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The response to the question below was authored by Marc Mitnick DPM

Severe ankle pain 11 years after a break

by Melissa
(Northern ireland )

11 years ago I fell down the stairs and fractured my left ankle in 3 places, the first hospital I attended placed a backslab on and I attended another hospital the following morning. My leg was pulled and pushed back into place and I was casted. I think the cast was on for approx 8-9 weeks. For the first couple of years I had bruising and swelling and some discomfort which was to be expected, as the next few years went by I had minimal pain but still a bit of swelling after flying or being on my feet for long periods. The past year has become unbearable from I wake I limp and the swelling is a lot, sometimes I can walk fine but this is becoming less and less. There is bruising at the swelling and it feels like someone is sticking a knife through my heel. The ankle is sore below my break towards my foot, it feels stiff and throbs right up to my knee at times, elevation and anti-inflam help,but is this normal all this time later? Ian only 35 and don't want to spend the rest of my life limping about in severe pain. I did not receive pt nor was I operated on.

RESPONSE

Hi Melissa,

I would certainly have to see a set of new x-rays but it would seem to me, on the surface at least, that if you sustained three fractures in the ankle, surgery would have been indicated. I do not know how they could just manipulate your ankle back into place.
Yes, the fractures probably did heal and

that is why for the first few years you had minimal problems.
The real question becomes what was the condition of the alignment of the ankle joint. One of the biggest issues with ankle fractures is how the ankle joint lines up after surgery. It is one thing to put all the bones back together, but it becomes another issue on the congruity of the ankle alignment.
If the ankle joint does not line up properly then there is going to be issues with the function of the ankle joint down the road. You are now "down the road", meaning because of an improper alignment by just casting you and not operating on the fractures, your ankle joint sounds like it is beginning to wear out. If you have improper alignment of any joint in the body, over time, the joint will begin to wear out. It is the equivalent of having improperly balancesd tires on your car; over time, the tires wear out prematurely.
So, what are you going to do about this? If there is a foot specialist in your area you should be evaluated both in terms of how the fractures healed and the alignment of your ankle joint.
In some cases, a foot insert can be added to your shoes in an effort to better align the foot relative to the ankle which will then more properly line up the ankle joint and in theory at least, will reduce your pain.
If the fractured bones healed in an improper angle you might have to entertain surgery on the ankle to get better alignment.

Marc Mitnick DPM
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ADDITIONAL REFERENCES

Mayo Clinic

Johns Hopkins Medicine

MedlinePlus

Arthritis Foundation

University of Rochester Medical Center

Harvard Health

Drugs.com

American Academy of Pediatrics

Penn State Medical Center

National Institutes of Health

Columbia University Department of Rehabilitation

ScienceDirect

Stanford Health Care

Illinois Bone and Joint Institute

Mount Sinai Hospital

Institute for Chronic Pain

University of Florida Health

American Family Physician

Cedars-Sinai

University of Maryland Medical Center

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location unknown

Severe ankle pain 11 years after a break

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