unable to walk properly on right foot after broken ankle 3 yrs ago

by joyce
(baltimore, md)

Hi< I am 53yr old female in great shape-3 years ago I broke my ankle and have pns and plates. About 3 months ago I started not being able to walk properly on the foot. It will not let my normal gait. If i walk on my tip toes it feels find however if I try to walk normal i can't due to pain and or no strength. I have been back to my doctor who proformed the surgery and he has taken x-rays but each time he says its fine and that my tendons do not feel tight. I explained how i can walk find with 4 in heels or on my tip toes but not flat footed or low heels.. Doing this for several months now and even the high heels don;'t work. I need some anwsers on what I can do to walk properly again. Can you help ??

thanks

joyce

RESPONSE

Hi Joyce,

I would have thought you might have had problems with your gait from day one after your surgery, but apparently you were walking fine for about three years before this issue arose.
May I assume there was no further trauma to your foot and ankle?
That being the case, the inability to place your foot flat on the ground and walk normal and without pain is suggestive of an achilles tendon issue, which is the large tendon in the back of the heel. Even though that would be the first tendon I would look at, it does not necessarily mean some of the other tendons coming down your leg into your foot are not mal-functioning.
Even though the fibula bone (the outside bone on your ankle) is the one that is most often fractured in ankle fractures, I am wondering if there was any damage to the tibia (the larger bone on the inside of the ankle).
In either event depending on the type of trauma, the technique used during surgery to repair whatever was broken, as well as the final placement of the screws and plates, there may have been some damage done to the surrounding soft tissue, most likely one of the tendons.
For example, a tendon in the ankle may be rubbing up against a screw or possibly the plate in such a way that over time it has created an irritation to the tendon which has lead to your inability to walk normally.
You said you doctor took an x-ray, so I assume the hardware "appears" to still be in place. I mention this because sometimes screws will start to back out over time, and may be the source of irritation.
I realize I am giving you a lot of generalizations here, but realize I am making assumptions on the other side of the internet.
So, what should you do?
I would ask your doctor to order an MRI which will give a better visualization of the soft tissue in the ankle region, particularly the tendons. An MRI should be able to pick up any abnormality in one of the tendons that may be causing your discomfort.
If you get no satisfaction from your doctor, go see another doctor in your area for a second opinion (and MRI).
If there is an irritation from the hardware, at this point in time, the hardware probably can be removed.
If an MRI shows some irritation to a tendon, but not necessarily from hardware irritation, then some physical therapy may be in order.

Marc Mitnick DPM
DISCLAIMER