Foot turns red when not elevated after surgery

My nephew had ORIF surgery 4 1/2 months ago, and while his bone is healed and he’s 80 percent weight bearing, he’s really upset about the color his foot turns when it’s down. It becomes a violent red, sometimes even purple, and occasionally his calf will also turn red and mottled.

When he saw his surgeon, he was diagnosed with RSD. However, he doesn’t experience any pain, and his skin color changes aren’t due to temperature fluctuations. When his foot is up, it looks perfect, but when it’s down, it turns bright red. There is minimal swelling.

He had a leg scan to check for clots, and fortunately, his veins are in great condition with no clots found. However, he has been experiencing a crazy weird pain on the inside and side of his knee since the surgery, which the doctor says is due to a torn nerve.

So, his question is, even though he knows he has asked before (sorry!), can anyone share their specific experiences about recovery from a foot turning colors when down after surgery? He is worried if this will get better or if he now has venous reflux or something worse for the rest of his life. Is he being really paranoid, or does he have something to worry about? Is there anyone else out there whose foot, and sometimes calf, still turned colors four or five months post-surgery but eventually got better?

He really appreciates every answer! He’s also been battling an ear issue that causes severe pain and vertigo, which has slowed his recovery (it’s hard to start walking when you’re dizzy). He’s just very worried about his foot and leg. Thanks again!