[Nigel]

Hi all, I was wondering if any of the docs out there could offer some advice?

I took a bit of a tumble on Tuesday evening, fell approximately 15ft onto a flat rock with my left foot. I didn’t go over on it really, but it has been weak recently from a recent sprain (6 weeks old) and it immediately felt sprained. I got it X-Rayed in casualty, result of this was that there was a very very small flake of bone that had come off the medial malleolus (?), doc presumed that the force of the impact strained the ligament such that it pulled this flake of bone off.

Now the doc didn’t seem too concerned, he just said “we’ll treat it as a sprain”, told me to rest it for a few days to let the bone heal a bit, then get walking on it. However, I don’t want to jeopardise the bone healing, so I was just wondering if I should dive in and start walking as soon as poss (my usual treatment for a sprain) or whether I should indeed rest up to allow the bone to heal, and how long for. Any other info would be appreciated, as they basically gave me no info and I don’t have any appointments with consultants/fracture clinics?

I’m going to Scotland at the start of June, so I would like to be getting back to normal by then really.

Thanks in advance. 

[Mike Tyson]

Totally non ankle related but when I broke my femur I was encouraged to get back on my feet as soon as poss. It was held together by titanium though 

Hope you recover swiftly mate.

[JamesD]

Likewise when I broke my femur (and this advice came from one of the top bone people in London), apparently it helps the bone knit faster, however a sprain is pretty different, but most ankle sprains i've had (and i've had quite a few) have healed pretty quickly after the first week.
The ankle seems to be one of the muscle/tendon areas you can fuck up repeatedly and not suffer too much long term from it, must be due to the constant circulation from walking etc I guess?
Who knows, i'm no doctor!

[Nigel]

Yeah I've sacked my ankle quite a lot in the past and recovered very quickly, usually by walking on it as much as poss. That's what I want to do now but I'm wondering whether this will negatively affect the bone healing?

Golt my understaning is that with pins you can do what you like as they hold the bone together whatever.

[SA Chris]

These flakes and things can do funny stuff when healing. My brother had a flake of bone pull off in his hip/groin area as a result of a bad tackle playing footy and it didn't reattach properly, resulting in some odd porous bone forming where it pulled off, preventing it from reattaching properly. He ended up needing surgery to clean up the mess and reattach it. I have no idea if this is relevant or not, I'm sure someone a bit more medically minded will be along shortly.

To summarise; I probably have no idea what I am talking about, bummer, hope it heals before the trip.

[Paul B]

Golt my understaning is that with pins you can do what you like as they hold the bone together whatever.

they had me up a day after I had the ex-fix fitted. It feels so wrong.

[cowboyhat]

A few years ago I had what sounds like a very similar injury and they put a cast on for six weeks. The ligaments were obviously the problem though and had to have a lot of rehabilitation to sort them out.

Actually just looking at a drawing it was the Lateral Malleolus I fractured.

What did you fall off?

[jfw]

http://emedicine.medscape.com/article/85224-treatment

Quote: "Barely visible osseous chip fractures do not alter the routine active management of grade 1 and 2 ankle sprains."

But then it also seems to be referring to lateral malleolus (outside) rather then medial (inside).

[jfw]

here we go

http://www.foothyperbook.com/trauma/malleolarFx/ankleFxMgtMedMal1.htm

if your fracture is undisplaced

http://www.foothyperbook.com/trauma/malleolarFx/ankleFxMgtStab1.htm


"these fractures require only symptomatic management. In practice, we find that the majority of patients are more comfortable in an ankle brace than elastic bandaging alone. The following are unnecessary and should be avoided unless clinically indicated:

the use of casts
avoidance of weightbearing
follow-up radiography
Patients are encouraged to weightbear as soon as possible and to actively exercise the ankle. Follow-up is probably unnecessary."

EDIT:
But classification of undisplaced still says no medial injury
"Fox et al (2005) defined 2/3 of patients with undisplaced ankle fractures as stable using the following criteria:

the talus is congruent in the mortise
there is a trans- or infra-syndesmotic fibular fracture
there is no medial injury
there is no clinical evidence of higher-energy injury "

maybe get a second opinion?

[Nigel]

Char, I fell off the E2 direct finish to Millwheel Wall at B South. Thought it would be a good idea to prolong the life of my “good” boots by wearing my soft and battered pair. The small quarried edges clearly disagreed with me! Not my finest hour.

Cheers Jo, I saw that and it was encouraging as it roughly agrees with what I was told, mind you as you say mine is medial and they mention lateral?

I think I might get back in touch with the NHS to see what they advise, it was 3 in the morning by the time I got seen and I suspect no-one involved was as sharp as they could have been (including me)! Who shall I go and see? Walk In? I don’t have a doc in Sheff and its not really an A&E job anymore?

[Paul B]

There's a good walk-in service at the bottom end of Rockingham street.

[Jaspersharpe]

The walk-in at the Hallamshire were really good / quick when my Mrs fucked her wrist up. X-Rayed, strapped up and back out to the dinner we were on our way to before everyone else had finished ordering.

[Paul B]

see this is the problem with having golden feet. Very soft is high quality gold.

[Fiend]

Char, I fell off the E2 direct finish to Millwheel Wall at B South. Thought it would be a good idea to prolong the life of my “good” boots by wearing my soft and battered pair. The small quarried edges clearly disagreed with me! Not my finest hour.

You need to watch this climbing business, dangerous stuff.

Important to keep good blood flow to the area which the walking thing might help with...

[Kim]

I'm not sure if they do a walk in, but I saw/am seeing an ankle specialist at the fracture clinic at northern general who's really good.

[cowboyhat]

Char, I fell off the E2 direct finish to Millwheel Wall at B South. Thought it would be a good idea to prolong the life of my “good” boots by wearing my soft and battered pair. The small quarried edges clearly disagreed with me! Not my finest hour.

If only that boot deal had come through...

[SA Chris]

There's a good walk-in service at the bottom end of Rockingham street.

I think a hobble-in service is needed in this case.

[Jim]

to make you feel better, at least you didn't do this falling off 1ft up

[saltbeef]

last time i climb in evolves.
i'm amazed my little pins can support my vast bulk so its not a surprise they crumble when falling off.

[JamesD]

Girlfriend just broke hers today, jumped in a controlled manner, from the top of a high overhang at Mile End wall.
It seems however she managed to find the only section of the mat in the place that was soft enough to bottom out to the floor below.
Bizarre thing was there was a complete lack of swelling and no muscular/tendon damage, literally the only injury was this fracture, weird eh!
Anyhow, she is not a happy bunny bless her, she was making so many great improvements in the last week or two, and now she is gutted that it's 4-6 weeks in a cast

[nathan wind]

Hi all, I was wondering if any of the docs out there could offer some advice?

I took a bit of a tumble on Tuesday evening, fell approximately 15ft onto a flat rock with my left foot. I didn’t go over on it really, but it has been weak recently from a recent sprain (6 weeks old) and it immediately felt sprained. I got it X-Rayed in casualty, result of this was that there was a very very small flake of bone that had come off the medial malleolus (?), doc presumed that the force of the impact strained the ligament such that it pulled this flake of bone off.

Now the doc didn’t seem too concerned, he just said “we’ll treat it as a sprain”, told me to rest it for a few days to let the bone heal a bit, then get walking on it. However, I don’t want to jeopardise the bone healing, so I was just wondering if I should dive in and start walking as soon as poss (my usual treatment for a sprain) or whether I should indeed rest up to allow the bone to heal, and how long for. Any other info would be appreciated, as they basically gave me no info and I don’t have any appointments with consultants/fracture clinics?

I’m going to Scotland at the start of June, so I would like to be getting back to normal by then really.

Thanks in advance. 

I broke my left ankle and sprained the right one pretty badly in Bishop last year, so maybe this will be of some use..

I broke / fractured the medial mallellous in my left ankle and was told in ER to do nothing whatsoever on that leg for a minimum of four weeks to six weeks, apparently the fracture was relatively small and I was given crutches and splints for both legs, but sacked the splint for my right leg off and just took a load of ibuprofen (and alcohol) to help with pain of walking.. With regard to the break, after a few days I was referred to a specialist and he said all was good but again on no circumstances was I too use it, even for biking in a gym after say four weeks, basically as it takes bone six weeks to heal.. they gave me an air cast similar to the ones pro-footballers get and I was sent home.. on returning to the UK I was put in a cast immediately as a precaution and got a pretty scary lecture about the vulnerability of the bone in question, the fact that it hadn't fused as expected and the fact that if it didnt set properly it may need pinning, and may basically take significantly longer to heal...

So.. after all that, personally I'd get a second opinion, if its broken or fractured that sounds like pretty duff advice you've been given as both here and in the US I was told nothing for six weeks.. which was gutting but I accepted.. though that said there was no chance of me realsitically doing anything within the first month as both the broken and sprained ankle were such a mess, so the level of pain you're in my guide you, but yeah, get an appointment to see someone in orthopaedics I guess, at least get them to look at your x-rays again if you're in any doubt...

Hope this is of some help...

[nodder]

to make you feel better, at least you didn't do this falling off 1ft up

but was anyone running round in circles shouting HELP HELP?