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Suggest Treatment For Persistent Pain In The Hands

Posted on Wed, 5 Apr 2017

Question: Broke tibia/fibula a month ago by falling on ice. Oblique spiral break with a large chip out of it about 6 inched above ankle. 18 inch rod and 6 screws. No cast.
Last few days the pain at night is achy and doesn't allow for sleep. Trying to throttle back on hydrcodone to one per 8 hrs. Any suggestions why night pain and what to do?

Answered by Dr. Mahaveer Patil (45 minutes later)

Brief Answer:
Overpumping of ankle / protruding screw

Detailed Answer:
Hi,

Thank you for posting the question.
I have gone through your medical history in detail.

Actually,you should not be having pain 1 month after the operation. You should be absolutely painless till now.

A possibility is that pumping the ankle up and down may be causing inflammation of the leg and ankle muscles resulting in night pain.May be you are overdoing the pumping exercises.

Another possibility is of a protruding screw.
You mentioned of 6 screws being put inside your bones. One or two of the may have loosened or protruding causing the tip of the screw to irritate the surrounding soft tissues causing pain.

I suggest you to stop the pumping of ankle for a few days to see if the pain goes away.Start on anti-inflammatory tablets,muscle relaxants. Apply compression bandage and local analgesic gel over the painful area.

I would like to see the pre-operative and post-operative Xrays so that i can help you better.

I hope the answer was useful.

Feel free to ask me any follow up queries that you may have.

Thank you.
Kind regards.

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Mahaveer Patil (1 hour later)

Hi, I have provided some attachments. Please review them.

Answered by Dr. Mahaveer Patil (47 minutes later)

Brief Answer:
where is the pain exactly?

Detailed Answer:
I have seen the attached photos.

Where do you get the pain exactly?
Is it the ankle or calf or the fracture site?

The post-operative photograph does not show the fracture site.

See if you can post it as well.

Thank you

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Mahaveer Patil (16 minutes later)

That's all I have for electronic photos. Pain is generally achy from the knee, where they inserted the rod, all the way to the foot. The incisions are sensitive as hell in the ankle area, not so much at the knee. The knee incision area is stiffer tho when is hasn't moved for some time. Just want to rub the whole lower leg because that feels good. The break area may be a little more achy than the rest. It all reminds me of "growing pains" as mother referred to them when I was young. But it's a bit more intense. We farm so I crawl around equipment, carry heavy things, and climb 30-60 foot grain storage bins. I just want to make sure all is well so I don't have long term limitations.

Answered by Dr. Mahaveer Patil (15 minutes later)

Brief Answer:
You will be fine

Detailed Answer:
Actually,the most important Xray is missing.

Its ok. I feel this is all muscular pain and you should take the medicines as i have advised.

If the pain keeps aggravating,then you should see your operating surgeon and get a Xray done to see if the fractured bone has united.

From the Xrays that you have posted,there doesn't seem to be any problem with the operation.

Once your fractured bone unites,you will be able to do all the work that you used to do before.Do not worry.

Do not forget to post the recent Xray of the fractured part when you get it done.

Thank you.

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Mahaveer Patil (5 hours later)

Ok. Will do. But I can't just order prescription drugs, obviously. Do you prescribe via this platform?
And they told me before leaving hospital to not take Advil and Aleve type drugs because they can decrease bone formation. Just Tylenol and hydrocodone if needed.
6 week follow up with surgeon is in 8 days. We are 50 miles from the hospital so just running in when I can't drive is a big deal.
Wife is a nurse with experience from emergency room to home health care so she kinda helps me.

Answered by Dr. Mahaveer Patil (14 hours later)

Brief Answer:
tynelol will help

Detailed Answer:
I am sorry,but prescriptions on this platform are not allowed.

You can take tynelol instead of hydrocodone for better pain relief.

You are just a week away from seeing your doctor.So,Tynelol will help till then.

Thank you.

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

Above answer was peer-reviewed by : Dr. Nagamani Ng