I had titanium surgical implant in my ankle to repair a trimalleolar fracture 4 months ago. One month ago the syndismosis screw was removed. How long before the soreness and discomfort goes away?
Person's Gender: Male
Person's Age: 62
I have been through 16 PT sessions, and the only painkiller that seems to work is ibuprofen for general soreness, and percocet when the pain really flares up.
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Did you have soreness and discomfort prior to the syndesmosis screw removal?
Where is the pain? At the incision site of the screw?
yes, it was worse
What other hardware was put in? A plate on the lateral side?
two screws on inside of ankle - plate and supporting screws on outside
I guess I am trying to figure out if the pain and discomfort you are talking about is from the injury, the original surgery, or the screw removal. can you clarify?
I believe it is from the original surgery - ankle was very stiff until syndismosis screw removed.
Well based on your age and that it was a tri-malleolar fracture - that is a bad injury.
Where is the pain exactly?
at the plate site, the incision, or just the whole ankle?
inside ankle at 10 :00 position & outside at 3 :00
how high up the ankle?
near top of the ankle about 2 inches above ankle "point"
also some pain in front of ankle where leg joins foot
So it sounds like the pain is related to the syndesmosis injury if it is at that level or higher.
the anterior ankle injury could be from the original injury or arthritis.
for the most part a tri-malleolar fracture is almost like an ankle dislocation.
what can I do about the soreness/occasional swelling? How long can I expect it to last?
It is hard to say. Usually at 6 months people are pain free. If the hardware is prominent or irritating then it may need to come out. Did the doctor say everything was already healed?
He said bones were healed and I did not need to see him again.
Do you think the pain is related to the plate?
No, I believe it is generalized - if it is localized at all it is at top of ankle and on inside of ankle.
plate side seems ok - just a little stiff
I think if after 6 months it does not go away I would offer you an injection into the ankle to see if that helped. If it did then it probably means the pain is related to arthritis from the ankle trauma. However I would need to see xrays of your ankle to see what we are working with.
If you are stiff then you need to do formal physical therapy. Have you done this yet?
16 2hr sessions
range of motion judged ok by therapist and Dr.
Hmmm and you still feel stiff?
Then you must have a lot of scar tissue in there from the injury.
If you have an arthritis ankle then occasional injections would be the answer.
Curiously, when I get up and walk around the pain diminishes
That is good. Given that you had a bad injury and surgery and your age, the causes of continued pain could be many: arthritis, loose body/cartilage, scar tissue/nerve injury, or hardware irritation.
thanks - we'll see @ 6 months
I think maybe mention to your surgeon the continued pain and see if he would give you an injection. If you get relief from the injection then the pain is from the ankle joint itself.
Ok good luck.
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