left ankle non union distal fibular

[michaelp937]

I fractured my fibula last March 16, 2007.  I followed the doctors orders diligently; (cast for several weeks, walking boot for several more weeks, physical therapy etc.  It healed to a certain point but still felt swollen.  The best way to explain it was that it felt like the fractured foot was a half shoe size bigger than the other one.  The doctor gave me a shot of cortisone; no help.  I recently had an MRI that showed a non union distal fibular.  The MRI also indicated torn ligaments from a previous injury.  The doctor is recommending a bone stimulator to help the non union.  If this does not work, he said I should have surgery to insert screws!!  The pain in my ankle is not severe, but is uncomfortable and fairly constant.  Question: Do you think the bone stimulator will help?  Are there other alternatives, i.e. physical therapy etc?  Will the non union eventually heal by itself?  I do not want to have surgery. Thanks for your help.  

[jemjem680]

I ALSO HAVE A NON UNION THATS 2..7 AP BY  1.7 XV BY 3.8 CC  .is surgery neccasary  I could get used to it pain is minimal and  my foot is stiff and limp is surgery really neccasary

[bevikins]

14 weeks ago i broke my fib and now told delayed union, showed about 20 percent fix..so sent away with another cast and tablets to promote bone growth..yest using one crutch to dye my hair and partial weight on it, am now in agony yet again, not really in the brake site,but underneath the  ankle bone, ... is this pain caused by the actual brake, im getting concerned its something totally different, feels like somthings wants putting back into place ..anyone feel this..thanks

[delayedunionfib]

I have a delayed union fibula fracture right above the ankle. I am using a bone stimulator.Which type,electrical or ulrasound is usually more effective.Also.should a short walking boot  or a boot that goes up to your knee be used.Should I be full weight bearing to help fracture heal.It hurts after only a short time walking.Fractured 5 mos ago

[ElizabethS1]

Dear Michael,

I did a double spiral break to my fibula on MARCH 17th (St.Pats Day!!) 2008!!
I have the cast on 2 months, got it off NO HEALING what so ever, nothing.. nadda. I spent May, June, July and most of August walking on it, waiting for a Internal fixture surgery. Aug 20th came had the surgery = recut bone (4 cuts) put some silly putty in added a 10cm long plate and 7 screws & 14 staples. One month post op..... NO HEALING, I went in the other day 5 months post op.... IT Kinda looks like a shadow of some sort. So doc "Thinks" it may finally be on it's way! Jesus! ya know.... I would have been better off with a bionic part from the get go I figure!! LOL, I just laff when I go to x-ray now!!  So in between  ALL of that. May 21st I had a carpal tunnel surgery to right hand, then end of July I find out I have stage 3B/IV Cervical cancer!! Still, I am laffing.... I WILL NOT ASK:"What else can go wrong, afraid to!!"


Oh Oh, P.S. sorry I got off track there> The surgery was OK! Not kidding, very little pain. Staples came out very easy @ 2 weeks post op. and I was flying around on it in no time. Only difficulty with it now, is where they had to screw the plate into the distal fibula IBall portion of the ankle) It is almost to the bottom of this, and it sure hurts when you go to rest directly on it!!! I may well have to get it out down the road.

So, ya surgery is OK, no lie. It is best to get it OR down the road you are gonna HURT like NOBODIES business!!! For the rest of your life.

Take Care
Elizabeth

[Cubanakle]

Dear Jain MD,
I have a similar situation. I broke my ankle 2 months ago and although mobilitity has improved and I have no pain in the area the x rays show no bone union. Should I wait one more month and try the ultrasound stimulator.
Cubanakle
PS I posted this also recently
Thanks!

[JainMD]

Hi Michael,
How are you feeling?
Good that you are not a smoker as that would delay bone healing.
If the MRI report says that it is delayed union that suggests that the fracture has probably healed, but it has a longer time to heal.
I think it will heal on its own, but having said that you also need to monitor with the help of imaging study as to how it is faring.
Yes you can definitely post your MRI report here, though it will be difficult to read the scans.
Keep me informed if you have any queries.
Bye.

[michaelp937]

No I am not a smoker.
I read more into the MRI and one section says it is a delayed union.
Is it correct to assume that this is taking longer to heal?
Will it heal on its own?
Is it possible to send you my MRI report to review?
There are many technical terms that are difficult to understand.
Thanks for your help

[JainMD]

Hi,
Electrical stimulation to help bone healing can be accomplished by several methods like, invasive method in which electrodes and power pack are inside the body systems, semi-invasive method in which electrodes will be inside and power pack is externally placed and totally noninvasive method in which the electrodes are placed over the cast surface and are connected to an external power pack.
An ultrasonic bone growth stimulator is a noninvasive device that emits low-density, pulsed high frequency ultrasound to promote the healing of delayed unions and non-unions that are refractory to standard treatment.
Nonoperative interventions for non-union should include Bone stimulators (electrical or ultrasound), Smoking cessation, Discontinuation of NSAIDs and Use of weight-bearing casts or functional braces.
Are you a smoker?
Non-union would persist as it is a functional area and would persist if it is not taken care.
Surgery would be considered only in patients with severe medical compromise, poor soft-tissue coverage, or poor vascular supply may be candidates for amputation.
Keep me informed if you have any queries.
Bye.