48 yr old female with fracture

by Terri
(new york )

I have been diagnosed with an ankle fracture on my right ankle the outer edge below the ankle i feel like its more than just a fracture . would just like to know if it is common to have pain over the back of the heel and across top of foot i am beginning to think it is more than a fracture it has been almost six weeks i had a cast on for three weeks and i am now wearing a removable boot for three weeks this injury happened on the 31 st of may i am still getting quite a bit of swelling when i walk with the boot is this normal

RESPONSE

Hi Terri,

Pain is a relative term. The same injury in two people many times will end up with two different experiences.
There is a lot that goes into the amount of pain one may experience from an injury. Primarily the extent and mechanism of injury will determine if a person is going to have a lot of pain or not.
Pain thresh hold is another aspect. One person may be screaming "bloody murder" while the next person will say the injury is "no big deal".
So...on the surface it would seem that after six weeks you are having more pain than one would anticipate. I am not all that concerned about the areas of the foot and ankle that you mention because along with a fracture, there is usually soft tissue injury as well and your complaints do sound like soft tissue injury.
Since you live in New York, I can go out on a limb and suggest the added heat and humidity only slows down the healing process or said another way exacerbates the pain that you are experiencing.
The rule of thumb I give my patients is to assess their pain level each week. If the amount of pain they are experiencing this week is any degree less than last week, then they are doing fine. Everyone heals at a different rate so it is difficult to tell someone exactly when they will be cured.
If you have reached a point where your healing has seemed to have stagnated, then there may be cause for concern. Things like your activity level, the types of shoes you are wearing, your weight and other factors will also play in to the recovery process.
If you are really concerned that the healing process has come to a standstill then I would suggest you consult with the doctor who originally treated you, or if you were treated in an emergency room, follow up with a foot specialist in your area.
If the doctor suspects there may be more going on than a small fracture, he or she will probably order an MRI to evaluate any soft tissue damage that may have occurred during your initial injury.
You do not make mention of having had any, but physical therapy in these cases can go a long way in speeding up the healing process. If the doctor determines that there is nothing more than an ankle fracture going on, and assuming it has shown signs of healing, ask if you can go for physical therapy.

Marc Mitnick DPM
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