Chronic pain after bimalleolar ankle fracture MEDECIN LIBRE

M X, 45 years old, victim of a bi-malleolar ankle fracture operated on 14 months ago,
has significant residual pain limiting walking and returning to work (the patient is a self-employed physiotherapist).
Following his operation, he presented with very debilitating type 1 CRPS or CRPS. Currently there is still pain (red zone).
Examination of the patient found hyperesthesia of the front of the foot and the outer edge of the leg (red zone).
The bone scintigraphy performed a few months ago by the patient found bone hyperfixation reproducing the painful topography of the forefoot.
fracture-bimalleolaire2
fracture-bimalleolaire4

fracture-bimalleolaire3

Examination of scars (rolled palpation) is very unpleasant and tends to reproduce the patient’s pain (green area).
The treatment of the scars allows a clear reduction in pain with, however, persistence of stiffness of the ankle linked to the prolonged non-mobilization of his foot. the first injection allowed an improvement lasting 1 year. A new infiltration was necessary after this period.
General information on cicatricial neuropathies.
General information about CRPS.

Post operative chronic pain