A malleolus is a projection of bone beyond ankle joint. The medial one is called medial malleolus. Other arising from tibia is called posterior. A counterpart called lateral malleolus is distal end of fibula
Medial Malleolus may get fractured in ankle injuries.
Tghe present xray shows a fractured medial malleolus in the lateral view. Anteroposterior view is of the same ankle and can be passed as normal thus emphasizing need for two views.
I fractured my ankle 6 weeks ago and had 3 screws inserted but still have swelling and cannot put weight on it, as i get a shooting pain in my heel. Is this normal?
Dr Arun Pal Singh Reply:
August 14th, 2009 at 1:44 pm
@Grant,
Make sure you do not have an injury to the heel bone and work on putting your weight gradually on that foot.
Sometimes soft tissue may cause this pain but it is necessary that we rule out a bony injury because that would require your foot off the ground for some more time.
Okay,
I have a question. I broke my medial mallelous last september. According to the doctor that I was seeing it healed. I have had problems with it since then with swelling and being uncomfortable. On tuesday of this week i slipped rolled my ankle and broke the same bone. Not to the same severity but enough to cause discomfort, swelling and pain.
From what the xray tech told me he said that it was just a little fracture. (i am still waiting to see the ortho)
Will they cast me?
THank you,
Heather
Dr Arun Pal Singh Reply:
August 14th, 2009 at 1:24 pm
@Heather Gammage,
If you have a fracture, even of the undisplaced variety, it is always advised to immobilize the part with cast or other type of splint.
A broken bone (even a crack) needs protection.
I fractured my ankle at the malleolus lateralis fibula and malleolus tibia bones 4 weeks ago and had surgery – 6 small screws inserted into a plate along the fibular and 1 large screw across the tibular.
I do not have a caste, it seems to be healing ok so far, i’m wondering what is the best next step for a speedy recovery – a boot? (where best to find in Singapore please) and when i can begin to put more wieght on this foot?
Thank you very much,
Whittle
Dr Arun Pal Singh Reply:
September 6th, 2009 at 11:16 am
@Whittle,
Keep your body health, have nutritious diet and follow your doctor’s advice. No external agent can hasten the recovery.
I do not have an idea where yiou could find the boot in Singapore.
I have a dislocated fracture of the medial malleolus that also rotated 180 degrees & slide up 8mm. My surgeon had never seen it before along with three other orthopedic surgeons. I had surgery with one screw putting things back in place. My tibia/fibula were never harmed during the accident. What is my best way to recover. Will I be on crutches for six weeks.
Thank you,
Jasmina
I have fractured my medial malleous and was in plaster for 6 weeks.now after 4 months there was an incomplete union seen in x ray. My ortho doc says it is due to periostum /soft tissue laying between bones causes the delay in union what is u r openion?IS surgery required?
Thank you
Sathish sabu.t
Dr Arun Pal Singh Reply:
September 20th, 2009 at 8:10 am
@Sathish sabu.t,
If the fracture is displaced, surgery is usually required
Hello Dr Arun Pal Singh
I last posted on here 0n 18th March 2009. My ankle is making progress but i still have pain and swelling , by the end of the day, mainly on the outside of my ankle which i presume is soft tissue damage. I have seen a consultant and had an x-ray and he is satisfied that the medial malleolar fracture has united. I just have a few questions if you could please help me with, on my medical report he has stated that the new xray shows a congruous ankle mortis – what does this mean? He also states that i am looking at next spring before i will have made a full recovery which by then will have been 15 months from the date of injury, is this normal and why is it taking so long?
Dr Arun Pal Singh Reply:
October 2nd, 2009 at 10:53 am
@Tracy,
That is a good think to have. that means your ankle joint is restored anatomically.
Fractures unite early but the minor swelling persist for a long time.
They do go away eventually in most of the cases.
And everybody has a different severity of injury and capacity to heal.
Al these might cause differences in the rate of recovery.
The medial malleolus bone in ankle was broken, As per the Doctor for a speedy recovery they have joined the ankle medial malleolus bone with a screw. As this is a new experience.
1) Kindly let me know Is this a critical issue or I can take I lightly,
2) what all precautions should be taken?
3) Later once the screw is removed how long will it take to fill or join the gap of screw in ankle medial malleolus bone?
4) Please let me know if you have any more information on broken ankle medial malleolus bone
Dr Arun Pal Singh Reply:
October 9th, 2009 at 1:48 pm
@Selvan,
1. A fracture that needs surgery should not be taken lightly.
2. Please follow your doctors advice regarding weight bearing.
3. Removal does not cause any problem per se. The gap is too small to be worried about.
4. Please let me know what information do you want?
i have fractured my medical malleous and i had surgery 4 weeks ago. i have put some pressure on it, is there any way that the screws will come loose? i have been worrying about this. sometimes in my cast i have like an akward feel where i broke it and it feels like the pins are like loose where my ankle is
Dr Arun Pal Singh Reply:
October 9th, 2009 at 1:57 pm
@Ryan S.,
Only way to know is visit your doctor and get xrayed.
It is six week running after the operation in medical malleous ankle, the broken medical malleous is fixed by a single screw. In sixth week I still feel some kind of pain. Taken a X-ray and In X-ray I can see a joining line of the broken bone. Kindly let me know How do I know if a bone is healing. Dr. said that I can partially put wait on my leg. Is it okey to put wait on legs when there is line seen in bone joint.
Dr Arun Pal Singh Reply:
October 21st, 2009 at 2:38 pm
@Selvan,
Best parameter of union is seen in radiograph.
If your doctor says so it should be okay.
Dr Arun, The ankle medial malleolus bone was broken and its operated and fixed with a screw. Now it is 6th week, broken joint is visible, there is no swelling,
As the broken bone is fixed with screw, is there a possibility of dislocation of the broken bone?
Broken joint is visible in X-Ray in 6th week and there is no swelling in ankle, can I put partial weight on the leg. Will there be any issues later as the joint is visible now.
Broken joint is visible in X-Ray in 6th week, when will the joint be seen as a natural bone or when the joining of broken line will disappear and seen as a natural bone? How can I send you the Xray for your reference?
Dr Arun Pal Singh Reply:
October 21st, 2009 at 2:51 pm
@Raja,
The line eventually disappears. You must ask your doctor if you can bear weight.
I broke my medial malleolus on my left foot about 3 weeks ago and I was told by my ortho doctor that I will beable to put weight on it by the middle of December. I was not told that I would be going to pt so I was wondering if there are any suggestions on how I should go about my own physical therapy at home?
Dr Arun Pal Singh Reply:
November 9th, 2009 at 11:38 am
@Chantel,
You did not mention how you are being treated. Were you operated or treated with cast?
Dr Arun Pal Singh,
The ankle medial malleolus was broken and a screw is fixed. Now it is 9th week running, I started walking (limping) now. Still there is some pain in the ankle joint, I cannot move the foot to upwards. I feel a stiffness in ankle But I can move the ankle in all angle except upwards movement.
The ankle upper skin is sensitive
Should I have to consult the doctor or it is a known symptom?
How long the pain will be there?
Can I start putting normal weight and walk as usual walking or should I have to limp and walk for some more days.
Can I do the exercise on ankle movement?
Dr Arun Pal Singh Reply:
November 12th, 2009 at 1:17 pm
@Selvan,
The duration of pain varies in different individuals. It is always better to consult the treating doctor if you have a concern.
Exercise and weight bearing advice would be best given by the treating doctor.
I was operated on, the screw is not going to come out. Right now I am in a moon boot. After 12/11 i was told i can start putting pressure on it to walk. I was wondering if there were any physical thearpy ideas I could use.
Dr Arun Pal Singh Reply:
November 16th, 2009 at 12:48 pm
@Chantel,
After surgery any physical therapy should be done with consent of treating doctor as he is fully aware of your condition.
And it should be under supervision of physiotherapist.
I advise you to pay a visit to your doctor and ask him/her directly.
I suffered from an accident on August 27, 2009 in which the front wheel of a car ran over my right ankle. My orthopaedic doctor after examining the X-ray report told that there is a fracture in the lateral malleolus and a crack on the body of talus. There was a plaster for a month. Now, I am able to walk without much problem. But there remans some uneasiness and pain at the time of walking. Besides, I am not able towalk as fast as I used to do earlier. I dont fnd much problem in climbng up the stair case. But at the time of climbing down, I feel a little nervous and stop at each step without a continuous walk over the steps. I am undergoing physiotherapy for the last 10 days and taking electrical stimulas, Infra Red light and sometmes wax treatment. Will please suggest me something more, particularly some exercises?
Dr Arun Pal Singh Reply:
November 21st, 2009 at 3:17 pm
@D K Sarkar,
I think you are already doing enough. Give your body some more time.
12/19/09 (saturday) I ‘cracked’ my right ankle coming off ski lift (some 3 hours away from home), several hours later, arrived ER to get Xray and had to wait till the next business day (monday) to see foot doctor.
12/22/09 (monday) – went to foot doctor with the Xray, results shows a broken Medial Malleous; I was told if the fracture is 2mm more, they would need to put pins. They wrapped my right foot from 4 inches below knee, with some kind of wrap that becomes hardened overtime.
I noticed the top and bottom of it are not tight (I can shove my whole hands from top) and few fingers from the bottom hole (where the toes are sticking out). Is this normal ? Its been like this since day 1 of cast. I thought it should be tight from top to bottom ?
I also noticed that I always have to have my foot up, otherwise it will feel puffy and will turn purplish if laid it down (or standing up) for x minutes.
Question #1: when I put my foot up, where should the contact point for resting be ? right on the heel (with the rest of the cast not touching the pillow) ? or should the resting point be equally distributed (so the whole cast will be rested )on the pillow ? I feel #1 makes me feel more comfortable.
Question #2: when I put my foot up, should I let the toe be point straight up all the time ? or can i also turn it like 45 to 80 degree ?
Question #3: whats the maximum duration that I can put my foot down ?
Thanks and happy December to all
Dr Arun Pal Singh Reply:
January 2nd, 2010 at 12:46 am
@Alexander,
1. Whatever way you feel comfortable
2. Toe movements are encouraged to avoid stasis of blood flow.
3. You would be guided by your own symptoms. Generally, prolonged dependent position should be avoided.
Dear Dr.
It was recently discovered on an X-ray of my daughter’s spine that her ribs are not connected to the vertebrae in the normal manner. The head of the ribs has a tube-like piece of cartilage connecting them to the vertebrae. There are also 2 sinous processes on each vertebra instead of one. And two vertebrae in her neck are fused. Have you had any experience with such anomalies and is there any possible harm that could come from this condition?
Dr Arun Pal Singh Reply:
January 6th, 2010 at 11:32 am
@Joe Sparks,
I do not see if it could cause a major problem. But you should get her checked for any other anomaly in any other system.
A paediatrician would be of help.
sorry for the typo, that should read, “spinous processes”
Hi Dr Singh,
I’m Alexander from the Dec 26,2009 posting. Thanks for the reply
I got cast on 12/21/09 to treat my Medial malleolus fracture. 2 weeks and 3 days later, I still have the same experience –> whenever I put my foot down for over 1 minute, my feet turns red-ish slowly with pressure starting to build (thus making my cast feel tight).
Is this normal ? being 2 weeks and 3 days with cast. My cast is due to be off on 1/13/10 + further diagnosis.
Thank you sir !
Dr Arun Pal Singh Reply:
January 12th, 2010 at 9:38 am
@Alexander,
Did you talk this to your doctor. Usually this should not occur within one minute.
Tomorrow when your cast is removed, let your doctor know about this.
Only thing I can think of is that cast is bit tight
Hi Dr Singh,
Thank you so much. I had my cast removed and xray indicates that no surgery is needed. I was given an Ossur Air Walker. I found several wounds on my calves probably due to the tight cast.
From time to time the air cast feels tight so i simply loosen the velcro.
I have few last questions for you, if you don’t mind, sir :
1) How tight or loose should I set the Air Walker velcro ?
2) Do I sleep with it or do I take it completely off to sleep (and elevated) ?
Thank you sir
Dr Arun Pal Singh Reply:
January 19th, 2010 at 9:44 am
@Alexander,
1) It should snug but should be comfortable. Adjust accordingly without making it loose to toggle.
2) I do not think you need it during the sleep. As per your information almost a month has passed since injury.
However you need to protect your limb when you bear weight. That mean walking and standing.
Hello Dr Singh,
I broke my Medial malleolus on 19-Dec-09. I was cast on 22-Dec-09. There was no dislocation (movement) of the malleolus and no surgery was deemed necessary. It has been monitored by X-ray on a weekly basis. It seems to be healing well and the joint position is good. I am still in a cast (due off 27- Jan-09). I am not experiencing pain of any consiquence.
Clearly, I will need my doctors own advice on weight bearing etc. based on my specific injury. However, what would the generally expectation be for the amount of time in weeks (from injury) before one might be expected to (1) bear full weight on the leg/ankle and (2) be able to downhill ski – given that the ankle/malleolus is held within a ski boot?
Many thanks
Ian
Dr Arun Pal Singh Reply:
January 19th, 2010 at 9:57 am
@Ian,
There is no specific answer to your questions but I will try to give you an idea.
After fracture has united and you are off the cast, you would be asked to bear full weight on your limb in graduated manner.
Your gait would not be normal immediately after the cast as the joint had been immobilized for so long and would need practice and physio to come to previous position.
This time varies with age and persons. Usually range from 2-4 weeks.
After your joint is normal, you are free to do anything including downhill ski.
But it must be borne in the mind that your bone may not be strong enough to sustain minor traumas that may occur with forceful use of the joint.
Therefore it is prudent to wait for a few weeks more and then graduated practice can be begun.
Some people face a swollen foot after exertion. This can continue for some more months and usually if not insulted again does go away.
But this does not occur in all the people.
On Dec. 13, 2009 I fell off a 4ft ladder while hanging a xmas wreath(wreath never got hung). From the fall I sustained an open fractue of my right ankle. Upon x-rays they find fracture of medial malleolus and tibia in addition to severe bone loss(about 1″) of the fibula. I also have loss of cartilage and tendon & ligament damage. I had a 3 hr surgeon to put me back together again plates, screws and wires. To make matters worse I am a marathon runner!! I am in a cast currently and I am a healthy 44 y/o
My questions. 1. How long does it take for bone to regrow, there is a plate along the fibula in hopes it will grow in order to avoid bone grafting.
2. I am just looking for an honest opnion regarding ever running again, all the docs are beating aroung the bush.
Dr Arun Pal Singh Reply:
January 26th, 2010 at 10:05 am
@moe,
1.) Fractures usually take between 6-12 weeks to heal. The time frame is different for every individual.
2.) No body would be able to tell you that right now so it is better not to ask that question.
When you ask running again, I think you mean running like you use to before.
No body would be able to tell you that.
If your fractures heal well and and you get your joint motion back I do not think there should be problem in running.
So! It is wise to wait for the outcome. Let your fracture unite and see how does your joint behaves.
All the best.
Let me know how did it go?
Hi Dr Singh,
Thank you for the reply from Jan 19. I became comfortable with my Ossur Air Walker in about 5 days and I have another doctor appointment on Jan 28.
I have another question for you if you don’t mind :
1) how long do we usually have to wear the Ossur Air Walker ? Mine will be 2 week on Jan 28.
2) after the Ossur Air Walker, do people usually need Physical Therapy ?
3) usually, how many more weeks before people can drive ? (mine being on the right foot).
THanks again Sir
Alex
Dr Arun Pal Singh Reply:
January 26th, 2010 at 10:08 am
@Alexander,
1. 3-6 weeks should be sufficient in my view but that is not ask your doctor to be sure in your case.
2. It would depend how your joint behaves.
3. same as in 2. You need better control on your foot when you drive. So drive only when you are very sure.
Hello Dr. Singh,
I posted a comment on January 18 above. I broke my medial malleolus on 19-Dec-09. I was cast on 22-Dec-09. There was no dislocation (movement) of the malleolus and no surgery was deemed necessary. It was monitored by X-ray on a weekly basis. According to the doctors at the fracture clinic, It healed well, the joint position is good and so the cast was removed on 27-Jan-10. As expected, there is still some stiffness and mild pain (enough to slighty impact my gait). The pain and stiffness are reducing gradually.
However, there is quite a lot of swelling and fluid around the joint and for a few inches up my leg. Is this normal or should I get it checked out?
Many thanks
Ian
Dr Arun Pal Singh Reply:
February 8th, 2010 at 6:24 pm
@Ian,
Yes! That can occur for some time especially if you keep your feet hanging.
Take frequent breaks and raise your foot intermittently.
if it persists beyond few weeks or you have some additional symptoms, consult your doctor.
Hi Dr Singh,
wow I and Ian have the same injury and on the say day too ! Anyways, I want to thank you for your assistance – its really nice and uplifting to talk to good-hearted doctors like you
I’m on the same boat with Ian – my cast is off ( I was wearing the boots for 3 weeks) and now I’m wearing my regular sneakers but my ankle gets swollen and changes color to red when I put my foot down for over 1 hour. I have not attempted to walk on it yet ( I still am using crutches); I’ll wait until next week’s Physical Therapy session – I’ll let them decide what i need to do next.
Dr Arun Pal Singh Reply:
February 24th, 2010 at 10:00 am
@Alexander,
Thanks for your kind words. All the best.
I was in a Car accident on 2/25/10. The ER xrays said that I had ‘chipped’ my ankle bone and was reffered to an ortho. The ortho did more xrays and stress test xrays. He said I had a Medial malleoulus fracture. He then put me in an air cast (kept me on crutches said 6-8 weeks) and sent me for a CAT scan to “see if we need to do surgery.” Ive gotten my CAT scan but I cannot get another appointment until 4/1/10. Do you think I will need surgery? Isn’t it a problem that I am waiting for so long to see if I need surgery if I infact do? If I have surgery how long does it take until the screws can be removed? Once they are removed how long until I can get off crutches? Thanks so much for your help!
Dr Arun Pal Singh Reply:
March 19th, 2010 at 12:11 am
@Evan,
In my practice, I prefer to decide early if patient needs surgery or not. That saves a lot of morbidity for the patient.
I am not familiar with your medical system but you have to be treated within that.
I cannot tell you if you need surgery. Only your treating doctor can.
Screw would be kept for long time in spite of union. Usually it takes about 6-8 weeks for a fracture to unite.
to follow up on my comment. My swelling has greatly gone down and is now only on the inside ankle and a small part of the outside one. There is very little to no pain and nothing looks out of place.
Hi Dr Singh
Just dropping-in to give you an update
I went for a 1-month of physical therapy, 8 sessions of light stretch exercises and 1 session of strenght training. My doctor wanted me off the crutches even before my first physical therapy session, but my physical therapist didn’t want the aggressive approach so I got off the crutches just recently – on my last session (1 week ago).
I have been walking (slowly) now even though my ankle are still swollen and reddish. The angle (range of motion) are getting better but far from my normal range of motion. That means I’m unable to walk down stairs because I can’t bend my injured ankle good enough for my good foot to touch the next step.
I’m due for doctor’s visit / xray tomorrow though.
Can I get your opinion on the following:
1) do I need to extend my physical therapy session ? or can I do the exercises myself ?
2) what types of exercises do you recommend ?
3) do I still need to ice my ankle at the end of the day /or after exercises ?
4) how long will the swelling and redness go on ?
5) should I stop doing stretch exercises and just do the strenght exercises ? or should I still do both ?
6) for both stretch exercises / strenght exercises, can I overwork it ? or should I still treat it like a baby ?
7) should I wait until my ankle can do the normal range of motion before I can drive again ?
Thanks for your assistance
Sincerely,
ALexander
Dr Arun Pal Singh Reply:
March 25th, 2010 at 12:21 am
@Alexander,
1. If you know what you do you can do it at home.
2. You need to talk to your doctor.
3. I do not think there is any harm though I do not think there would be any benefit too.
4. The redness should not be there. You can show it to your doctor to know if something is wrong
5 Both would help you
6. Try doing bit more everyday. The idea is to go slightly further than the limit.
7. Driving with a foot with poor control is out of question
Hello Dr,
My name is Shweta.
I had closed tibia stable spiral fracture due to twisting of my foot.
The doctors have put me on a long leg cast. It has been eight weeks
in full leg cast and I have two weeks more for my next visit to the doctor.
After seven weeks the dr said the fracture looks good but did not mention
if it was healing.How long does it usually take to heal for this kind of
fracture and how can I know looking at the x Ray if it is healing ?
Kindly advice.I am 37 year old.
Regards and thank you.
Dr Arun Pal Singh Reply:
March 24th, 2010 at 10:00 pm
@Shweta,
I think what your doctor meant was that union is in progress.
Please discuss your queries with your treating doctor and he would be able to tell you better.
To know whether your fracture is uniting or not, you need to train your eyes first to see the stuff and with plaster on it becomes even more complex.
Either talk to your doctor or if you wish, you can send me an xray so that I am able to visualize.
my 10 y.o. son has just cracked his medial malleolus. it is a small non-displaced translucency on x-ray distal to the growth plae which appears unaffected.he was put in a back slab cast to be removed and re-evaluated by an ortopod in 1 week. what is the best case scenario for a speedy recovry time,what can we expect the next step with the orthopod to be?
Dr Arun Pal Singh Reply:
March 24th, 2010 at 7:51 pm
@liam,
If it is a non displaced and stays non displaced, I think it should be treated by non operative means.
All the best.
i have a question, my son have his medial malleolus protruded more to my liking any thoughts
Dr Arun Pal Singh Reply:
March 24th, 2010 at 7:49 pm
@Kenton,
Is there any problem or you just have your doubts?
Hi Dr Singh
Yes my son part from the protrusion of his medial malleolus, also has pain, we have an X-ray taken and the radiologist who review the x-ray says its just ossification of the tip of the bony prominence of the tibia of the Medial Malleolus. there was also the presence of growth plate at the site. this is part from the normal growth plate at the epiphysis. from observation the medial malleolus is becoming more prominent and that is my worry for my son.
Dr Arun Pal Singh Reply:
March 27th, 2010 at 12:53 am
@Kenton,
Did you discuss it with your doctor?
Yes i have discussed with my orthopedic Surgeon, he said that it is common with kids who are hyperactive, and it is an area of increased ossification, commonly results from Avulsed fracture which happens overtime. my son is 10 yrs and will grow and overtime this protrusion will remodel by the time he is 16 or more.
Dr Arun Pal Singh Reply:
March 30th, 2010 at 11:07 am
I have not come across this kind of query before and I could not find much on this issue.
A condition called bursitis has been reported in athletic children but otherwise!
Keep a watch on it. If it does not increase in size or prominence, it could be a a normal variation.
You would be better guided by someone who can examine the child too.
i have medial malleolous tibia undisplaced closed fracture.
doctor had done a fibre caste .&was asked maintaine for 6 weeks.
after removal of plaster there is no proper healing acording to doctor by x ray exam.
inbetween i walked with one leg with the help of walker.
now he asked to increase pressure on affected foot slowly day by day 10 kg/day.
will it be recovered or should i do according to u?
thanks..
Dr Arun Pal Singh Reply:
April 7th, 2010 at 6:56 pm
@vasudeo,
If it was undisplaced it would have been healed. An xray would revel if it is united.
Hello Dr ,
I had posted following query some 2 weeks back.
————————————————————————————————
I had closed tibia stable spiral fracture due to twisting of my foot.
The doctors have put me on a long leg cast. It has been eight weeks
in full leg cast and I have two weeks more for my next visit to the doctor.
After seven weeks the dr said the fracture looks good but did not mention
if it was healing.How long does it usually take to heal for this kind of
fracture and how can I know looking at the x Ray if it is healing ?
Kindly advice.I am 37 year old.
———————————————————————————————————
I visted the doctor again at 10 weeks of fracture.The doctor removed the full leg cast and checked by pressing at the fracture site.I did not feel any pain at the fracture site, but there was pain when he presses at the ankle bone.So he put me on short leg cast and has advice me to use walking boots on the cast and walk.
Also, he said the fracture was still seen in the x-ray.I am not sure what is the progress of the healing .
Also, due to stiffness in long leg cast, I am finding it difficult to move my knee.Do I need to go for a physical theraphy or it will be alright by exercises at home.And what kind of exercise can I do at home for knee movement.
Regards and Thank you,
Shweta
Dr Arun Pal Singh Reply:
April 7th, 2010 at 6:53 pm
@Shweta,
You must have been told exercises. Usually these are range of motion exercises for knee and quadriceps strengthening exercises.
Dr Singh,
I’ve been reading the various reports of ankle injuries herein with great interest. On March 17th I managed to break (separated the lower portion) my left ankle’s medial malleolus. It was apparently a pretty clean break, according to my doctor and the xrays I was able to see, and due to its nature the orthopaedic surgeon I saw immediately declared that it needed surgery to restore the bone’s full integrity and how it mates with the talus beneath it.
I had the procedure on March 26th, having two screws inserted through the displaced portion up into the tibia. The surgeon said it was a very good fit and should result in proper union of the bone. I go back on April 6th for a follow up, xrays to check the fit, etc.
I’m presently in a half-cast thing that goes under my foot, up my left calf, and partially wraps the entire ankle on both sides. It’s held in place by elastic bandages, which allows me to ice it and flex my toes nicely. I still get a little numbness in my foot if I don’t elevate it for a while, which I credit to the wraps being a little snug. I haven’t loosened them myself because I feel I shouldn’t monkey with something they did at the hospital.
If, in fact, my malleolus heals as nicely as my surgeon seems to indicate it will, can you gve me a ballpark idea of how long I might be off of it. I’m a 61 year old male, and I was a very active golfer until this happened. I’m concerned because a sturdy left leg and foot are pretty important to a proper golf swing. In addition, there’s a lot of twisting of the left foot & ankle at the finish of the swing that I fear may be compromised by the repair of my ankle.
Also, in a couple of the earlier comments from patients, they asked about having the screws removed from their repaired ankle bones. Is that commonly done? Is it at all necessary, or can the screws remain in place to help the structural integrity of everything down there? Would the screws pose a problem in my later years regarding pain, stiffness, arthritis, etc?
Dr Arun Pal Singh Reply:
April 7th, 2010 at 7:05 pm
@Joe,
A fracture usually takes 6-12 weeks to heal and after that usually 2-4 weeks of physiotherapy are required.
That enables the patient with a united fracture to move around without support.
Fro a sports related activity you would need to train for ankle strengthening exercises and it might take a bit longer. How long would depend on your progress.
No! The screws do not cause any harm per se. THey can be left as such if the.re is no problem
Thank you Dr for your reply.
I have started to walk with shoe on cast with partial weight bearing.My knee is still stiff.The doctor did not recommend any particular exercise for stiff knee.He said as I walk, the knee will loosen up with time.
If there is no pain does that mean the bone has united, but not completely ?
Thank you,
Shweta
Hello Dr.,
I had an X-ray done and i have a crack on my medial malleolus. I have a walking cast on for four weeks. Do you think I will need it longer? About how long until I can walk regular? Because right now I cannot put any weight on it. I have been using crutches. I am also on cheer and was wondering will I be able to tumble/flip again (that is how I broke it) or will my ankle be to weak. Is there any way to make it heal faster? And also my toes get numb when I have it evelated for a long time is that normal?
Thank you.
Dr Arun Pal Singh Reply:
April 18th, 2010 at 4:59 pm
@Crystal,
Healing does take time. Your fracture would heal within 6-8 weeks, sometimes longer.
After that you need to train your joints and muscles and things would get better gradually.
Take a good diet. That is only you can do to heal aat normal pace.
Till now external measures that could expedite healing have not been discovered.
hey doc
i have a small chip at the end of my fibula about 1 eighth inch and its displaced bout quoter inch. i am not in a cast and am wondering how long i should keep off it. i can put all my wight on it with hardly any pain. will the chipped of bone dissolve
thanks doc
Kalani
Aloha
Dr Arun Pal Singh Reply:
April 18th, 2010 at 1:30 pm
@Kalani,
If the chips is small enough and you are not exeriencing any pain it is better to leave it like that.
Yes! With time it might
Hi Dr Singh,
Im quite impressed with your responses. I dont have a broken ankle but a broken wrist *unshifted*. I hope you could answer some of my doubts.
I had a cast for 6 weeks but the doctor said that the bones are still not united. Im asian and living in Austria, could it be that for asian it takes longer to unite. The Doctor said that normally it takes four weeks before a broken wrist gets united again. Im on my second month now but mine has not reunited yet. I now have sort of a gloves to protect the wrist but is it ok that my healing process takes so long?
Thanks for any advice.
Best Regards,
Strike
Dr Arun Pal Singh Reply:
April 18th, 2010 at 1:40 pm
@Strike,
Yes! Your question is at wrong place but I would answer it anyway.
I am not aware of any study that says Asian unite slowly.
Sometimes, people do hel slowly for no apparent reason.
Take another xrays after 8 weeks and most likely it would unite.
Dr. Singh,
Thanks for your kind reply earlier to my questions regarding how long I might expect to recover and whether the screws in my medial malleolus would present a problem if left in place. I have one other concern regarding the swelling in my foot & ankle that persists still.
I have had my lower leg hard cast replaced by a walker boot that I can remove and typically don’t use when I am just sitting in my home or sleeping. In fact, I rarely use it at all since my ortho surgeon has thus far prohibited me from placing any weight on my left leg other than to provide balance if I should stand for any reason. I still occasionally ice my ankle/foot, and take low doses of ibuprofen to combat the swelling but I see no noticeable progress in reducing it.
Is persistent swelling typical, or should I contact my orthopedic clinic and have this looked into? I have a regularly scheduled follow-up appointment with them on April 27th, another 9 days from today, and will wait until that if you think I am not experiencing anything unusual. But I believe the swelling should have abated by now. But then again, I’ve never broken an ankle before, so I have nothing to compare this to.
Dr Arun Pal Singh Reply:
April 30th, 2010 at 10:11 am
@Joe,
There is a severe delay in my reply and I am sorry. I hope your visit went fine and your queries have been answered.
i fractured my medial malleolus in a lax game and am have pins put in it tomorrow i would like like to know what the time will be untill i can walk again.
Dr Arun Pal Singh Reply:
April 30th, 2010 at 10:12 am
@reid,
Please discuss it with your doctor. How did the surgery go?
I have a question. I am a 44 year old female. On March 6th (7 weeks ago this Saturday), I was thrown from a horse and fractured the spinous processes on my T3, T5, T6, T7, T8, and T9 vertebrae. Not sure how my T4 managed to stay intact, but it did!
Follow up xrays on the 24th of March showed that I am apparently healing without any problems.
I am moving much better and am slowly returning to my normal life. However, I still experience considerable pain (particularly after being on my feet or walking a lot) and do not feel comfortable driving yet.
Is this fairly normal for this sort of injury? On average, how long does it take for full recovery? Specifically to be without pain.
Thank you. And by the way….I have decided to “retire” from riding horses.
Dr Arun Pal Singh Reply:
April 30th, 2010 at 10:19 am
@Donna,
Spinal injuries usually take around 12 weeks. So you seem to be progressing fine.
Hi Dr Singh,
Just dropping by to say hi and thanks for your kind assistance
Anyways as of my last session of physical therapy (March 19), I’ve been walking and driving since then with no problem or pain.
The redness has diminished (but not completely), but the swelling hasn’t gone away …is it true it will take up to a year before the swelling to completely go away ?
I have been walking a lot more (2 hours or more at the park) but I tend to get lazy so I haven’t been doing the stretch exercises. Does walking for 2 hours good enough ? or should I still do the stretch exercises ?
And from my hours of walking the past month, I noticed that purple-colored tiny veins are showing on my ankle area, in addition to the visible green colored veins – are these normal ? The flexibility range-of-motion (toe pointing toward me and against me) isnt like the other yet (does this take up to a year to become normal again ?)
And my last question : how long more do you think I should wait until I can do stuffs like surfing, etc ?
Thanks again
Dr Arun Pal Singh Reply:
April 30th, 2010 at 10:17 am
@Alexander,
Everything seems fine to me.
I think you can gradually begin but do not overdo.
I have a question. My husband recently suffered a tibial bone fracture and had to be corrected surgically.On the same leg he had an ACL reconstruction 6 years back.Anyhow post surgery he still complains of numbness in the foot even after 36 hours. I would like to know why?
Dr Arun Pal Singh Reply:
July 16th, 2010 at 8:33 am
@sumana,
I hope I do not have enough information from your side to answer that.
It would be better if you ask this the treating doctor.
I fractured my medial malleolus in my left ankle(non-displaced/clean). This happened 3 weeks ago from a fall. My doctor has been monitoring with X-rays and the week 3 X-ray showed there is a clear callus forming, to the point where the fracture is hardly visible. I have read in a number of places that early weight bearing is the key to no physio and I have to this point been putting at maximum 50lbs. on my left leg. My doctor says that this will cause the bone not to heal but based on the latest x-ray and the fact that I have been weight bearing to some degree the whole time I disagree. I plan to be full weight bearing at 4.5-5 weeks and my cast doesn’t come off until the 6th week. My question is, What is the timeframe for a the spongy soft callus to become a hard callus. I believe it is 4-6 weeks, but I’m not sure. I am a police officer and want to return to full duty sooner then later. I think the Doc has alterior motives with the physio, if I could walk his buddy wouldn’t get his money after the bone healed. Maybe I am way off base. Thank you for your consideration.
Dr Arun Pal Singh Reply:
July 28th, 2010 at 4:45 pm
@Miller,
You are right about timing of the callus but you are wrong in not following your doctor’s advice. You might have some beliefs but they contradict with laws of science.
When a joint is injured as in your case, it is in the best interest to keep the limb of the ground so that joint can heal properly.
I broke my rightmeidal mal…It happened may 28 2010…its now aug 8th 2010…
i started therapy 1 month ago i get so much pain at the mis day..i cant waer my shoes with out my ankle swelling over my shoes…I had 2 screws put in…
i tell my theripst whats happening i feel like im being ignored
Dr Arun Pal Singh Reply:
August 13th, 2010 at 3:55 pm
@marie,
Talking with your therapist would help
Dr. Singh.
I injured my ankle and medial maleoulus fibula 11-17-04. My ankle swelled and I iced and rested it. However I could stand and still walk. So I never went to a Doctor. My ankle is now completely useless and I have trouble standing and walking. What should I do?
Dr Arun Pal Singh Reply:
August 28th, 2010 at 9:41 pm
@geoffrey,
You should see a doctor who can examine and diagnose your problem. Then you can be offered the treartment based on your diagnosis.
I hope that helps.
Hi, it’s been 24 days since I broke my ankle and fractured the fibula about half way up my leg. I’m still in a fiberglass splint and was to have surgery 3 days ago, day 21. They aborted surgery because of a potential heart condition that was caught in the surgery prep. I don’t have any pain right now, it subsided about 7 days ago, I have reduced my pain meds, I keep it elevated for about 16 hours per day, swelling is now greatly reduced. I have not or will not put any weight on it. My diet is very good
My question- given the CAT data below, is surgery mandatory for me? Will I be able to function at some point without surgery? I feel neglected, should things take this long?
Thank you
TECHNIQUE: Spiral CT imaging was obtained in contiguous 3 mm segments through the ankle
and proximal foot. These images were reviewed on standard axial imaging on soft tissue and
bone settings as well as three dimensional surface rendered imaging and parasagittal and coronal
reconstructed studies.
FINDINGS: The patient shows presence of a comminuted distal tibial fracture. There is both a
fracture through the medial malleolar area which is comminuted but non-displaced with fracture
margins at less than a millimeter of separation. The fracture also extends posteriorly involving
the posterior component of the tibia including approximately 5% of the articular surface. Again
the widest gapping of the fracture occurs at the level of the posterior tibial articulation and this is
measured at 2 mm. The remainder of the fracture margin shows good apposition of less than a
millimeter distraction. There is relative gapping of the distal tibia and fibula with slight lateral
subluxation of the talus suggested. This is estimated at approximately 1-2 mm and most likely is
associated with some ligamentous injury of the medial collateral area of the ankle joint. On the
axial images, there is a small curvilinear 2 x 0.5 mm calcification interposed between the distal
fibula and the distal tibia along its anterior margin. This most likely reflects a small cortical
avulsion injury associated with ligamentous trauma. Evaluation of the tarsal bones shows a small
sclerotic bone island within the calcaneus. The talus is intact including both the anterior and
posterior subtalar joints. No fractures of the navicular or visualized portions of the cuneiforms
are noted. There is soft tissue swelling of the joint commensurate with fracture injury.
IMPRESSION:
1. Comminuted distal tibial fracture including the medial and posterior components of the tibia.
Overall alignment and apposition of the fracture margins is fairly well-maintained as discussed
above.
2. Findings also suggest slight lateral talar subluxation of a few millimeters, most likely
consistent with some disruption of the medial collateral ligaments of the ankle. Given these
findings I would be considerate
Dr Arun Pal Singh Reply:
August 29th, 2010 at 7:37 am
@Mike,
There is nothing as mandatory. Choice of treatment is greatly affected by patient’s condition and his demands.
From your findings, it seems that you have a fracture which is comminuted but not displaced much.
So non operative treatment should also provide satisfactory results.
All the best and let me know how did it go.
I fractured my lateral malleolus in my right ankle, i was in the cast for 2 weeks after removing the cast i walked for 2 days again swelling and pain started. Doctor put me another cast for 6 weeks yesterday there removed that but little swelling is there and also some offen i will get pain on injured area…is it common or else do u have any advise….
Dr Arun Pal Singh Reply:
September 2nd, 2010 at 5:38 am
@shamsheer,
Did you take any xray after the cast was removed? What did it say?
Hi Dr,
I had a rhinoplasty about 9 months ago, the hump on my nose was filled down and then my nose was broken to reset the bones. I could feel a little gap where my nose was fractured from, will bone regrow and close this gap?
Regards,
Saj
Dr Arun Pal Singh Reply:
September 2nd, 2010 at 6:41 am
@Saj,
I cannot advise you on this issue as ENT specialist is the right person to talk to. Discuss it with your doctor please.