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Had Ankle Reconstruction Surgery. Getting Pain And Swelling. Diagnosed Water In Ankle. What To Do?

Posted on Fri, 19 Jul 2013

Question: I had a ankle reconstruction on 9/12/2013 then for 3 months everything seemed to be going ok until XXXXXXX 2013 when I started to have pain again. My ortho doctor went in and took out some sutures on 3/13/2013. My ankle was not healing at all and pur was coming out the whole time. He went back in again on 4/22 to clean it out. It finally started healing until 3 weeks ago. I started to get pain so bad that I have to take Narco everything single day. 2 weekends ago my pain was so bad that I was unable to walk and my ankle was very swollen and very red. I went to go see him on 6/17 and he told me its not an infection and its nothing. I left his office and went to see my primary doctor. She told me it looked to be an infection and took a culture, blood work and did some MRI's. I called her today and she said I have water in my ankle but nothing else. I do not know what to do anymore. Can someone please help me out.

Answered by Dr. Rahul D Chaudhari (1 hour later)

Thanks for writing to us.
I would like to know more details about the ankle problem. What was the original problem to ankle? injury? arthritis? any diagnosis? What kind of ankle reconstruction done? Do you have any Xrays ? if possible please upload the xray and culture and MRI report to understand the problem.
From above information, it seems to be infection and wound wash was given to eradicate the infection. Were you given intravenous antibiotics for long periods- weeks to months?
Please get back with above information. thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rahul D Chaudhari (10 hours later)

The ankle problem is a sports related injury. I was sprinting and running when I injured it last year. The doctor put my first through physical therapy but that didn't work. It turned out to be torn ligaments. What the doctor told me after the first surgery was that he reconstructed the torn ligaments. Like I stated above everything seemed fine until about January of this year. My ankle went into more pain and he opened it up again on 3/13/2013. He took out the sutures. The ankle would not heal so he went in again to flush it on 4/22/2013. My ankle doctor took cultures and said that there was nothing wrong with them. He put me twice on Cephalexin 500 mg. I have been on Hydrocodone/Acetaminophen 10-325 T the whole time for pain. My primary doctor on 6/17/2013 took cultures and blood work and said everything was fine. There were no elevated white blood cells and nothing showed in the cultures. The MRI showed water in my ankle, but no infections. Unfortunately I do not have the results but I did upload a picture of how my ankle looks. My primary doctor put my back on Cephalexin 500 mg and added Clindamycin 300 mg. The primary doctor would like for me to go back to my ankle doctor but I am afraid that he will not do anything because there is nothing showing in my results, but something is wrong if I keep taking Hydrocodone/Acetaminophen 10-325 T 2 pills because the pain is so bad. If you can help me out in anyway I would greatly appreciate it.

Follow up: Dr. Rahul D Chaudhari (3 minutes later)

Also I forgot to add I have been on Cephalexin 500 mg 3 times. My ankle doctor put my on that medicine after my 2nd surgery for 10 days and 3rd surgery for 10 days and now my Primary doctor put me on it for 10 days again. Clindamycin 300 mg I am taking it for 10 days and Hydrocodone/Acetaminophen 10-325 T I am taking for pain 2 pills because 1 pill is not helping.

Answered by Dr. Rahul D Chaudhari (26 hours later)

It looks still swollen. I wonder if you had reaction to sutures used for the reconstruction. Did he remove all the sutures?
Some times we prefer to keep the patient on long course of antibiotics. I would suggest to use a ankle brace and try to give maximum rest to the part for 4-6 weeks. If its not infection and no sutures left then it should settle down in few weeks. What the impression in MRI? any mention of arthritis?
I would suggest to immobilise the joint and keep it non weight bearing for few weeks. As the reactionary fluid will go away slowly. Thanks.

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar