broken fib. and painful ankle.

[Gallypro]

Hi doc. thanks for the reply, much apprciated. first  i should tell you that  me and another person slipped on ice and my friend fell on my leg causing the fracture, not sure but i may have rolled my ankle at the same time . You mentioned radiographs, not exactly sure what that is but Ive had my sergion look at few X-rays, he was looking at the space between the bones in tha ankle, his concern was wether or not to put a screw in, cause apparently my fractured fibula can cause swelling in the the ankle and thus spreding the bones out of posistion causing instability but he thinks the x-rays look alright, so he sent me home after 6 weeks and asked me to come back in 3 weeks, should i be pushing for a sooner date.

[Gallypro]

The fracture is almost half way up my leg, thought i would mention that.

[Gallypro]

I've been trying to bear some wait like my sergion asked but it hurts my ankle too much to bear wait on it alone, therefore i'm still depending on my crutches, the pain is deep inside towards the rear on both sides and around my heel and achilles.. But i'll keep slowly giving it tolerable amonts of wait, Hope I don't need sergry?

[JainMD]

Hi,
I am sure you would like to have a good follow up with us. Hence I would like to request you to kindly post your new comments on previous post only.
I think you should be asking him to see as early as possible. I also feel that this the right time to do an imaging study i.e. X-ray as much would depend on how does the x-ray looks.
I think if you feel comfortable, then you should be doing weight bearing otherwise not.
Keep me informed if you have any queries.
Bye.

[Gallypro]

I just saw my sureon three days ago, he has done x-rays and feels they look alright and don't need any emediate attention. I'm booked to see him in three weeks. what else should i do.

[JainMD]

Hi,
If imaging is being done and those according to surgeon appear normal, then there is no need to worry. You can continue with passive range of motion exercise as taught to you by your physiotherapist.
Do not over-exert your self.
Bye.

[Gallypro]

I have not been refered to physio. yet , should I be? maybe I should go back too my gen. practitioner ( family doc. ) see if he thinks should start some physio. even though I'v been passed on too seeing my surgeon now,  and he didn't mention physio. yet. ?

[JainMD]

Hi,
I think you should be asking for physiotherapist to start with tolerable passive range of motion exercise.
This will avoid disuse atrophy of muscles around the joint.
This will help in your swelling and in weight- bearing too.
Keep me informed if you have any queries.
As I said earlier do not exert yourself.
Bye.

[Gallypro]

can a fractured fibula have an effect on the peroneal tendons? that seems to be the source of my pain.

[Gallypro]

Does it help to be soaking my foot in warm water once a day , or icing it , or both?

[JainMD]

Hi,
Yes a fractured Fibula can have effect on peroneal tendons if the fracture is near the peroneal tendons. If the fractures are near the peroneal tendons then they can cause compressive pathology on the peroneal tendons.
Yes it would help soaking your foot in warm or ice water once a day.
You can do those alternatively as that would help in treating the pain perception and further pain relief.
Keep me informed if you have any queries.
Bye.

[Gallypro]

My fracture is about 4 or 5 inches up from the bottom, could there still be pain involved with the peroneals. and will a MRI show if there is a partial and or complete tear in those tendons?

[JainMD]

Hi,
Your symptoms of pain could be due to nerve irritation or nerve injury. Numbness or paresthesias may arise if damage to the peroneal nerve has occurred.
It is possible to have peroneal nerve damage due to fracture fibula.
Yes indeed a MRI will definitely show an injury, tear or displacement of tendons.
Any soft tissue pathology could be assessed with the help of MRI study.
Radiologist would note different signal intensity on a scan.
Are you planning for one? Or is the Orthopedist planning one?
I think it is to be done as early as possible.
Keep me informed if you have any queries.
Bye.

[Gallypro]

I saw my orhopedist two weeks ago, when he told me to come back in three weeks, so I'll be seeing him in one week from now. He will notice my pain and lack of ability to bare much weight, after nine weeks, and  will probably look deeper into the matter. Because I live in a smaller community there is only a travelling MRI that the area shares and I think there is a long list to get in, I hope he doesn't call for an orthoscope instead.

[Gallypro]

In an earler post you used the term union and non-union, what do those mean?

[JainMD]

Hi,
I am sorry but I can't find my post where in I have mentioned regarding union and non-union. I wanted to know with what reference I have mentioned, if at all.
In case if it is regarding fracture then union means that both ends of a joint have healed and hence there is joint line present and a non-union means exactly opposite.
Keep me informed if you have any queries.
Bye.  

[Gallypro]

Maybe I'm just paranoid, but sometimes when I'm shiftting in bed I think I faintly feel a slight click where the fracture occured. Is a non uinon fibula a bad thing, does it require attention, and does an X-ray show if the fracture has healed properly.

[Gallypro]

I am hoping you will get a chance to reply to last post first,  My next question for you is that; do to my bordem caused by a lack of activity I find my self going out for beers with my friends every second or third night, is drinking too much beer inhibit healing time . I also eat very healthy foods such as alot of fruits and veggies and I also take alot of vitamines and other supplaments. Thanks for your replies I find them very helpful.I think this a great services to the public, thank you. Gallypro.

[JainMD]

Hi Gally,
How are you feeling?
Your first question is regarding, non union fibula a bad thing?
-Yes it is indeed a bad thing.
Does it require attention?
-Yes it definitely requires attention and an immediate one.
Does an X-ray show if the fracture has healed properly?
-Yes x-ray will indeed show whether the fracture has healed properly or not.
Keep me informed if you have any queries.
Bye.

[Gallypro]

maybe I'm just paranoid cause it is still tender in the area of the facture, is it normal to be tender  8 weeks after injury, if so than up to how long might one feel some tenderness for?  and what are some symptoms of a non-union. My x-rays must have looked okay when I saw the orthopedist two weeks ago, or I sure he would have said something.

[JainMD]

Hi Gally,
Is that your name? If not, what should I address you?
Your question regarding your alcoholism every 3rd day and healing says that alcohol is bound to delay bone healing and effect bone remodeling.
Chronic and heavy alcohol consumption is known to contribute to low bone mass, decreased bone formation, an increased incidence of fractures, and delayed fracture healing, a review article in the December 2005 issue of Alcoholism, Clinical and Experimental Research points out [*].
Heavy drinking disrupts the balance in bone remodeling by suppressing new bone formation by osteoblasts, says author Dr Dennis Chakkalakal (Orthopedic Research Laboratory and Alcohol Research Center, Omaha Veterans Affairs [VA] Medical Center, Creighton University, NE).
But experimental evidence suggests that stopping drinking leads to a prompt recovery of osteoblast function, and this has important clinical implications.
You can find the above mentioned information on following URL;
http://www.medscape.com/viewarticle/538462

*-Chakkalakal DA. Alcohol-induced bone loss and deficient bone repair. Alcohol Clin Exp Res 2005; 29:2077-2090.
Keep me informed if you have any queries.
Bye.

[JainMD]

Hi Gally,
You can have tenderness after 8 weeks at the fracture site. I mean mild tenderness which is not annoying. If the tenderness is annoying then you need to evaluate the cause of such tenderness with help of imaging study and also by examination from your surgeon.
The symptoms are as follows;
Patients have a history of a fracture that continues to be painful.
The patient may have broken hardware.
Pain often occurs after use of the limb.
Keep me informed if you have any queries.
Bye.

[Gallypro]

Ya Gally is my nickname. I don't drink every night but it sounds like I should reduce my consumption as much as possible. My leg is terribly tender so hopefully this wed. when I see the doc. the x-ray will look fine. On the x-ray image my guess is that the bones should be in line, but can you see the bone formation at the joint?
      I"ve been going to the pool, in chest deep water been walking around trying to exercise the ankle, the next moring I'm a little stiffer and maybe little sore but not really any more pain, this exersice seems like a good idea to me but what if there is tendon, nerve, or ligament damage in the ankle am I going to further the damage, hence delay recovery?

[Gallypro]

Looks like your  busy with alot of other posts, but I was hoping you would get around to awnsering my last post

[JainMD]

Hi Gally,
I am sorry that I am not able to respond you on time. But I feel you are online at this hour.
If you are comfortable with your exercise of your ankle, then it should not be stopped on mild pain, but you can reduce the repetition of each exercise to minimum tolerable level.
If while doing that underwater exercise you have any ligament, tendon or nerve damage, the first sign would be feeling of giving away at ankle joint.
Theoretically it should not delay your recovery if you have accompanied ligament injury, but yes this injury might cause fracture instability and hence mal-union or non-union can occur.
Keep me informed if you have any queries.
Bye.