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Suggest Treatment For Pain And Swelling In The Ankles Post Injury

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Posted on Wed, 8 Mar 2017
Question: I sprained my ankle a little over 3 months ago and have continued pain and swelling. After x rays and an MRI the doctor said there is still a bruise on my ankle bone, slight thickening in the outside ligament and fluid in the peroneal tendon sheath. He is recommending surgery. Is surgery really necessary?
doctor
Answered by Dr. Aashish Raghu (33 minutes later)
Brief Answer:
Flat foot?

Detailed Answer:
Hi there

Thanks for the query

I have read your query and understood your problem.

You seem to have damaged the peroneal ligament which may require reconstruction, with possibility of flat foot as well. Peroneal tendon dysfunction can cause a flat foot such can cause pain on walking.

If you have a flat foot, use a medial silicone wedge inside your footwear. This will help to maintain the foot arch.

It would be very helpful if you could upload the MRI Report and detail what kind of survey you were advised. This will help me to advise you the other treatment options as needed.

The bone bruise will cause pain. Apply ice, keep the limb elevated. Use a crepe bandage of the US swelling. Gross Tablet Chymoral forte or any tablet with Trypsin, Bromelain and Rutoside combination twice a day for 5 days. This is available over the counter and will drastically reduce the bone bruise and swelling.

I hope I have answered your query.

I will be available to answer your follow up queries.

Regards,

Dr. Aashish Raghu

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Aashish Raghu (27 minutes later)
I don't have a flat foot, so that's not an issue. I can't seem to upload the MRI as there must be a copyright on it. When I try to download the images, the program immediately closes.
So here's what my doctor wants to do... go in with a scope in one incision and in another scrape the ligament to thin it down. Make another 3" or so incision to drain the fluid from the peroneal tendon sheath. After surgery, 2 weeks with a bandage and immobilized in a walking boot. After the bandage is removed 2 more weeks in a boot and then physical therapy at home. I'm wondering is surgery is really my only option...?? I have yet to read that surgery is necessary if there isn't a complete tear in a tendon or ligament. Your thoughts on this?
Is Gross Tablet Chymoral forte over the counter? Typically, how long does it take to heal a bone bruise? And, could some of the swelling be due to this?
Thanks!

Also... how this happened... I didn't see the last stair at the landing of the stairs at the hotel. Only my heel caught the stair and my foot fell off and my ankle rolled really hard. I stumbled, caught myself and had to sit down on the floor since it hurt so bad. I was able to walk after. I iced it and wrapped it, but since I was out of town on business, couldn't really rest it as it needed, as I had work to do that had to be done.
doctor
Answered by Dr. Aashish Raghu (2 hours later)
Brief Answer:
Please type the MRI report for me. Use boot

Detailed Answer:
Thanks for your reply.

It would be useful if you could type the MRI report and post it for me. You can upload the report here.

Surgery may not be indicated unless its a chronic non-healing tear. You can try using a hard soled boot. It should provide relief.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Aashish Raghu (19 minutes later)
I didn't receive an MRI report, only the actual disc with images that won't let me upload to my computer and won't let me share or email. You would need the actual disc to see the MRI results. There is no tear in any ligament or tendon. My doctor told me because there is no tear, I no longer need to wear the hard soled walking boot. (I had been wearing that for a month prior to the MRI).
Still not sure what your thoughts are on if I need the procedure described previously? Or my other questions... Please respond.

Thanks!
doctor
Answered by Dr. Aashish Raghu (35 hours later)
Brief Answer:
Try the boot

Detailed Answer:
Hi there

I suggest you go ahead with the surgery as this will prevent ongoing tendon damage and give you permanent relief. But this would take a few months to get alright after the surgery,needing you to wear the immobilisation boot and perform required physiotherapy.

You can take the medication as listed previously to reduce the oedema. Try using an immobilisation boot now itself to see if that works. If it does then survey can be deferred.
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Aashish Raghu (7 hours later)
Thank you for getting back to me. I have one final question.... I read yesterday that a bone bruise can take up to a year or longer to heal and that they cause swelling and fluid to build up around them. I have a large bone bruise still visible on the MRI (3 months after the injury) on my ankle bone. Could this be the cause of the continued soreness and swelling???? The article also said bone bruises are very slow in healing and are very painful. IF this is the case and the bone is still bruised, how is surgery going to help? It makes sense to me that if this is the possible cause of the swelling, that after surgery, it'll continue to do so... Does this make sense to you as well???
doctor
Answered by Dr. Aashish Raghu (8 hours later)
Brief Answer:
Answers

Detailed Answer:
Yes, Bone bruise is the cause of your pain.

It can take even months to heal especially if it is not given adequate rest. We usually wait 6-10 weeks to do any surgery in a bone bruise.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
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Dr. Aashish Raghu

Orthopaedic Surgeon

Practicing since :2011

Answered : 5482 Questions

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Suggest Treatment For Pain And Swelling In The Ankles Post Injury

Brief Answer: Flat foot? Detailed Answer: Hi there Thanks for the query I have read your query and understood your problem. You seem to have damaged the peroneal ligament which may require reconstruction, with possibility of flat foot as well. Peroneal tendon dysfunction can cause a flat foot such can cause pain on walking. If you have a flat foot, use a medial silicone wedge inside your footwear. This will help to maintain the foot arch. It would be very helpful if you could upload the MRI Report and detail what kind of survey you were advised. This will help me to advise you the other treatment options as needed. The bone bruise will cause pain. Apply ice, keep the limb elevated. Use a crepe bandage of the US swelling. Gross Tablet Chymoral forte or any tablet with Trypsin, Bromelain and Rutoside combination twice a day for 5 days. This is available over the counter and will drastically reduce the bone bruise and swelling. I hope I have answered your query. I will be available to answer your follow up queries. Regards, Dr. Aashish Raghu