ankle sprain/fracture

Hi. I rolled my ankle 2 weeks ago… went to ER and they said it’s just a sprain. 48 hours later I tried to walk on it. probably did some more damage. it was very painful and still swelling. on the 3rd day, the hospital called and said there's small avulsion fracture. they gave me an aircast. Now two weeks later it’s still very red and swollen. Sometimes feels like it’s burning. So I saw the doc again and he said for this kind of fracture, the swelling and inflammation should’ve settled down by now. so the continuation of symptoms suggests there might be some serious soft tissue damage. however, I can move my foot around (though very limited) so I doubt it’s a type III sprain. Basically, if I’m to get this treated by a specialist it’ll mean flying back to my home country, which is very troublesome. so I want some opinions… should I just give it a couple weeks more to see if it settles down? Or best to fly back now? I’m not sure if leaving it for an extra couple of weeks is a significant risk or not? but I am worried hence I’m seeking advice here. any help would be very much appreciated.

[Michael L Gross, MD]

Usually those avulsion fractures are not clinically significant, and do nothing to change the course or treatment of the injury.  For a lateral ligament sprain, I usually recommend using an Aircast full time (except for bathing) including sleep, for three weeks. I follow this for 3 weeks of daytime wear.  Occassionally I see patients from the ER who are wearing an Aircast trainer, or Aircast lite.  These are usually two small and do not offer enough support.