9 weeks ago I fell from a 10 foot ladder landing all my weight (6 foot 260lbs) on my left ankle. Needless to say it was nasty, the whole foot purple swollen from knee to toes, got a huge blood blister (which is still there) on the outside of the ankle, my foot was unrecognizable. Went to ER and they took various xrays and nothing showed up, but they were sure I broke it, but nothing. They said it was a bad sprain and that I would be hurting for about 4-6 weeks. I have had many sprained ankles and I tend to heal fast. Well my ankle still looks horrible, very swollen, some discoloration, so I went back to my doctor. He said it looked horrible and a sprain should not look like that 9 weeks out. They sent me for another xray before going to orthopedic. The xray now shows a fracture on the medial malleolous (it is weird like a crack going up and down away from rest of ankle on xray). I am hoping that finding this out 9 weeks out will not have affected me from healing it properly. There is some pain especially on stairs where it is slightly unstable. On level ground I can move pretty good, no running or cutting but walking without a noticeable limp is pretty easy. Does anyone have any information before I see DR?
I guess my main concern is avoiding surgery. From what I read I have no idea, some say I wont need it and others say yes.... What are the chances I will need surgery? anyone have this fracture?
It is hard to determine what the outcome will be at this point and your doctor is really going to be the only one who can give you a good answer. I had a fracture from a fall in my tibia on the posterior side, so it wasn't through the malleolus, but did go undetected until I had an MRI probably 8-10 weeks after my fall happened. It ended up being non-displaced, and was the least of my problems from that fall. When I went in to have surgery for other problems I was having, my dr checked the site of the fracture and said it was stable and didn't feel as though it would cause any problems. Goodluck!
The Following User Says Thank You to poppyg1 For This Useful Post: bridaman (10-12-2011)
You can see the fracture on the x-ray. It is different from the x-ray images I see on line with the similar injury as their fracture go across, it looks like mine goes up and down and the piece is completely away from the rest of the ankle. I am able to walk on it on level ground pretty well, stairs are hard but doable. The ER stated it was probably the worst sprain they every saw and did not recommend and therapy or re visit. I went to my doctor because it is still pretty swollen and discolored and still painful at times. I also read that if it was displaced the ankle would feel unstable, and my ankle does not feel unstable. So hopefully that is a good sign. Thank You for the post. I will see tomorrow.
I am also reading that usually minor fractures are treated like a sprained ankle and usually heal them selves. I treated this injury like a sprained ankle and 9 weeks later the fracture is still showing up. If it was a minor fracture should it still be showing on the xray or could this be a little more severe? I am hoping that that maybe if we splint it up and I stay off it for a few weeks maybe that will heal it. Again I am not sure how it should have healed in 9 weeks, would the fracture still show after 9 weeks if it was minor?
The fact that the x-ray is still evident at 9 weeks isn't a good sign. Treatment at this point depends mainly on one thing - the position of the fracture. If the fracture is not lined up properly or if it is displaced (separation within the fracture site), you will want to have surgery. I say "want" because if the fracture heals but it is in a bad position you are bound for a life of potentially significant arthritis and pain. Whether it does need to be fixed or not, you will be non-weight bearing for at least 6 weeks. Ultimately, it doesn't matter what anybody on this message board is saying because we can not see the x-rays and not every fracture is treated the same. I know you want reassurance as to the outcome of your ankle, but it is virtual impossible to tell you what needs to happen over the internet. Obviously, you need to be seen by a specialist to get a diagnosis and treatment plan.
The Following User Says Thank You to j9879 For This Useful Post: bridaman (10-12-2011)
I am seeing the specialist tomorrow morning and I will give update then. They got me in as soon as possible but still had to wait 2 days. I understand what you are saying about not seeing xray and diagnosis I guess I was just wondering about the fracture showing up 9 weeks later and healing. would it be possible that the fracture has started to heal, especially since I can walk on it. If it is healing and it is not healing correctly will they have to basically re break it? I have heard of that with broken arms and such where it started healing and they had to re break it, would this be similar? Bottom line is I am just trying to find some reassurance, I really dont want surgery on my left ankle and on my right knee at the same time.
"On level ground I can move pretty good, no running or cutting but walking without a noticeable limp is pretty easy. "
If your doctor didn't mention surgery, be happy. From the above statement sounds like you are doing fine.
Usually after nine weeks a fracture like that would be healed but walking on it slows it down. The pressure will keep the new bone from growing together. Although you still see it on xray, the fracture is probably healing. What did your dr say?
Be very happy that falling that distance did not do serious damage to your heel.
My family doctor looked at my ankle and said that aint normal. It is still very swollen and discolored as well. I also had gotten a big blood blister on the outside of my ankle which still has not healed either. My doctor would not touch it since it looked the way it did 9 weeks out, he just sent me for X-rays and referred me to ortho. Of course the radiologist called back and confirmed the finding of the fracture which was not present the first time. My doctor did say that it was probably so swollen that the fracture would not show as it was held together by swelling. Well that is what he said in a nutshell. I see ortho tomorrow 2 days from referral, my doctor was serious about getting me in as soon as possible.
Saw ortho today. He looked at xray said it was not a fracture but calcium deposit on the ligament. First said it was torn ligament then said stretched and now has calcium something or other. He said everything was fine and sent me on my way. I guess I lucked out. My only worry now is that he was so quick and did not even really look at my foot much that down the road something else will come up. Maybe the pessimist in me, but I am glad he said there was no fracture.
"He said everything was fine and sent me on my way"
"My only worry now is that he was so quick and did not even really look at my foot"
Am I the only one that finds these statements disturbing? Its 9 weeks out from an ankle injury and you are still having pain, swelling and bruising. Everything isn't fine! Even if you damaged the deltoid ligament, the very least you should get is a brace of some sort to make you more comfortable and physical therapy. It sounds like you were happy just hearing it wasn't a fracture, but dismissed the underlying problem you related to us. You are still in pain, can't run, have difficultly with stairs, etc. Pain this far after an ankle injury generally means something more is going on and at least should be investigated further with an MRI. Sounds to me your orthopedist doesn't deal with ankles often or doesn't like treating them. He was treating your x-ray and not your ankle.
I was happy when he said no fracture but you are correct. He did not even touch my foot, he looked but did not. I was in there for 15 minutes and only 5 of which did he talk about my foot. The reason I passed it off as no big deal is because I am going to see another ortho on the 25th of this month. This is my regular ortho that I have been seeing about my knee issues for over 10 years. He is one of the area's top ortho's and does all the surgies and stuff for Virginia Tech sports teams as well as the local minor league teams. I originally wanted to see him for both but because he was in surgery all this week I could not see him for the ankle and they wanted me to see an ortho as soon as possible. At that point in time I will be almost 12 weeks out so he will take care of it. I will post what he says later. I think the doctor was not concerned because my pain was not sever enough, and the stability was not to bad. Really stairs are my biggest problem.
My regular ortho was much more thorough. Although he said he was not a foot and ankle specialist. He also checked the xray said there was NO fracture that it was a calcium build up. The pain in the ankle is not so bad, I can still move pretty good on level ground but stairs, hills and unlevel ground are problems. Sometimes my ankle hurts where the calcium is built up (but not bad) and on the lower outside part of my foot (right below that ankle bone that sticks out). it is not unbearable but still persistent. The ankle is still very swollen and still pops when I do my rehab exercise. I have been in physical therapy for 3 weeks now, going twice a week. I can do jjust about everything he has me doing (mostly stretching and some thera band work with the ankle). I am not sure it is working as the ankle does not feel any better. No worse but it is not getting better. I am now 15 weeks post injury..... This is my last week of therapy, I guess I need to start getting some answers....
My regular Ortho checked it over pretty good. Looked at the xray again agreed about the calcification. Said there was no break or displacment. Recomended I go to physical therapy. Well this is my fourth and final week of therapy. The ankle is still swollen, still sore at times. Again I can walk pretty good on flat surfaces, hills, stairs and uneven stuff are still problems. When I do my therapy exercises there is a lot of popping feeling. The outside part of my ankle below where that knobby bone sticks out (sorry do not know the name of it) gives me a tearing feeling when kind of stretch my ankle out on that side. It is not so much pain just a general tear (like a stretch only painful). I am not sure where to go from here I guess I will have to speak to the therapist today. We will see.
I had my last PT yesterday. My ankle is still really swollen, some discoloration at times. The swelling in mine is constant does not come and go. However I have not had much pain, or the giving out feeling. Mine is more uncomfortable, popping, grinding type of thing. Also when I was doing some of my exercise that pulled the foot to the inside, it would feel like I am tearing something on the outside (lower, back part of my ankle). It does not feel like a stretch it is a much worse feeling than that, like I am actually tearing something and that is painful so we stopped doing that. My PT actually went back to the ortho immediately after I left (he told me he would go talk to him but did not know he meant immediately). The ortho called me within 10 minutes of me leaving and got me an appt on Monday. Again I am not so concerned with my ankle as I am my knee. I think the ankle is okay, I dont feel like I am expierencing the same symptoms as so many others with the lose, giving out feeling or tons of pain, really just uncomfortable. Really I just want to run again
You mention that your ankle is continuously swollen and that you are not concerned about it. To me, that should be a concern. Is your PT doing anything to help bring the swelling down? It's not good to be in a chronic state of inflammation.
What are the next steps for your ankle? MRI? If it is not feeling normal, continue to investigate. Who know what problems you may be at risk for in the future or further damage you cause by not figuring out and treating the problem properly.
The PT did work on swelling, pretty much that is all we did. He iced, heat, anti inflammatory meds. We also worked on range of motion but some of those exercise irritated it and he did not want that because of the swelling. I say the swelling is not a major concern because there is not a lot of pain, I figured if something was wrong there would be a lot of pain and discomfort, and I do not have much. I figured it was just fluid build up (but I am not a Dr). I see the ortho again today, probably will schedule an MRI I am sure. We will see.
Wow 8 monthes later and my ankle is still swollen and sore. We treated the opposite knee hoping it would help the ankle but that was not an issue either so my knee ortho (who was trying to help with ankle but not his are of expertise) sent me to a ankle specialist he recomended. I saw the specialist yesterday and he was concerned. I took some Xrays including a xray (I cant remember what he called it) that showed the bend of my ankle inward. He said there was significant difference between my two ankles. He also said there was a lot of debris in there that needs to be removed as well. He said he is very conservative doctor and did not want to persuade me one way or the other but recomended reconstruction surgery on the ankle as it is very loose. He said luckily it is going back currently. He is doing and MRI to see the extent of the tears and to look at any possible tendon tears that might be present as well so he will know what he is up against. Anyone have ankle reconstruction? He said it is above 90% success rate and at my younger age would benefit me and my ankle.
Yep! Had it done 4 wks ago for the 2nd time, but I made the mistake of letting a general OS do it and not a foot/ankle OS. My experience the first time was fine, but the foot/ankle surgeon doesn't believe everything that should have been fixed was fixed and I had so many severe injuries after the first surgery that I believe that's what happened too. Anyway, my ankle OS also quoted me above 90% success rate and he trained under the doctor for whom part of the procedure is named (Brostrom-Gould-trained under Dr Gould). I have had a fantastic experience so far. Still in my cast for 2 more weeks and crutches too. I've had to be NWB for 6 wks. Then I will move into the boot, begin weight bearing and start PT. I'm glad you were finally able to get some answers and help! Good luck with your decision! There are several of us on here who have just gone through ankle reconstruction so whatever questions you have, ask away!!!
My OS is a foot/ankle specialist as well recomended by my Knee OS, told me he was the best around. He has gotten all great remarks from former patients and was very personable and took his time, was very thorough in his analysis. Said he will never try to persuade anyone into surgery unless it was truley necessary. I just want to know if it is worth it, I do not like surgery, or needless or things like that. I coach so I do not like being on crutches for 6 weeks, a walking boot no problem but as much as I move around crutches are no good. I am currently able to move around pretty well on flat gorund, uneven ground a bit more troublesome but not horrible (atleast I dont think so Dr. did). I just really wonder if I should go through with it, what happens if I just let it be. He said it is as good as it will get right now, and will not get any better without surgery. But will it get worse? is surgery worth it?
