Not sure if this help, but I got a long spinal fusion from the thoracic to lumbar spine when I was age 11 (I’m now 40), so it’s been a good while. I’m not sure if it’s the same with an ankle, as ankles have a lot of range of motion, but while the spinal fusion (multiple rods and screws) solved one issue, I do have chronic back and neck pain from it.

I was told that where the metal naturally restricts my range of motion, it transfers that force to the bones and muscles surrounding it, which aren’t necessarily designed to take that much load. A side effect is I’m more likely to develop osteoarthritis.

Again, not sure if that would be similar with screws in your ankle, but the other thing that affects me is restriction from scar tissue. Even though the scars look fine on the outside, scar tissue can pile on and pile on under the skin causing restrictions that can also refer pain. A PT was able to help me with exercises for the pain and also recommend some scar manipulation techniques I could do on my own to help loosen it up.