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Non union fracture - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Bones, Muscles and Joints
Answered by

General & Family Physician
Practicing since : 2004
Answered : 37 Questions
User :   Hi, i fractured my medial malleolus approx 5 months ago. It didn't show up on x-ray and i was diagnosed with a very badly sprained ankle, due to the amount of pain i was in my ankle was put in a cast for approx 3 wks. Following this i was in a walker boot. I was still in alot of pain and an MRI scan was ordered. This showed i had a non union fracture of the medial malleolus. Weeks of physio followed and a month ago the specialist signed me off of his care as he felt things were healing well. However, since then my ankle has not made any further progress. I am still in pain every day and cannot run - 2 strides and i am in excruciating pain. I am a keen sportsperson (mainly football) and strangly i can kick a ball pain free but just cannot run or jump on my foot. My ankle also clicks and grates when i rotate it. Is this all normal for this type of fracture? I am worried the grating could be a sign of cartilage damage or could it lead to arthritis. I've been thinking about going back to see my GP but im worried they wont listen to me and tell me its normal but is it? 5 months on and still in pain, unable to run at all and still on pain killers will i ever be able to get back to playing sport?
Doctor :   Hi
Doctor :   Let me read the query.
Doctor :   May I know your age and gender?
User :   Im 24 and female - generally fit and healthy.
Doctor :   Do you have pain at rest too?
User :   To a degree if i have been doing alot but 90% of the time its when i put weight through my foot. Doesn't go away either like if it was stiff.
Doctor :   Ok
Doctor :   Do you have any other medical illness?
User :   No
Doctor :   Ok
Doctor :   Let me explain it to you.
Doctor :   Depending on the severity and the type of the fracture, initially the duration of the healing varies.
Doctor :   On an average it takes 3 months for a fracture to start uniting, if it has been immobilised appropriately.
Doctor :   However to completely get back to the normality as it had been initially, it can take upto 6 to 8 months.
Doctor :   Hence depending on the severity of the fracture in the past, this pain may have been due to the bone that has not completely healed.
Doctor :   I would suggest you to consult an orthopedician with your previous reports for a physical examination.
Doctor :   In the mean time, I would suggest you to avoid strenuous physical activities such as severe exercises, athletes and sports.
Doctor :   Have you followed what I have suggested?
User :   yes, thank you for your time. Just out of interest if it is found that the bone has not completely healed how would it be treated? Also could i have caused further damage or prevented it from healing properly by doing too much too soon?
Doctor :   This is what is termed as a non healing fracture.
Doctor :   The treatment here will be based on the physical examination findings and more importantly on the radiological findings.
Doctor :   It can either be by means of immobilisation, surgical methods.
Doctor :   I mean by means of either conservative immobilisation or by means of surgical treatment referred to as Ilizarov's surgery.
Doctor :   You can avoid further damage by restricting the physical activities.
Doctor :   Have you followed what I have suggested?
User :   yes thank you. I will consult my doctor and avoid physical activities in the mean time. thank you for your time.
Doctor :   Do you have any other query that I can assist you with?
User :   no that's all, thank you
Doctor :   Thanks for consulting me. Bye for now. Please refer your friends to our service.
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