Question: I had been having redness, swelling and lot of pain in the foot of my polio leg, and then the knee-lock in my brace caliper collapsed, and I fell, resulting in a fracture at the base of the first metacarpal bone, extending into the joint surface (cuneiform bone) in the polio foot. There was no dislocation as the foot was in the brace and shoe. I wore a cast and nursed the foot back to health (for five months) through regular physiotherapy and hydrotherapy. Recently, I have noticed redness, swelling and pain again in the foot of the polio leg. Is this a cause for worry? This leg does have osteopenia.
A: I would be concerned about recurrence of the swelling if it had resolved for a period of time. It could represent a stress fracture in your osteopenic foot or simply some arthritis and/or strain in the area of the fracture that needs to be nursed back again as you did before. And then give it more time to gradually build up to full activity or receive some extra protection by some minor modifications in your brace and footwear/orthotics. Definitely have the foot re-evaluated if the recurrent swelling persists for a week or more in spite of some modest cutback in activity and some local icing and/or anti-inflammatory medication use.
Post-Polio Health (Vol. 28, No. 3, Summer 2012)