ankle pain after fractured foot and ankle

[tcpuccio1]

Hi all.

Question... Back in early June I took a stumble down a couple of stairs chasing my dog and son and rolled my foot up onto the inside of my shin and "fracturing" a bone in my foot and the ankle bone it's self. It was treated just by immobilization with 2 short leg casts for a total of 8 weeks. I then proceeded to have PT for 3 more weeks before I returned to work. I have been back about 3 weeks now and I still have pain in the ankle joint it's self on the inside of the leg in the joint just below and in front of that little knob that juts out. If my foot is twisted or torqued towards the outside it's like someone is sticking a fork inot the joint and from time to time I have a burning sensation there as wel and that spot if pressed on is "tender"l. I know ther had to be some sort of ligament issue in there as well an MRI was performed and I wasn't told of any thing else wrong other than just a bone issue. I have been doing some of the exercises the PT guy gave me but the pain at times has me worried. Other times it feels pretty good and I would say that 95% of my limp has gone as well. Has anyone else had this kind of an issue? I'm sure if it's persistant than some sort of surgery would be in line?? I know these things take time but I'm 4 months inot this right now.

[tcpuccio1]

I keep putting off the obvious that i have to go back to see another OS or podiatrist about my ankle pain it hasn't gottn any better the past 2 weeks or really any worse I'm just stuck at the same spot. I did however try accupuncture A DR. friend of mine is licensed in NY for this. It didn't help. For those of you that may have considered it you should. My friend has told me he has helpt countless people with leg injuries and that is has to just be the right circomstancees for it to work properly but it does work so he says just not in my case. One different thing to my issue is it's finally cold here and we had our first snow of the season that was maeasurable. I went out that night to shovel the driveway so in the AM I wouldn't slip on the ie and break a leg or ankle. after being outside for about 20 minutes i went back in and almost instantly when i hit the warm air my anle felt like someone was driving a gutter spike inot the spot where the issue has been. I haven't had that kind of pain since the original injury! I'm a bit freaked out by it. It was the first time I had been out in the cold since this happend, Does this indicate my fear that there is some sort of tissue damage and the cold just affected it?????

[JainMD]

Hi,
What is your name? How old are you?
I think there is some inflammation happening at the site of injury which is making you feel sore and pain whenever you move around.
You should be doing an imaging study to see the regrowth of bone after fracture.
An imaging study would tell us had the bone grown properly or whether there is malunion?
Is there any tissue overgrowth present which is causing the symptoms?
Whether there is ligament injury or not, either an orthopaedician after examination or an imaging study can tell?
I would like to know what has happened.
What treatment modalities you have employed or are the symptoms still same?
Bye.

[tcpuccio1]

My name is Todd I'm 38 in good health and pretty good condition as well I keep active.  Let me back up The original injury was in mid june and I was initially told just a moderate sprian I wound up walking on it for a month before an MRI was ordered. At that point it was determined that I had bone bruising to the cuboid and talus bones and it was bad enough to treat it as a stress fracture. Thus the cast's for 8 week total. They told me tha tthey was no ligamnet damage that showed up but I have to belive that ther was some maybe a streached nerve?  I still have pain in the inside of my ankle side to side movemnet is okay but any twisting of the leg on the ankle joint is painful. The area where the issue was is tender to the touch and really no swelling but compaired to my righ tankle that area looks a bit deformed it's sort of puffy but not really swolen. I did 3 1/2 weeks of PT before I returned to work. I'm on my feet for 10 hours a day in work boots.  If I'm out in the cold for any length of time when i return back indoors it tightens up and It's hard to walk and it's quite painful.

[JainMD]

Hi Todd,
How are you feeling now?
I think the pain is persisting as ankle joint is a weight bearing joint, plus your work involves you to stand for 10 hours and you had bone bruising of cuboids and talus.
Have you done any imaging after cast and physiotherapy?
What pain meds are you on?
Keep me informed?
Bye.

[tcpuccio1]

I did have a set of X-rays between casts I really don't know what he was looking at he never saw the issue the first time a round. after the second cast was removed he told me that I should progress at a rate that my body told me was safe and he didn't feel that I needed PT  after a week of walking around like apeg legged pirate I contacted my primary DR. and he wrote me a script for PT. I basically was released from the OS I saw after 8 weeks in a cast  and three 1/2 weeks of PT. No further x-rays or imaging was done has been done since early August. I take Advill from time to time when it really flairs up. I have days when it feels okay but other days it really bothers me. I had to chase my Son down in a parking lot last week and it really flaired up and has taken a week for it to subside. like I sated before if the foot is twisted on my leg is when it hurts just straight line walking is okay but that "hot spot" in front or on top of the Talus is still tender 7 months after the fall.

[JainMD]

Hi,
I feel physiotherapy is must and also are pain medicines.
An imaging study would help decide further course of action and would also let us know whether the fracture has healed or if there is any Malunion.
I think passive range of motion around the joint is fine.
You need to take adequate rest after you are back from work.
You should be following rice protocol in evening or whenever at rest.
I know it is meant for initial management, but you can continue to follow.
Rice protocol is as follows:
Rest: Less weight-bearing activities as much as possible.
Ice: apply ice packs to the area that is painful or the focal point of the injury. Apply ice intermittently.
Compression: apply an ACE bandage or other elastic wrap to help prevent swelling.
Elevation: elevate the leg to reduce swelling.
Hope this helps.
Keep me informed.
Bye.

[tcpuccio1]

I do not have a swelling issue per say. Like I stated before that area on the ankle and foot looks different then my right leg but not really swolen. Being on it all day doesn't appear to change the  way it looks and feels when it acts up it doesn't matter if it's in the AM or PM. the compression thing doesn't work because the area is pretty much tender to the touch and pressing on it with an ace bandage  is not a good feeling. One thin that really makes it not feel good is while sleeping if my foot is flexed downward like sleeping on your stomache it will wake my up