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Used cast for medial malleolus fracture. Ankle hurts while walking. What treatment should be done?

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General & Family Physician
Practicing since : 2001
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Hi, I have had an xray that shows a 3mm fragment has broke of my medial medial malleolus. The intial treatment was a leg cast for 1 week until a booking at the fracture clinic. On visting the fracture clinic they said that they believe it was an old injury and would not be treating anymore. 1 week later now and walking is producing a sharp pain in my ankle and at night it swells and is almost unbearable. I have no history of injuring this ankle before and have never had this pain. I am booked in to the GP's this week as my physio will not treat the sprain yet as he thinks this is a new fracture. What treatment should i expect if this is a new 3mm fracture to the tip and it is now 3 weeks since the injury?
Posted Sat, 9 Mar 2013 in Bones, Muscles and Joints
Answered by Dr. Michelle Gibson James 1 hour later
Hi, thanks for using health care magic

With no previous history of injury other than 3 weeks ago, it is understandable to believe that it is a new injury.

The treatment would depend on whether the fracture is displaced (not in the right position) or not displaced. With a 3mm injury it is unlikely that there is any displacement. It would also be influenced by the extent of healing that would have already occurred, this would be indicated by the presence of new bone formation on x XXXXXXX
In the absence of displacement, your doctors are likely to suggest immobilisation- at acute injury it is normally done for 4 to 6 weeks but since the injury is 3 weeks old , it would be suggested for a shorter period of time- 2 to 3 weeks. This is done with a boot or cast.
If there is any evidence on the new xray that healing is not occurring properly then surgical treatment would be suggested.
During this time it is important to avoid excess weight bearing activity.
Anti inflammatory pain medication may be given to help with your discomfort.

Physical therapy would be restarted after the immobilisation period.

I hope this helps, feel free to ask any other questions
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