Swelling of Foot after Injury

Injuries around the ankle and foot are common, whether soft tissue sprains or fractures. Swelling of foot and ankle after treatment, conservative or operative, is a real concern for the person. Patients are worried about the duration of swelling and getting back to normal.

Ankle and foot injuries are either ligament sprains or fractures. Minor injuries are treated by splint or plaster casting. More serious injures like complete rupture of ankle ligaments and displaced fractures are treated by surgery.

Usual time of fracture healing is 6-8 weeks. It takes less time for healing in children and more in elderly. Other chronic diseases like kidney problems and osteoporosis further delay fracture healing. If a person is taking steroids / cortisone for some other condition, fracture healing will be delayed. Soft tissue injuries also take 3-4 weeks for healing. One study has shown that “the time for disappearance of the swelling in 50 per cent of the patients was 18.6 weeks” (1).

Swelling at foot and ankle, after removal of plaster or after few weeks of surgery, is common and takes further time to clear. Besides incomplete healing of injured tissues, weakened muscles and stasis of blood in veins are main causes of swelling.

Measures to reduce swelling

Sitting in a position with foot elevated higher than knee 3-4 times a day for about 30 minutes. Exercises of foot and ankle in this position also reduce swelling by increasing venous return.

Cold sponging and ice pack application for 15-20 minutes of every hour in day time for initial two days. Later on same ice pack application for 15-20 minutes three times a day is sufficient.

Physiotherapy to improve range of motion at the joints and to re-strengthen weak muscles is also recommended.

Medicines for pain relief can be taken but specific drugs to reduce swelling do no benefit. This is because swelling is caused by tissue injury and stasis of blood resulting in water logging in soft tissues.

Type of initial treatment of the injury also affects outcome. One study concludes that “the use of the air stirrup led to a significant improvement in early patient comfort, post-fracture swelling, range of ankle motion at union, and time to full rehabilitation” (2).

In cases of surgery, infection can be a cause of persistent swelling. In infection there is redness of skin, raised local temperature, often pus or fluid discharge from the wound and sometimes fever. Post surgery infection should be taken seriously. This needs consultation with doctor, who will prescribe required antibiotics after necessary tests; and will also advise other important aspects to clear infection.

Swelling of ankle and foot after fixation of fracture with plate and screws.

References

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