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What Do The Following X-ray Results Indicate?

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Posted on Mon, 18 Jul 2016
Question: Hello Dr XXXXXXX I contacted you a month ago with a dislocated left ankle. You looked at my x-rays and said I have a bimalleolar Potts fracture with intra-articular extension that needs a rigid fixation with screws.
You suggested surgery and also said if surgery is not done the bones will eventually heal but there will be stiffness that will need therapy.
I decided to not do the surgery because the only orthopedic surgeon on my island seems to only do what's best for his pockets, so I was not trusting him. Anyway, it's been a month since I've been in a cast and it finally came off today. He looked at my new X-rays and was not very happy with the results. Can you look at the before and after X-Ray and give me your opinion and what options I have now because my surgeon was not being straight with me and I left his office feeling very dissatisfied and disheartened. Thanks. By the way, I don't see an option to attach my before and after X-rays, can you direct me on how I can get them to you, I remember you had an email address for me to send them to you?
doctor
Answered by Dr. Dr. Praveen Tayal (46 minutes later)
Brief Answer:
The fracture has almost healed.

Detailed Answer:
Hello,
Thanks for posting your query.
I have seen all the four X-rays attached with the query. Now that you have opted for a conservative treatment, you need not worry. The fractures are healing well and there is callus present at the fracture site.
As I told you earlier, you need a very good physiotherapy now. Initially there will be pain and swelling at the ankle. It will subside with hot compress and by keeping the leg elevated on two pillows while resting.
I feel that you will regain almost 90% range of movement within 4-6 weeks if you continue with a regular physiotherapy. You can do a partial weight bearing on the foot now with crutches and walker. Gradually increase the weight and reduce the support over two weeks.
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.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Praveen Tayal (56 minutes later)
Hello Dr XXXXXXX so the callus you mentioned, do you feel that it may hinder any blood circulation to my foot because i notice a vein right above the bone lookingvery prominant and swollen. Is surgery still an option perhaps to grind down the callus or would the surgeon be better off breaking the bones to go through with the initial surgery of rigid fixation?
doctor
Answered by Dr. Dr. Praveen Tayal (6 hours later)
Brief Answer:
No need of surgery now.

Detailed Answer:
Hello.
Thanks for writing again.
The prominent vein is not due to callus. Callus is formed deep inside and veins are superficial structures. It cannot hinder the blood circulation.
The callus will gradually remodel itself and take proper shape of bone in next 5-6 months. There is no need of surgery now. Breaking off the bones now will further add to the complications.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Dr. Praveen Tayal

Orthopaedic Surgeon

Practicing since :1994

Answered : 12314 Questions

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What Do The Following X-ray Results Indicate?

Brief Answer: The fracture has almost healed. Detailed Answer: Hello, Thanks for posting your query. I have seen all the four X-rays attached with the query. Now that you have opted for a conservative treatment, you need not worry. The fractures are healing well and there is callus present at the fracture site. As I told you earlier, you need a very good physiotherapy now. Initially there will be pain and swelling at the ankle. It will subside with hot compress and by keeping the leg elevated on two pillows while resting. I feel that you will regain almost 90% range of movement within 4-6 weeks if you continue with a regular physiotherapy. You can do a partial weight bearing on the foot now with crutches and walker. Gradually increase the weight and reduce the support over two weeks. 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. Wishing you good health. Regards. Dr. Praveen Tayal. For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal