Fracture pain, is this normal?

[DinosaurDuvet]

Sorry posting here for traffic, I’m at my witts end with pain this morning & I’m not sure if this is to be expected or not.

I had quite a severe trimalleolar ankle fracture and subsequent surgery on it 19 weeks ago. Got pins & plates in my ankle plus my tibia and fibula were bolted together further up my shin. This particular piece of metal was to break when I started weight-bearing to allow more normal flexibility.

Last check up at fracture clinic was 10 weeks ago and everything seemed to healing well & I was discharged. However it was noted that this bolt had not broken as expected.

Apart from normal tenderness everything was good & only continued to get better ...until about 6 weeks ago when I started getting horrendous bone pain in my shin and sometimes ankle. It’s not always constant but it’s that bad it’ll wake me from my sleep, even the weight of the duvet on it will cause pain.

Does anyone know if this is a normal part of healing from a fracture of this kind? If so how long to go away? Don’t want to bother GP with something silly if it is just part & parcel of healing & I’m being a big wuss. Or perhaps it’s this bolt that hasn’t broken annoying my shin.

So here’s my AIBU

YABU - it’s normal part of healing
YANBU - it’s not normal

Call 111 but I’d say worsening pain after a complicated injury almost 5 months ago needs looking at. An X-ray at the very least to check the bone and metalwork are correctly aligned.

If you turned up in A&E it wouldn’t be inappropriate IMO.

I hope you feel better soon.

I'd phone the fracture clinic direct and ask if you need a GP referral back or can they see you without one for post-op complications.

That needs looking at - I've had a fracture pinned together before and (unless I bang the end of the bolt bit) it never hurts at all.

Have you got the contact details for fracture clinic? You will need to be seen by them - it's just a question of whether you can self refer back into the system or need to go via the GP / A&E.

This could be nothing and just part of the natural healing process but equally it is definitely worth checking out. I had a very minor fracture compared to yours which started to feel much better but then began getting worse. The physio dismissed it as just normal but I escalated it and was ultimately diagnosed with Complex Regional Pain Syndrome. It is quite rare but can be serious, (mine is very mild). I would definitely raise it as an issue with your doctors.

I broke a bone and it still hurts two years later. My sister broke her ankle last summer and hers still hurts too. So I presume it’s normal.

@Albien

I broke a bone and it still hurts two years later. My sister broke her ankle last summer and hers still hurts too. So I presume it’s normal.

I've had more than my fair share of fractures (10 ish) and literally none of them hurt. The only one that ever does is the one that was pinned, if I bash the pin.

I'm not sure it is normal at all tbh

I would be getting in contact with your GP for a referral back to the fracture clinic.

I've never personally gone through this, but I do know someone who has. Not sure exactly what they had done, but they had pins and plates in their foot and ankle, but something went wrong and they've had multiple surgeries since to correct the problem and its been an ongoing issue. So if you're worried, I would absolutely get it checked out

I have pain 10 years on from a complicated break but not agony like you describe. I'd want that checked out asap.

Get it checked. Also, check vitamin D if you've been indoors more due to the break, I had horrendous shin and lower leg pain from low vitamin d

I think it needs checking, especially as you know the metalwork isn’t functioning as originally intended.

I had a somewhat similar surgery years ago (ankle fracture with pins and plate, not as extreme as yours though) and have never experienced pain like that.
It was tender right after surgery for two weeks, and maybe for three weeks after I started to bear weight. But tender. and swollen. Not massively painful at all.
Now, I still have the pins and plate, I can feel it under the skin, and I may experience tenderness if I'm sat cross-legged for a long time or if I bang it.

Anyway, a lot of rambling to say that it doesn't sound normal to me, you should definitely call the fracture clinic.

My thoughts are the bolt was meant to break once weight bearing. It hasn't. I would think that remaining intact is putting torsion where the bolt is and is causing the pain.

Alternatively it could also be muscular. I get unbearable, deep, throbbing pain at times between my knee and shin. If you've had that sort of pain, you know what it is - it's constant, nothing you do will get you away from it and it's nauseating. Due to an issue with my knee, it can't be straightened so the muscles up the whole leg are constantly activated. My exercise physiologist fixes it. You might have something similar as the muscles would likely be injured as well.

@Albien

I broke a bone and it still hurts two years later. My sister broke her ankle last summer and hers still hurts too. So I presume it’s normal.

It shouldn't hurt after a few months let alone years! My friend broke her ankle and after a while she was still in a lot of pain. My worry, which was sadly true, she had developed CRPS in her ankle hence the constant pain.

I would contact your fractures clinic @DinosaurDuvet and have a chat with them.

Usually the consultant discharges you with a proviso to return if further issues. Call the hospital and ask for the secretary of your consultant (or just any orthopaedic secretary) and they should be able to get re booked for a review. have you hospital number handy too.

I broke mine over 20 years ago, pinned and plated just like yours.
Unfortunately I still get pain and some days I could cut my foot off, but you do learn to live with it. Still cannot walk too far and I cannot run as anything with impact is really painful.
I think mine is so painful because it was a particularly bad break, both fibula and tibia in the actual ankle joint with dislocation as well.

@Babs1937 that's my experience too, people underestimate joint breaks.