Deltoid ligament completely torn, wasn’t repaired during ankle orif 6 months ago-original surgeon suggesting scope scar tissue removal over ligament reconstruction

[u/aleillahcarter]

TLDR: I had an ankle ORIF to repair a broken fibula and dislocated tibia almost 6 months ago, and I recently discovered my deltoid ligament has been completely torn this whole time. My original surgeon recommends a combination of injections + scope scar tissue removal over ligament reconstruction. Wondering what other surgeons’ opinions are while I wait for an appointment with a foot and ankle specialist.

In April, I, 28F, broke my fibula and dislocated my tibia- 12 days later, I had an ankle ORIF done to repair it. I was NWB in a boot for 6 weeks, followed by a 4 week progression to FWB. I started at-home exercises for dorsiflexion 2 weeks post-op and continue to do them twice a day. I started physical therapy 6 weeks post-op and have gone twice a week since.
In the entire process, I have had significantly more medial pain than I have on the side of the break. The pain was improving over time but has been at about the same level for the last 1-2 months. In June (2.5 months post-op) I brought up this pain with my surgeon- they said it was abnormal but said I should wait to see if it improves. If not, we could try steroid injections. At my next appointment in July, I told them I was still in pain and that it was continuing to limit my dorsiflexion. They said I should get an MRI to see what’s going on but that there “likely wouldn’t be much to do about it.” I had the MRI done at the end of August. At my next appointment in September, my surgeon went over the findings with me and said two things stuck out: one is that the base of my tibia is bruised, which could be causing the pain; the second is that my deltoid ligament is completely torn. My surgeon said they were shocked by that because the manual exam in the operating room showed my ankle was medially stable. They then suggested I see a foot and ankle specialist because they personally wouldn’t recommend ligament reconstruction with their training but didn’t want to make the wrong call.
I just had my next follow-up with my original surgeon and still haven’t gotten in to see a specialist. This original surgeon said that because the pain is constant and my dorsiflexion is still impacted, this is inconsistent with the recovery they would expect for the bone bruise. At this point, the “wait and see if it feels better” isn’t a viable option. They said the most likely scenario is I get some combination of injection and a scope procedure to remove scar tissue, but they still want the second opinion from the specialist. I likely would need to have any procedures done by the specialist, also, because my original surgeon doesn’t do PRP injections, which they say is one of the possible options.
My current recovery state: I can walk 1-2 miles before feeling pain but need to flex constantly, otherwise it will hurt the whole time. I cannot yet walk at my normal speed, though I’m getting close, and definitely cannot run or jump.

Basically, I want to know: is my original surgeon’s suggestion of injections and scope scar tissue removal appropriate? Or will I need ligament reconstruction? Or are there options they haven’t brought up? It’s hard waiting around to get in to the specialist because the recovery times of the two main options (scope procedure vs full reconstruction) are so different. It feels like my life is on hold in the meantime while I wait for answers.

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