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Fell and hurt ankle. Paining and had swelling. X-ray showed avulsion fracture of fibula. Suggestion?

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Orthopaedic Surgeon
Practicing since : 1994
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I fell on Wednesday afternoon, hurting my right ankle (as well as other parts of my body, not as seriously). I managed to walk afterwards to complete the chores I needed to do, but my ankle was painful (lateral malleolus area) and started swelling immediately. I went to a local storefront clinic, they took X-rays, and I was told I have an avulsion fracture of the fibula, not serious, and the doctor ace wrapped it and told me to come back Sunday for an air cast splint. Since I have a trip planned for next Wednesday, I decided to see an orthopedist yesterday. He took one quick look at the X-rays and immediately confirmed the initial diagnosis, seemed to indicate a fairly minor injury, and did give me an air cast splint. He said the splint was to prevent lateral movement of my ankle, that anterior/posterior movement is fine. I felt much less pain, practically no pain, when walking with the splint. He said it would take about 4 weeks to heal. I asked him about driving, to which he responded "just be careful"...not sure how he meant that (not the most communicative doctor). I neglected to ask him about showering and wearing the splint while sleeping, so those are my most immediate concerns now.
I am a 66 year old active female in fairly good health, despite mild HTN and slightly high cholesterol, which are controlled with meds. I am a retired Occupational Therapist who worked in Physical Rehab, mainly orthopedics, so I have some basic knowledge in this area.
My ankles are very (too) flexible (I can never wear high heels), and I had a terrible ankle sprain when I was a teenager and I've had numerous minor ankle pains since then...a simple ace wrap for a day or two relieves the pain.
I just tried sleeping in the air cast splint and found it very uncomfortable. I'm afraid to sleep without ankle support because of my ankle flexibility and the fact that I move a lot when I'm sleeping. Would ace wrapping be sufficient for sleeping. Unfortunately, I need to go to the bathroom several times during the night...would an ace wrap be enough support for that (about 30 feet away from my bedroom)?
And should I get a cast cover for showering?
I just noticed that "User Category" says back pain...I guess I missed something somewhere...should be ankle pain
might be significant...I have very flat feet, overpronate when walking...wear orthotics in my sneakers
Thank you for your help.
Posted Thu, 4 Jul 2013 in Bones, Muscles and Joints
Answered by Dr. Praveen Tayal 36 minutes later
Thanks for posting your query.
From your description, it seems to be an undisplaced fracture. You can remove the cast while sleeping but weight bearing during the night will cause a pain. You can use an ace bandage at night and avoid weight bearing on the foot as much as possible.
While showering, it is best to use a cast cover to avoid it getting wet.
This will take 4-5 weeks for proper healing.
Since your right ankle is injured, it is best to avoid any driving and do only restricted movements of the ankle joint.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Please accept my answer in case you do not have further queries.
Wishing you good health.
Dr. Praveen Tayal.
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