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Chronic pain/fibila non union after osteotomy
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Chronic pain/fibila non union after osteotomy

My stepdaughter, now almost 15, suffers from chronic pain from a non union of the fibula after osteotomy 3 yrs. ago.  She originally broke her ankle at age 8.  The original fracture killed the growth plate in the tibia, but the fibula kept growing so her ankle and foot were twisted over by age 11. So the growth plates at the bottom of both legs were both removed surgically, and then the bone length difference was corrected by taking out 3" of fibula and using it to lengthen/straighten the tibia. The fibula was left "hanging" and they expected it to grow back and rejoin within a year. However after 3 years it is still unjoined by ~1-4 mm. There has been continued slow growth (1 cm gap in Feb. 08 decreased in 18 months to ~1-4 mm by Sept. 09), so the docs want to avoid surgery if possible and see if it will heal. Her treatment and care were not managed well before she came to live with us, and she was just living in constant pain.  She has a 15 mm leg length difference that had gone unaddressed and was affecting her knees, hips, spine. So we have gotten that fixed with an orthotic, and physiotherapy is addressing all the muscle issues from walking like that for so long, plus strengthening her ankle.  She also receives acupuncture and naproxin for pain management, and electrical stimulation across the bone (weekly), hoping to promote growth. She's taking supplements Ca, Mg, Zn, D. The naproxin is to give her some relief from the pain, calm down the chronic inflamation (inflammation), and help her be able to do the PT. She's pretty tough but in constant pain without the medication.  She is very sensitive to weather changes.  She can walk well, but running or jumping leaves her very sore.  She thus cannot do PE or sports.
I have a couple questions.  
1.  Is it true that the anti-inflamatory may interfere with bone growth?    
2.  Can chronic bone infection be detected by x-ray or by blood test?  
3.  In the most recent x-ray, the ends of the bone are not smooth or even but appear to have rounded bumps and shadows.  (I have digital x-ray dcm files if there is a way to post or send them.)  I wonder if scar tissue could be interfering with the joining of the two ends.  Would surgically cleaning off the ends of the bone promote faster rehealing now that the gap is so much smaller?  We would like to avoid bone graft if possible.
4.  Is there anything else we can do to promote healing and/or reduce the pain?  Visualization, other supplements...
5.  If the bone does rejoin, can we expect the pain to be decreased?
Thank you in advance for any information or suggestions...

  
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