Non Union Distal Fibula - what to do

[BballMom12]

My son, now 17, broke fibula (very low) in June 2009.  Healed (we thought) with cast/boot.  No followup xrays after bood in mid July 2009.  Began play basketball again late August.  Continued through end of December, when he rolled his ankle at practice and it broke again.  Thoughts were was it ever healed or only held together with fibrous tissue?  Went back into cast for 4 weeks, attempted to play basketball (healing was occurring, per xrays).  Played for aprox 3 weeks until season was over.  After that, attempted to continue to heal.  End of March, went back into cast to try to get the brake to finish healing.  After 3 weeks, xray looked like healing took a step backwards.  Casted for another 3 weeks, with no change.  All along he has been using a bone stimulator device.  What do some people get non unions?  Apparently our options are to do nothing (continue bone stimulator) - rehab and hope he can play on it.  Next option is surgery with bone graft which we find very scary due to complications - and is it guraranteed.  He has had lots of blood work looking to see if any reason for non healing (vit D = 31 at last check) - but pediatrician says he is healthy.  His orthopod is the best of the best, but would it be beneficial to see an Ankle specialist?  Any and all thoughts are welcome.  He really wants to play basketball his senior year... Thanks

[BballMom12]

My son had an appt with a top ankle Dr. yesterday regarding his non union.  He indicated his thoughts are ligament/tendon damage issues - which is behind why bone is not stable enough to heal.  He wants to operate on ligament and put in screw in ankle.  If no surgery occurs, he indicates this injury will constantly bother him due to major instability of ankle due to ligament issue.  Dr. more concerned about ligament issue than bone.  Looks like we may schedule surgery for 3rd week in July.  

[BballMom12]

We are around a big college (and his current Dr. is associated with their sports program - and considered a top dr.).  He has been very sympathetic to his athletic needs.  Surgery scares us so we very much want his body to heal itself.  We worry about infection, and other surgical issues.  He has already had MRSA once in his life (6 years ago), and the prospect of that post surgery is scary.  In your experience, how long did it take to recover from the bone graft surgery?  That is a big concern for my son - when can he play again, etc.  Also, what is the chance he can play on such a non union?  In my opinion, he did for a long time last year without really knowing it.  But then again, it did eventually, break again.  His Dr. is trying to get him into an ankle guy - just waiting to hear now.

[PedroH]

In researching for myself over the last 18 months I have found that is not rare to have non union with the fibula. I had tib/fib fractures w/ hardware inserted to the tibia. 5 months after, my fibula was not healed so I had a bone graft.Bone grafting sounds scarier than it actually is.Yes, your hip is abit sore & you get a piece of hardware but I was only in the hospital for 24 hours and was only mildly uncomfortable.However,that being said, get a second opinion maybe from an orthopod that has special interest in sports medicine( are you around a college big college town?)As these Drs. would be more sympathetic to an athlete especially going into his senior year. Good luck to you and yourson.