Ongoing ankle pain and arthroscopy Help

Hi,

I could do with some insight and i'll try and him it short :rolleyes:
Trimalleolar Ankle Fracture with dislocation Aug 09 and received ORIF, plate 11 pins and 2 screws to repair the damage. Cast & NWB for 8 weeks then a walking boot and various other issues.

The fracture took a long time to heal but pain continued so in Novemeber last year they removed the metalwork and an overgrowing piece of bone that had formed on my medial malleolus.
Did see a physio after this who just massaged from ankle and calf. ROM did improve once the metalwork was gone. I have stopped seeing the physio but still have real balance and strength problems.

X-ray in Jan this year show the extra bone was regrowing already.
The pain is near constant and my ankle clicks frequently so they sent me for a CT scan a few weeks ago which shows that the original fracture has healed (they were concerned it wasnt) but still needs some remodelling to be done where the pins were removed.

The consultant has now said I need an Arthroscopy?? and thinks it may be that the inside part of my Tibia is rubbing on the cartilage in my ankle. He is not 100% about this though.
I'm not sure what to expect after the procedure?
Will I need physio again? WIll they do more if they find something else is wrong?

17 months and counting and have no idea what to expect? I just dont want to be in pain anymore.
I dont know if anyone can give me any advice. I would be much appreciated.

Thanks

hi Hopalong80.

Ok...the obvious stuff first.

1. lack of balance and strength problems = rehab rehab rehab - yes you will need to see a physio, preferably someone who doesn't just give you a massage to your ankle and calf but gives you exercises to improve your *Functional* abilities - that is the exercises are related to you doing stuff in everyday life... not just pushing a theraband or lifting a cuff weight around your ankle!

2. I am going to guess everyone (including you) is fixated on your ankle...makes sense but NWB, walking boot, constant pain, operations, 17 months etc = other stuff is affected - e.g. knee, hip, pelvis, back. I am surprised you haven't reported that you also have back or neck pain of some type.

3. Get MRI before arthroscopy - it will show the state of the cartilage but looking around is definitely best to assess the state of the cartilage - it is just another operation to add to the list though :(

4. This is a bit more exotic...perhaps the clicking is occurring because some joint up higher is not controlling itself properly and causing a twisting force down your leg. This would cause a twist in the ankle joint which has lots of scar tissue and bone bits around which might flick or click...perhaps someone needs to check all the different regions of your body to see what is causing what...

Anyway, best of luck - let us know how you go :)

Cheers

Hi Antony,

Thanks for your reply if has been very helpful and has given me so hope with regards to the physio aspect ;)

1. I booked in to see another physio on Monday and someone actually spent 45 mins just talking to me about pain, which no other physio has done. She was very thorough.

2. Well yes this is a fair point! I did have lots of knee, hip and back pain after original operation that settled down somewhat but is slowly getting worse.
My new physio asked me all about my knee, back, hips etc... and has made such a difference that someone is looking at me as a whole rather then just ankle. From this I have found out I have Plantar fasciitis, Shortened Achillies Tendon, Very very tight calf muscle, swelling (which she is going to try ultrasound on) ankle instability and the fact that my Talus bone is not sitting straight??? And the usual lack of strength. ROM is good other then on Doriflexsion which is not great.

3. I did ask about an MRI and was told that it was not needed. So another op it is, my poor ankle is going to look like something from a horror film by the time this is all finished:)

To be honest because of the other physio's I have seen not really doing what they should I did get to the point of thinking it was me imagining some of this other pain. I think not being given the help I needed for rehab has probably hindered my recovery.

I am glad I posted on here as I'd almost given up but it pushed me to find a new physio.

Many Thanks Again

Liz

Excellent hopalong80! So happy to see that you found someone you trust :)

If you need anything, please let me know - just send me a private message :)

Otherwise i am sure we would all like to hear about how you are going with your new physio!!

Cheers!