Question: I was diagnosed with a medial malleolar fracture of my left tibia following a skiing accident. Based on the ED evaluation, the fracture was non-displaced at the time and "likely would not require surgery". There are two views, one more oblique than the other, the latter of which shows a slightly more displaced fracture. I am 5 days out from the injury and am in a short leg cast. I am in discomfort, am completely non weight bearing, and have generally babied the ankle, keeping it elevated while staying in bed, but have had the occasional unavoidable knock into a door frame, etc, while navigating with crutches to and from the bathroom or my desk.

I was hoping to have a look at the x-ray (mindful of the fact that I will be returning in less than a week for more imaging to determine the need for surgery, which the PA-C suggested would not be likely if everything stayed in place). What are thoughts on surgery for this type of fracture? I am a 32 year old male who leads an active lifestyle. I want to be able to return to my fitness routine (and skiing), but also need to be able to return to weight bearing as soon as safely possible for my job. Given the imaging where displacement is apparently minimal, is surgery indicated? (I recognize that this could change).

Assuming nothing moves, and the bone stays as pictured, what are general thoughts on the appropriateness of surgical reduction anyway? Any effect on recovery time, and ability to return to full strength and activity in the future? I've read about impaction and indentation. Based on these films, is this a factor herein?

Kind regards.

Thanks very much Dr. Tayal.

My follow-up question concerns DVT. Obviously, I am immobilized and am non weight bearing, so my ability to do any physical movement of the affected ankle is restricted. How concerned should I be about developing DVT? I am a 32 year old male, non-smoker, healthy BMI.

Nobody mentioned anything about a blood clot until today, a week after the injury, when my ortho advised to start taking Aspirin 2x daily, and to look out for calf pain. However, my entire lower leg is sore. I can't tell which pain is associated with possible DVT, and which is from the injury itself. Should I be taking blood thinners?