Greetings,
I discovered this website when searching for anything that could elucidate or help in my case. I am a 32-year old man from Brazil, and eight years ago (when I was 24), I accidentally fell down a flight of stairs and had torn 2 of my ankle ligaments (calcaneofibular and talofibular, I'm not sure if those are the right names in english, I apologize for that).
Anyways, I went to a doctor who was adamant that we should do reconstruction surgery as soon as possible, and so I did as I was told and fit as soon as I could on his schedule, which meant that I had surgery 1 month after my accident. I didn't do physical therapy or anything during this time period, except being immobilized with a cast while awaiting for surgery. Post-surgical recovery was a bit complicated but I moved on with my life, trying to overcome the mild pain I started to feel.
Not much later though, a few months after, I started developing all sorts of complications. Morton's neuroma, tenossivitis on the achilles tendon, and then worse, I started having knee and hip pain, likely because of mechanical issues with my ankle. The doctor overlooked all these symptoms, and it was onlu 7 years after it gradually became worse and worse, that I decided to change doctors. To my utter shock, all 3 doctors I scheduled appointments with just told me right there on the spot that I shouldn't have done surgery as ankle ligament injuries normally demand a 3-month period of adjusting and seeing if surgery is indeed needed. I recall that before surgery, I didn't have all these weird symptoms that I have now (extreme sensitivy to touch on the dorsal foot, feeling of electric shocks, pain standing etc., to name just a few).
My symptoms now become worse everyday and just a single walk to the supermarket is terribly painful. I started searching and I believe a lot of this can be blamed on arthrofibrosis, which was detected on MRI scans. My ankle feels stiff and bloated and it won't complete movement accordingly. Also, to make matters worse, ENMG detected denervation on the extensor brevis muscle of the dorsal foot, which is now completely atrophied and with no chance of recovery, according to doctors.
I feel absolutely crushed and devastated. I used to love to go on long walks, and now I can't even walk around the block without feeling terribly sore. I'm trying all sorts of treatments but it seems that nothing ever works, and no doctor I've talked with has yet to touch on the topic of arthrofibrosis.
I was wondering if anyone here could please send me any information that could help me. I live in Sao Paulo, Brazil, I don't know if the IAA network knows of anyone who lives in Brazil, or even in South America for that matter, I'm willing to go abroad if needed for some treatment. I'm trying not to lose hope that something can be done in my case, but it's getting increasingly difficult to maintain an optimistic view of my life.
Sincerely,
Augusto Salmon
Hi Augusto,
Thanks for your question. I'm really sorry about your situation, it's very difficult!
I don't know of any foot surgeons in Brazil, I have heard about one in the US, but I don't know if he understands arthrofibrosis. I could ask a couple of knee surgeons in Europe if they know of a good ankle surgeon. Would that be helpful? It's possible that surgical release of the scar tissue could help, if appropriate techniques are used (see the surgical checklist).
It sounds like your foot has a lot of scar tissue in it. It would be a good idea to be tested for auto-immune and auto-inflammatory conditions. When the sheath around the nerve becomes fibrotic it can trap nerve, creating the Morton's neuroma. A similar process creates Achilles tenosynovitis, as well as inflammation.
It's probably worthwhile to consult a pain specialist, since there is nerve involvement, but personally I'm wary of nerve ablation and similar procedures. Botox injections are sometimes offered for the treatment of nerve fibrosis, for example, shingles pain, and appear to have anti-fibrotic properties, but haven't been tested in arthrofibrosis yet. It might be worth looking into for treating the neuroma and possibly even the tenosynovitis.
It's probably important not to aggravate the pain, so far as this is possible. Crutches would help with this, but avoid the under-arm crutches as supporting body weight can damage the nerves there.
All the best, and please feel free to ask more questions. I can't offer medical advice, but can pass on my understanding of the research.
Kayley