I had an avulsion fracture to my left ankle 10/2010 to medial malleolus Acute Non surgical \ only PT ordered non union fragment. 1/18/2011 Twisted both ankles on black ice and had significant swelling and pain to bilateral lower extremities. May 2011 had an MRI of left ankle for pulling tearing pain to calf/shin and inner ankle. MRI showed bone fragment, ganglion cyste and ankle sprain . instability with antalgic gait , 3/2012 had reconstructive surgery to left ankle to repair ligament, pain continued and worsened. Begged for repeat L ankle MRI and now Posterior tibial tendon Hypertrophic tear Grade 1 has progressed to caudal extent. It is crippling me at this point . Md is saying tendon transfer and calceotomy with fusion. if this was diagnosed last year, could this surgery have been prevented? could conservative treatment been done? MD relied on report and never reviewed MRI . IS there any other tx besides this extensive surgery?