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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Incomplete Union Of Ankle Fracture

I broke my ankle in Sep 2013. I had 2 screws and a device similar to a sling put in it. I began walking on it in Dec and had no pain until I started Cardiac rehab in Apr 2014. A recent xray says On the present examination metallic screws noted at the medial malleolus and the Union is incomplete at the medial malleolar fracture. Degenerative changes of right ankle noted with overlying soft tissue swelling . What can be done to help this ankle heal?
Mon, 7 Dec 2015
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Podiatrist,  's  Response
if you have no pain in your ankle, I would leave things alone. if you have pain in your ankle, things are a bit complicated. normally for a nonunion that the fracture fragments are in close proximity, I'd use an electrical bone stimulator to help te fragments unite. if you have a pacemaker, the device would be a big mistake as it creates an electrical field which a pacemaker can misinterperet. given the length of time since the fracture, there may not be enough bone activity/ bloodflow across the fracture to have the stimulator work. an MRI or bone scan can help decide that. if there is no bone healing activity at the site, the screw would need to be removed, fracture sites curretted out to bring new blood flow, then reset with internal fixation. a bone graft may be needed at that time, and use of bone marrow aspirate or PRP injections may help assist the new union.
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Suggest Treatment For Incomplete Union Of Ankle Fracture

if you have no pain in your ankle, I would leave things alone. if you have pain in your ankle, things are a bit complicated. normally for a nonunion that the fracture fragments are in close proximity, I d use an electrical bone stimulator to help te fragments unite. if you have a pacemaker, the device would be a big mistake as it creates an electrical field which a pacemaker can misinterperet. given the length of time since the fracture, there may not be enough bone activity/ bloodflow across the fracture to have the stimulator work. an MRI or bone scan can help decide that. if there is no bone healing activity at the site, the screw would need to be removed, fracture sites curretted out to bring new blood flow, then reset with internal fixation. a bone graft may be needed at that time, and use of bone marrow aspirate or PRP injections may help assist the new union.