My broken Ankle was Fixed, so Why does it Still Hurt?

Some of us are very sensible and still end up in accidents. Some of us do foolish things and obviously end up in accidents. Whether it was a car accident, sport’s accident or a stupid accident, should we have to suffer for the rest of our lives? Ankle fractures are very painful and the surgery includes multiple screws and plates. The recovery period is long and hard. But one would think five, ten, twenty years down the road your ankle would be free from pain. For some, this is true. For others, and ankle fracture leads to lifelong arthritis and pain.

There are four bones that make up your ankle. The tibia, fibula, and the talus articulate with one another to make the ankle joint. Many ligaments surround the joint to stabilize the bones into proper alignment to provide optimal function. Typical ankle fractures involve the breaking of the tibia and fibula bones and damage to a number of ligaments.

To reestablish a competent joint, surgery is almost always necessary. The surgeon will realign the fragments and fixate them back into place using screws. Plates are also used to stabilize the injured area of bone. Essentially, the surgeon will reposition the bones as close as possible back to normal.

Unfortunately, many suffer long term effects from an ankle injury. When the bones break and the ligaments lose their integrity, the bones can slam into and damage the articluar cartilage. The talus, the other bone that makes up the ankle joint, has a thick layer of cartilage that is poorly vascularized. The poor blood flow to the cartilage and the extent of the damage can make it difficult for the body to self repair the injury. These injuries to the cartilage are difficult to assess during surgery. If a surgeon chooses to address these small and difficult injuries, it involves more studied, more procedures and more cost to the patient. Thus, many surgeons chose not to address the injury.

The majority of the time, the body does a sufficient job at repairing the cartilage damage. If the lesion is small, the body’s repair process works sufficiently. Occasionally the lesions are larger and lead to osteoarthritis or degenerative joint disease. It is believed that this may be the reason why some people have residual pain after an ankle fracture. Treating larger cartilage lesions is done by using grafts, preferably from the patients. They will take small pieces of cartilage from your knee or other joints. Some synthetic transplants can also be used. An ankle fracture surgery is already very complex and doctors are not certain treating the cartilage problem at the time of the ankle surgery is what is best for the patient. The longer a surgery takes, the higher the risk of complications.

Some are willing to accept that arthritis is an unfortunate side effect of ankle fractures, but many doctors are studying and researching ways to reduce the number of people living with pain after a fracture. Doctor’s want to make their patients feel better, but sometimes there are too many barriers to completely eradicate the pain. Please be assured that we are dedicated in helping you with your foot and ankle issues even if the battle seems impossible.