Reminder

• Explain chronic pain
• Cicatricial neuropathies
• Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies.

Description

The ankle can be operated for disabling osteoarthritis, severe sprains, instability, fracture. The interventions are, depending on the case, ankle arthrodesis, ankle prosthesis, ankle arthroscopy, ligamentoplasty, rupture of the Achilles tendon. The different approaches are shown below:

• Ankle prosthesis by anterior approach, arthrodesis by an anterior or lateral approach

• Ankle fracture (bimalleolar)

• Arthroscopy

• Achilles tendon rupture arthroscopy or open surgery

• Ligamentoplasty, unstable ankle

All of these approaches can be responsible for neuropathic pain and/or CRPS type 1. Here are some painful topographies and where neurological abnormalities are located:

Like all chronic postoperative pain, the diagnosis will be evoked in front of a positive rolling palpation maneuver.

Clinical case(s)

• Chronic pain after bimalleolar ankle fracture

Treatment

• Treatment of neuropathic pain