Lateral Ankle Pain After Fibula Fracture Repair: Injury to the Superficial Peroneal Nerve

If you’re an athlete or weekend warrior who’s suffered an ankle injury or fractured fibula, chances are good you’ve had surgery to repair the damage. Many times, this injury requires internal fixation or the placement of a plate with screws to stabilize the bone and prevent re-injury. 

During the procedure, your surgeon moves the nerves that run along the side of your ankle out of the way. However, for patients with a severe fracture, these nerves may be injured or scarred, causing ongoing discomfort after surgery.  

These symptoms can make it difficult to get back in the game, but fortunately, there are ways to relieve this pain. At Anthony Echo, MD, in Houston, Texas, our board-certified surgeon has extensive experience with microsurgery and nerve repair surgery. 

Dr. Echo evaluates your symptoms and determines which treatment can best help alleviate your nerve-related symptoms after fibula fracture repair. Take a moment as we answer your questions about this condition and explain how our practice can help.   

My injury has healed — why do I still have pain or numbness?

If your imaging studies show your fracture has healed, your doctor may tell you to do more physical therapy or see a pain management provider to deal with ongoing pain or numbness in your foot or ankle. 

However, your symptoms may be due to the involvement of the nerves that run along the side of your ankle next to your fibula: the superficial peroneal nerve and the sural nerve.

Your superficial peroneal nerve is responsible for sensation along the top of your foot, while your sural nerve manages sensation on the outside of your foot and ankle. 

If you injured either or both of these nerves at the time of your fibula injury, the damaged tissue or scarring can compress the nerves. 

Nerve damage and compression can trigger ongoing pain in your ankle or a loss of feeling in your foot. As a result, you might have trouble returning to play — even if your fibula has healed. 

How can you tell if damaged nerves are causing my symptoms?

It’s important to see a nerve specialist, like Dr. Echo, if you have persistent lateral ankle pain or numbness in your foot and/or ankle after a fractured fibula, as orthopedic surgeons frequently overlook this type of damage. 

Dr. Echo performs a comprehensive evaluation to determine the root cause of your symptoms. In addition to a thorough clinical exam, Dr. Echo reviews the details of your injury and surgery and discusses the nature of your symptoms. 

To determine if the superficial peroneal nerve or sural nerve is involved, he may order an MRI to diagnose nerve involvement, an electromyography (EMG) to assess the function of these nerves, and a nerve block to confirm the diagnosis. 

What treatment helps resolve this pain or numbness?

Based on the nerve involved and the nature of the injury to the nerve, Dr. Echo creates a personalized treatment plan to help resolve your symptoms. For patients with compression due to scar tissue, Dr. Echo performs surgical decompression.

During this procedure, Dr. Echo removes the scar tissue and releases the thickened tissue around the nerve to take pressure off of it, easing your pain. This allows the nerve to heal, restoring sensation to numb areas.

For severely damaged nerves, Dr. Echo may recommend a nerve graft. During this surgery, Dr. Echo grafts a healthy nerve from another area of your body or a donor to the damaged nerve, restoring function. 

These treatments address the underlying cause of your ankle and foot symptoms, easing your pain and helping you return to play. 

 For help with ongoing ankle or foot pain or numbness after fibula fracture repair, don’t wait to schedule a consultation online or over the phone with Dr. Echo, an expert in nerve repairs.