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The response to the question below was authored by Marc Mitnick DPM

Ankle problems

by tammy
(wellston ohio)

My 15yr old son had surgery on august 12 2013 to repair a broken ankle, A plate and 4 screws were used to repair the break. Since the surgery he has and swelling, pain and seeping at the surgery site. The orthopedic doctor has diagnosed this as a staph infection, he has been taking clindamycin. However he has not gotten better the doctors in this practice seem puzzled. Could the screws and plate be the cause of the repeated infections?

RESPONSE

Hi Tammy,

"Puzzled" is not going to make your son's ankle get better. If your son has been on Clindamycin for more than a couple of weeks and nothing has improved, then a new strategy is necessary.
You are correct in your question about the hardware being part of the problem. In spite of the sterility of the inserted hardware, the surgical area can get infected (just like any other surgery), but the problem is the hardware can harbor bacteria, once present, and make it difficult for an infection to clear up.
If the doctors are convinced that there is an infection brewing and not a case of inflammation due to a lot of surgery in a small area, or perhaps a reaction to the implanted hardware (rare), then in my opinion they need the help of an infectious disease specialist.
If I understand the time line correctly, this problem has been going on for months, not weeks and if that is truly the case, I would also consider an MRI of the ankle to get a better "picture" of what may be going on. A bone scan would not be indicated at this point.
Some or all of my suggestions may have already been carried out, as you do not really elaborate, but the point to be made here is that you cannot just stay on Clindamycin indefinately and hope the infection goes away. More aggressive evaluation needs to be made.

Marc Mitnick DPM
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ADDITIONAL REFERENCES

Mayo Clinic

Johns Hopkins Medicine

MedlinePlus

Arthritis Foundation

University of Rochester Medical Center

Harvard Health

Drugs.com

American Academy of Pediatrics

Penn State Medical Center

National Institutes of Health

Columbia University Department of Rehabilitation

ScienceDirect

Stanford Health Care

Illinois Bone and Joint Institute

Mount Sinai Hospital

Institute for Chronic Pain

University of Florida Health

American Family Physician

Cedars-Sinai

University of Maryland Medical Center

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Unknown location

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Poland

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South Carolina

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location unknown

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location unknown

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Seattle, WA

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location unknown

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New Jersey

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location unknown

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San Diego, CA

Dr. Mitnick, Just want to say thank you so very much for your quick response and very informative reply! After reading what you had to say, I called the doctor's office and was able to get in and see him the same day as my injury. Toe was x-rayed and luckily, it is not broken or fractured. Very badly bruised and will probably lose the toe nail. And although my toe and toe nail are still very black and blue and very sore, they ARE both starting to feel a little better. So again, thank you! I am so very happy that I came across your website. The service you provide is outstanding and immeasurable!

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Albany, NY

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location unknown

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Whichita, KS

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Colorado

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Colorado

Wonderful advice

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This is the best site for foot problem info.

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location unknown

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location unknown

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location unknown

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North Carolina

Many Thanks Dr Marc!
Thank you for your response. It sounds like a good plan to me. He did not cut the wart out first ...

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location unknown

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Florida

Dear Dr. Mitnick, Thank you so very much for taking your time to answer my question. You have greatly relieved my anxiety related to the continual tingly I feel in my feet. I will share your response with my podiatrist next week. God bless you for having this question and answer page on your website! Most gratefully,

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location unknown

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a mom

location unknown

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Bellevue, WA

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location unknown

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