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ankle New drainage after 6 months? Why?

Discussion in 'Other Joints Forum' started by fugit, Jul 17, 2017.

  1. fugit

    fugit new member
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    January 2017, a ladder slipped out from under me and sent me straight down about 16'- 18', landing on my feet. Guess you could say I stuck the landing. Except that I basically broke both legs and was in a wheelchair for a few months.

    My right ankle was pretty much destroyed requiring a metal bracket to surgically installed, leaving behind a scar that reminds me of Frankenstein's Converse Hightop. Just one of them. Haha.

    So no complications to speak of really. I've been vertical and walking for almost 2 months maybe (albeit a little funny - you could use one finger and tip me like a sleeping cow probably). The scar is healing nicely for the most part.

    It's been about 6 months, both my feet still swell nightly by the time I turn in. Don't know when that's gonna go away. 2 days ago I scratched an itch at the incision site and accidentally peeled off a small scab where one of the sutures had been. This particular one never quite healed and turned to flesh like the rest of the suture scars. It retained a small scab-like crust all this time. Ortho said don't worry about it a few post ops ago. When it came off as I scratched, it didn't even bleed. Just... nothing. So I went about my business.

    That night, going to bed, that sock was very wet and I found that I could literally squeeze my swollen ankle and cause the fluid to discharge from where the scab had been. It has been continually draining on its own ever since. Left untouched, every minute or two a small drop of clear fluid just rolls down my ankle like a teardrop. It actually left a wet spot on my matress and I saturated a large band-aid with a piece of paper towel under it in a couple of hours. Like wring it out saturated.

    (FYI: fluid is clear, like water. No fevern, heat or redness. I did have celuitis in the other ankle a few weeks ago- that's gone after antibiotics. I suspect it is the same fluid that accumulates causing my feet and ankles to swell into cankles.

    I supposed I didn't need to be so long winded about it, but why is this happening 6 months later?

    By now I would think that the scar tissue is complete all the way down this hole which is now functioning as a drainage channel from below all the dermal tissue, and the skin won't be actually fusing together as it should have long ago.

    Is this correct? And why did it happen to this one lonely suture site and nowhere else along my 8" scar?
     
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  2. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    @fugit welcome to BoneSmart. So sorry to hear of your horrid accident. One of life's challenges I guess. I'm going to tag our forum medical expert @Josephine to comment on this drainage so far out from surgery.
     
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  3. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Hi fugit and welcome to BoneSmart! Sorry to hear about your problems. I put your surgery in your signature but I used a term ORIF which stands for Open Reduction (of fracture) and Internal Fixation (with bone plate and screws).

    My first thoughts are that you either have a low grade infection or just plain ol' lymphadema. Byt I need to ask you

    1. is your lower leg swollen at all?
    2. do you know if the broken bones are now healed?
    3. do you have a copy of an xray so I can see it?
    4. is there any pain associated with this?
    5. has this fluid ever been swabbed for laboratory tests?
     
  4. fugit

    fugit new member
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    Yes open redaction internal fixation is exactly the term he used. This is what he installed: www.dropbox.com/s/8g35zw8lr6v7092/71181724_distal_tibia_fibula.pdf?dl=0
    (forum won't met me post a link yet-first thread).

    1
    both legs swell daily. Again, ortho said don't worry about it moons ago. Have been advised to look into circulatory issues by family members.

    2
    honestly. I don't know.

    3
    I haven't seen any recent images myself. There are MRIs, CTs, etc but haven't collected them yet. So, no. Not at this time.

    I am able to walk, no pain to speak of .
    He told me "ok, you can ditch the wheelchair and walk now." About 2 months ago. At the Next post Op he advised to ditch the crutch. (I had started using a single crutch then a cane).

    4
    there is no pain, redness or fever. Just picked a scab that was always there by mistake.

    As I said, the other ankle was swelling worse and turning red and hot a few weeks ago. My PT turned me away to ER concerned about a DVT, but it tuned out To be Celulitis for which the ER docs had me come back 3 days in a row for an IV antibiotic, then orals at home. That's all ok now. Seem to be anyway.

    4
    This just began 2 days ago. So no lab tests yet. I'll be calling my worker's comp nurse/ortho office to advisement today.

    I slept with a towel under my feet last night. It's still pretty consistent. I need an ankle diaper. Haha! As I said I suspect it's mostly the fluid retained due to the swelling that is leaking as opposed to serum or a normal post op leakage.

    Thank you for your pointed reply. I had searched for quite awhile using various permutations of a description and found nothing except after more recent surgery. So I was baffled. Glad I stumbled upon this forum!
     
  5. fugit

    fugit new member
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    Thank you Jaycey! Happy to have stumbled upon you guys!
     
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  6. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Yes, you can post an image Uploading a Picture in a Post

    Thanks for the image - I see it was standard AO spade plates.

    I still think you may have a leaking sinus - (a site of low grade infection). This isn't uncommon in ORIFs like this because the skin over the metalaware is so thin. Do go and get this looked at.
     
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  7. fugit

    fugit new member
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    Have a call in to my ortho. Waiting call back. Thanks!
     
  8. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Excellent. Do let me know what comes of it.
     
  9. fugit

    fugit new member
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    Well that escalated quickly!

    The drainage stopped the day I posted this thread. The ortho again said don't worry about it unless it gets worse. It didn't. Just dried up.

    A couple of days later, I had a fever, body aches, chills, the whole bit for 2 nights, then it subsided on its own. Figured it was just a bug. The Friday after starting this thread, I noticed that now the ankle in question was definitely turning red and warm to the touch. Having just had cellulitis on the other leg, I expected the same. I went to ER for antibiotics. And didn't come home for a week.

    They said the hardware in my right ankle had to come out. The infection was already pretty advanced and could thrive in the hardware. So from Friday to Monday, big gun IV antibiotics, then surgery to remove the plate. After a solid week in the hospital, I came home with a picc line in my arm for daily vyncomycin (sp?) IVs for the next 6 weeks. The infection had indeed gotten to the bone.

    The blood cultures grew nothing, so I don't even know what it was. Some kind of staph maybe? The bone is healed (except maybe for screwholes now), I am able walk on it, it feels strong, but am allowed to yet. Recovering ok so far. As I said. It escalated quickly. Didn't see that coming at all. Other than that 2 day fever, I felt perfectly fine the whole time.
     
  10. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    @fugit So sorry you had to have more surgery. But it's good they caught this and you are on the road to recovery. Please keep us updated!
     
  11. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    This sentence doesn't quite gel for me. Did you mean to say "but I am NOT allowed to yet"?
     
  12. fugit

    fugit new member
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    Oops! That is correct. I meant I do not have permission to walk on it yet despite the fact that the original breakage has healed in the last 7 months. I suppose the infection may soften things in there maybe? Zero weight bearing for now.
     
  13. sistersinhim

    sistersinhim FORUM ADVISOR Forum Advisor

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    I am recovering from ankle and foot breaks I did on May/21/17. I had no surgery, praise God, since it was displaced only 2cm! I was in a hard cast for 5 weeks with non weight-bearing. I used a wheelchair and walker to get around. Not stepping on your foot is very important!

    You have been through so much. You don't want to damage what has been corrected.
     

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