Swollen And Painful Ankle, Had Plate Put In, Rash Around Incision. Can You Help?

Posted on Fri, 17 Aug 2012

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Fri, 17 Aug 2012 Answered on

Tue, 23 Oct 2012 Last reviewed on

Question : I had a plate put in my ankle 4/18/12 . It is still discolored and swollen and hurts...but i have had problems breaking out in a rash i have had for awhile now originating around the incision. I need to know how to find out for sure if i am having a reaction to the stainless steel plate in my foot...I thought it was hives last week it got so bad i need to know how to kknow for sure so i can have this taken care of can you help me? Went to er last weds. they referred me to the dermatologist, who sent me to the allergist saying he could test and let me know for sure dermatologist prescribed clobetasol propionate which is helping the rash and the itching but my body is telling me something is wrong and my bp has been up considerably as well...i need to know how to find out for sure if i am having a reaction to the plate and have it removed if that is the YYYY@YYYY is my email address....please let me know something soon it has been a very difficult time and i need to know more about this so i can get back to normal....help please

Answered by Dr. Praveen Rodrigues (4 hours later)

Dear XXXXXXX

Thanks for the query.

Relax. At the outset, yes this appears to be an allergic reaction to the plate/screws/metallic component. It is not as rare an occurrence as one would expect. To the best of my knowledge, when the allergy or reaction is acute, patch/prick tests done to ascertain allergies are usually not conducted for fear of a 'backlash' or 'rebound phenomenon'. But your allergist will be the person best suited to comment on the ground.

The rise in BP et al may just be on account of the anxiety, so please do relax.

Consult your orthopaedic & you will have to weigh the pros & cons of leaving the plate in situ vis-a-vis putting up with the allergy for awhile depending on how long you have been recommended to keep it in.

Addition of an oral antihistamine like fexofenadine180mg once a day will surely help you.

Hope this has becalmed you & get better soon. Relax, XXXXXXX all three specialists & take an informed decision keeping your best interest' in mind. I will be available to guide you if you have any other concerns.

Do wish you all the very best.

Cheers!
Dr Praveen Rodrigues MD
Dermatologist & Cosmetologist, XXXXXXX Hospital,
Bangalore, India.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Praveen Rodrigues (14 hours later)

I wonder why the dermatologist here was so sure it had nothing at all to do with the plate? I was told that even if he had a piece of what had been put in my ankle the test if done, may not tell me even then what i need to know....I am at the point i've been through so much already i just want the darn thing out of there...and let my ankle get back to normal....what can i do to find out for sure that the plate is indeed the problem? Do u or your colleagues know how i can tell for sure....and if possible, what is involved in doing so.....?let me know....thank you.

Answered by Dr. Praveen Rodrigues (7 hours later)

Hi there XXXXXXX At the outset, apologies you felt the follow-up question 5 hrs ago was not answered, but i must point out that some of us are based continents' away & many time zones apart, hence 5 hrs ago would have to be past midnight here & hence the lag. Sadly, 'allergies' & 'allergy testing' as a consequence have not been de-mystified in the medical field. By that, i mean that immunology is one subject that is constantly evolving & difficult to pinpoint any particular allergen or antigen in any given situation & rarely do we have what one could refer to as a 'clinching' diagnosis in allergies. I do empathise with your problem & understand this does not make your deciscion any easier. If i have read you right ( & i am in agreement with you here in principle), you would be happier to just get rid of the plate & let your ankle get back to normal! There is no way to be 100% sure the plate is 100% implicated or not. You dont need any 'piece' of plate to check..you just need to know what exactly the plate is made up of & then your allergist may be able to run those tests. Once again i reiterate, these tests (as am sure your allergist wil tell you are not 100% foolproof). I am not permitted on this site (being electronic & going by its guidelines) to tell you what you have to do but have made an exception in your case to 'suggest' what i would do if i were you if you can please read between the lines keeping in mind your best interests' at heart! Once again, Goodmorning from this end of the world & Have a Good day & hope this answer helps you make an informed deciscion & your ankle is quickly back to normal !! Please do give us some good nes soon & wish you a speedy recovery. Cheers & God-Speed! Dr Praveen Rodrigues MD, XXXXXXX Hospital, Bangalore, India

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Praveen Rodrigues (24 hours later)

hello...sorry about that...i am not the most patient of people and it's been a long road it seems to me to get this far...to have to start all over again in the healing department...but yes, you read me right...although i and my son do think this is a contributing factor to all the problems, this thing hurts and i forsee nothing but more problems leaving it in...even if it had nothing to do with all the rashes, hives, and higher bp....as far as the piece of plate ( stainless steel) that's what the allergist here told me i would need? ... thank you for your input and i will be talking to my surgeon Monday to discuss this and let him know how i feel and what i want him to do ..i don't figure he is going to like it much...but i can't keep going on like this and while i have my son able to help me with my paper routes...i need to get this taken care of...thank you and God bess...i hope to be back to normal soon....will let you know what happens...thanks again.

Answered by Dr. Praveen Rodrigues (23 minutes later)

Hi there XXXXXXX I empathise & in your situation, my patience may have run thin too. It's easy sitting on the other side of the fence always :) Am glad you seem to have made up your mind & sometimes, one needs to assess what the greater 'good' is & this may vary from person to person. Also dont worry too much what your surgeon feels. You are the patient & am sure he will come around to accepting your view providing it is in your best medical interests'. My gut feeling is all will be well soon. Glad i could be of some help & will be happy to hear of good news from your end soon..Monday is a day away! Cheers & God bless too. Dr Rodrigues.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar