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The response to the question below was authored by Marc Mitnick DPM
sudden pain 2 years after breaking ankle
by Jackie
(hayes Middlesex uk)
post operative broken ankle with screws and plates
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I broke my ankle in 3 places 2 1/2yrs ago. The metal work was removed 1 year ago. I haven't had too much problem since except a little tightness in the achilles occasionally. 2 weeks ago I did a voluntary position that involved a lot of standing for 3-4 hours at a time. Since then I have started getting sharp stabbing pain when I walk on the inside of my ankle. This occurs approx 5-6 times a day when walking.
RESPONSE
Hi Jackie,
When looking at x-rays of previously fractured ankles and their subsequent surgical correction, the first thing I look at is the actual alignment of the foot relative to the tibia and fibula bones, all of which make up the ankle joint. Looking at the x-ray with the plate and screws it appears that the alignment is good.
So, that leaves me with two possible scenarios. One would be that the fracture where the long screw was placed (and since removed) may not be completely healed, meaning at this point in time you ended up with what is known as a hypertrophic union where the fracture site did not completely heal all the way through and you have some degree of scar tissue in the old fracture site. A new x-ray might demonstrate that problem. It is impossible to tell from the x-ray with all the hardware inside the ankle.
Another possibility is a tendon or ligament problem on the inside of the ankle; I am leaning more towards ligament problem, specifically one of the medial ankle ligaments that attaches the inside bone to the foot.
It may have been partially damaged during the trauma and while you were recuperating from the surgery and resting the foot and ankle, the ligament healed, but again, with scar tissue. So...when you are called upon to be on the foot for long periods of time, the ligament becomes strained and it begins to hurt. Once it started to hurt, you may now notice it more often because it is strained.
Of course I am only guessing here because I do not have the luxury of examining you.
If you find that these episodes are very painful and if you find they are becoming more frequent in occurrence and more painful each time, then you need to seek medical treatment to find the cause of your pain.
If on the other hand, you notice that the episodes of pain are becoming less painful and are occurring less frequently, then you might want to wait a while and see if the problem does not disappear on its own.
Marc Mitnick DPM
DISCLAIMER
ADDITIONAL REFERENCES
University of Rochester Medical Center
American Academy of Pediatrics
Columbia University Department of Rehabilitation
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