a spur removal.
i retain a limp most of the time but the recovery continues. I am committed to recovery and sticking to the plan, its working despite my impatience. Physio is significantly painful but superb in achieving the goals set. I am a positive person but have been low, be true to yourself and you will achieve beyond current expectations.
Swelling is intermittent and I'm told not to worry.
School runs are keeping me sane