Post bunionectomy - stiffness and ache in lower leg above outer ankle

by Barbara
(Uk)

I had bilateral scarf with akin procedures and tendon release for hammer second toes 5 weeks ago. One foot has recovered great but the other has been more painful right from day one. It was the worst as the second toe crossed over big toe more, and I noticed 2 holes above mid foot rather than one on other foot so could just be more tissue damage. It still looks rather crossed but better visually. I have had no casts, only bandages 2 weeks then nothing but the heel bearing sandals since. In last few days, I have started hobbling a lot more on these with my crutches and am noticing that my leg and back muscles are being used awkwardly. However, I am waking with but discomfort and stiffness above right outer ankle that could just be stressed muscles due to my walking awkwardly...but I'm a little anxious that it's a dvt forming. I should add that it is not in my calf at the back, and that the hospital stopped the clot busting prophylaxis at end first week as they observed me to be very mobile and active even when confined to bed..lol. I am however, possibly Leiden factor 5 - which is a genetic blood clotting disorder- as my son has this, though do not know if it is me or my husband who gave him this.

Can you also help me with my concerns about why one foot is so much more painful and tending to swell than the other, or why it would have two holes mid foot..one just above second toe joint and one mirroring left mid foot. I am not due to see doc for xray for another 3-4 weeks. Can I also say how much I appreciate this site and thank you for your time and consideration...it's a lonely place out here when you are in pain during the night!

RESPONSE

Hi Barbara,

The best advice I can give you is to call your surgeon as it is he or she who would be the best suited to determine if you have a phlebitis (dvt) or not. It is impossible for me to make that kind of diagnosis on the other side of the internet.

There are many causes of ankle swelling, particularly after foot surgery and certainly a blood clot is one of them and it is probably the most dangerous cause of ankle swelling. I will also tell you that you do not necessarily have to have the classic posterior calf pain that is associated with blood clots.

Simply being on your feet more can cause swelling. Wearing a surgical shoe could also cause swelling in your ankle simply because it re-positions your foot relative to the ankle in an effort to keep pressure off the ball of your foot.

I would like to think that if you call your surgeon's office they would have you come in and if your doctor examined you and thought a blood clot is a possibility, the surgeon would go ahead and order the necessary tests. I know if you were my patient I would be angry if you did not call me and it turned out that you actually had a blood clot.

I am not sure that I know what you mean by a hole in the top of your foot. I will assume you mean incisions. It would not be surprising to have two incisions on your worst foot as that foot probably required more work to correct the deformities. Additionally, the more severe the original deformity, the more likely the final result will not be perfect.

You do not mention which foot is the worst and if it is the same side as the swollen ankle. My guess would be that they are the same.

It has only been five weeks since your surgery and so it is not surprising that you are still having issues as that is to be expected at this point, particularly since you had both feet done at the same time.

So, do yourself a favor and call your surgeon for clarity as to where you stand in the healing process.

Marc Mitnick DPM
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