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ankle pain 10 years after trimalleolar fracture

Approximately 10 years ago I suffered a trimalleor fracture of the right ankle. I was on holiday at the time, and had the ankle re-aligned under local anaesthetic (and gas and air), had a back slab for a few days to allow the swelling to go down before a cast was put on my ankle and I went home. Follow up treatment was continued at my local hospital where they were concerned by the lack of surgery, replaced the cast after 4 weeks (for a further 4 wks) before removal and physiotherapy. I made, what I thought, was a great recovery, although I still had a slight lump on my leg, and the ankle could still be sore if really put through it's paces! Now, 10 years on, I have quite a lot of pain in my ankle - a sharp pain in the outside ankle bone, and a 'hot' pain radiating down the outside bone down towards my ankle. Am worried this may be a bigger problem as I haven't done anything different to normal. It's not practical to 'rest' all the time as I have two under 3 year old at home, and we have recently moved into a house that needs a lot of work! What could this be? Any ideas of treatment gratefully received!!!


RESPONSE
Hi,
I think you already know the problem. As you stated in your description, the doctors who followed up on your fracture were concerned by the lack of surgery. What this tells me is that the alignment of the bones was not optimal but in spite of that all they did was cast your foot and ankle. The broken bones eventually healed but who knows how that left the alignment of your ankle. More than likely, keeping in mind I do not have x-rays to look at, the ankle joint ended up improperly aligned. The analogy would be driving with unbalanced tires. What happens? The tires wear out prematurely.
So, what I am saying is that if your ankle joint is improperly aligned as a result of improper care after your fracture, the ankle joint will wear out at a much more rapid rate then it would ordinarily and that is why you are having pain.
Because you have young children, I assume you are relatively young. What may happen is your pain may subside and you will feel better than you feel now, but, more than likely it will recur again and over time it will recur more frequently and will be more painful as the joint continues to wear out.
What I do not understand is if your local hospital was concerned about the lack of surgery, why they did not go in and surgically correct it. The accident had only occurred a short time earlier so the fractures were still fresh, meaning they could have been surgically repaired.
In any event you are left with this situation and the only advice I can give you is to schedule an appointment with a foot specialist in your area and have the ankle evaluated. There should be options available to you to improve your situation.

Marc Mitnick DPM
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