Broke tib/fib 2 years ago, now the ankle is giving pain

by Kyla
(Citrus Heights, CA)

Hello,

I hope to clear up some confusion I have. I had an open fracture of my right tib/fib in June of 2009. I broke it while quad skating playing roller derby. The break is about 4 inches above the right ankle. I feel pain and stiffness in my right ankle when I get out of bed and it's hard to walk normally. Throughout the day the pain lessens if I keep the ankle and lower leg warm. I walk between 3-5 miles almost everyday and that is my main form of exercise currently.
I healed and could walk with a limp 4 months after the break and I became pregnant 8 months after the break. I'm interested in finding out a few things:
Did pregnancy affect the healing of my ankle?
I was not told I needed physical therapy (Kaiser) and I'm confused about why that is. I was so happy to be able to walk that I didn't think to ask about PT.
How can i get full range of motion back in my ankle? I'm not able to flex it as fully as my left ankle. I can walk down stairs with ease but I'm not able to do yoga comfortably.
Also, my lower leg seems not to have healed straight. While my left foot points forward, my right points slightly outward. While I'm sitting to nurse my baby, my right foot falls asleep and I have to continuously roll my ankle to wake it up. Also I feel a slight hitch often during the day and the only way to relieve it is to flex my ankle as hard as I can until I hear a pop and the pain and hitch feeling go away.
I would appreciate any knowledge you can share with me about this.

Hi Kyla,
What caught my attention in your post is your observation that your two feet do not line up. Your surgical foot points in a different direction than the other foot. On the surface at least, that would mean to me that the surgery did not completely re-align your ankle joint in the proper position and that could go a long way in explaining why you are still having problems.
Keep in mind though, the more severe the trauma the more difficult it is to get proper alignment, particularly in a compound fracture where parts of bone may have been removed to get the tibia and fibular bones back "together".
Why you did not have PT is beyond me, that you would have to ask your surgeon. In most cases PT can be very helpful but it does not necessarily cure all problems.
I would go back to your surgeon or see another foot specialist and explain your complaints. Although there is not much anyone can do to improve the alignment surgically, you might be a candidate for an orthotic designed in a way to compensate for the abnormality you now experience in your right foot. By changing the position of the foot relative to the ground, you can actually create better alignment in the ankle joint, which may give you improved range of motion and thus a reduction in your symptoms.

Marc Mitnick DPM