Postsurgical nerve damage can occur for various reasons, including misdiagnosis, surgical error, and scar tissue formation. Common signs of postoperative nerve damage include tingling, numbness, weakness, or burning sensations.

The most common complication following foot and ankle surgery is cutaneous nerve injury.

Cutaneous nerves are sensory nerves that transmit information about sensations such as touch, pressure, and temperature from the skin to the brain. Cutaneous nerve injury can lead to long lasting discomfort, including postoperative numbness or tingling in the foot.

This article explores the causes, symptoms, diagnosis, and treatment options for postoperative nerve damage following ankle surgery.

Image of the lower part of a person's legs at the beachShare on Pinterest
kolderal/Getty Images

Generally, 10–40% of people experience surgically induced neuropathic pain, with severe pain reported in 2–10% of patients.

While postoperative nerve damage is a potential risk of ankle surgery, the likelihood of experiencing this complication varies depending on factors such as:

  • the specific type of ankle surgery
  • the person’s health before surgery
  • the surgeon’s skill and experience level

For example, in one 2017 study, researchers found that the prevalence of persistent neuropathic pain symptoms after open reduction and internal fixation was 23%. Another study showed that the incidence of peripheral neurological complications was between 1.8 and 21% in individuals who underwent total ankle arthroplasty.

Postoperative nerve damage after ankle surgery is a common but overlooked complication.

Potential causes of nerve damage after ankle surgery may include:

  • direct injury to the nerve during surgery
  • entrapment or compression of the nerve resulting from scar tissue formation or suture ligation
  • improper positioning of the affected limb during the procedure
  • incorrect use or placement of surgical hardware
  • inadequate postoperative care
  • pre-existing conditions such as:

Learn more about the types and causes of nerve pain.

Symptoms of postoperative ankle neuropathy can vary depending on the cause and the severity of the damage, but the most common symptoms include:

  • numbness or tingling in the foot or ankle area
  • burning or shooting pain
  • weakness in the ankle, foot, or toes

People who experience symptoms of postoperative ankle neuropathy should consult with their surgeon to determine the cause of their symptoms.

In addition to a physical examination, their physician will consider a person’s medical history and diagnostic testing.

Possible diagnostic tests may include:

  • Electromyogram (EMG): This measures how well someone’s muscles respond to electrical signals.
  • Magnetic resonance neurography: This is a noninvasive imaging technique that can detect abnormalities in the nerves and surrounding tissues.
  • Ultrasound: This can help identify any swelling or compression of the nerve and determine if any structural changes may contribute to a person’s symptoms.

The surgeon may recommend additional testing to rule out other possible causes, such as vascular disorders, autoimmune disorders, or infection.

Treatment options for postoperative ankle neuropathy may include:

Natural remedies may also provide relief for mild to moderate symptoms. These remedies include rest, ice, and elevation to address swelling and gentle exercises to promote circulation and reduce stiffness.

If the nerve damage results from an underlying condition, such as diabetes or an autoimmune disorder, treatment will focus on managing the pre-existing condition and minimizing its effects on the nerve.

The outlook for postoperative ankle neuropathy varies depending on the severity, cause, and the person’s overall health.

In general, if someone is able to properly address the underlying cause, and effective treatment is available, most people can expect to experience improvement in their symptoms over time. However, recovery may take several weeks or even years, especially if the nerve damage is severe.

If someone is not able to adequately manage or treat the underlying condition, the nerve damage may progress and worsen over time, leading to long-term or permanent complications.

Postoperative ankle neuropathy is due to nerve damage that surgery on the ankle or surrounding area can cause.

Symptoms may include pain, numbness, tingling, weakness, or a burning sensation.

Doctors may use imaging tests, nerve conduction studies, or electromyography to diagnose and assess the extent of the nerve damage. They can then suggest suitable treatment options.