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Ankle injury. X-ray shows sprain. Numb and cold toes and foot. Worried

I fell down the stairs pretty hard on Sunday, it is now Friday, I landed on my ankle/ foot . I went to the ER on Monday because I could not put any weight on my foot, they took an x-ray of my ankle and said it was bad a sprain . They put me in an air cast, told me to use crutches for a week, ice and elevate. By Wednesday my foot and toes were numb and really cold , I read the discharge and it said to come back if numbness, cold, or blue toes happened. I did not want to go back but by Friday it was worse, throbbing and so cold and pale and this stinging! So I went to the ER again and at first they could not find a pulse in my foot, so they left my cast off for a half an hour and checked again. After probing my foot for what felt like forever, the pain from them pushing on my swollen foot WOW, they found a faint pulse. They concluded that the cast was cutting off my circulation and that my old back injury was causing numbness in my foot. I was like thank god it was nothing major but it has been 8 hours without a cast on and the throbbing and numbness has not gone away. I am worried that I have broken my foot or that I have torn something major in my ankle? I have sprained my ankle before and I do not remember it feeling numb and throbbing on the top of my foot? Is this something that can happen with ankle injuries or should I find a specialist?
Asked On : Tue, 26 Mar 2013
Answers:  3 Views:  207
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Orthopaedic Surgeon, Joint Replacement 's  Response
Feb 2014
Thanks for posting your query.
Numbness of can occur during sprain due to injury to superficial nerve fibres.
You can take anti-inflammatory drug like motrin to reduce pain and inflammation.Apply compression bandage and elevate the limb. Avoid putting weight and rest well.
Hope this will helps you. Feel free to ask me if you have any further queries.
Wish you good health. Take care.
Dr Saurabh Gupta.
Orthopaedic Surgeon.
Answered: Sun, 21 Jul 2013
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Radiologist Dr. Vivek Chail's  Response
May 2014
Thanks for writing in with a very important question.

You had a soft tissue injury (sprain) for which a cast was applied over your foot. In 4 days you felt numbness and rushed back to your doctors. This is perhaps the best decision you have taken and saved your limb from permanent injury due to lack of blood supply.

There are many muscles and tendons in the ankle region and even a slight pull or tear in one of them can give rise to severe pain. You may discuss the pain with your doctor and get a MRI scan done if necessary to pin point the ligaments affected due to your fall. The cast can be replaced by a brace after sometime.

You can take pain reliever medications till such time you feel severe pains.

Hope this helps.
Answered: Sun, 21 Jul 2013
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Orthopaedic Surgeon, Joint Replacement Dr. K. Naga Ravi Prasad's  Response
Jul 2013
Hi, thanks for writing to HCM.

It is very common to find tense swelling, pain and numbness in ankle injuries.

As the xrays have ruled out a fracture, the only possibility in your case is a ligament injury.

Generally, these ligament injuries takes around 3 weeks to settle down with proper immobilzation in the form of a brace or cast. So up untill that time, it is normal to have some swelling and numbness.

An MRI scan will rule out a serious ligament damage.

Consult an orthopedic surgeon and follow his advice accordingly.

Hope this information is helpful. Good day

Answered: Sun, 21 Jul 2013
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