Broken ankle

by Cortney
(Graham, nc, usa)

I broke my ankle in a car accident March 2, 2016. The doctor said it was normal for it to be swollen and painful, for up to a year. However, my x-rays, look the same as they did the day i wrecked. Should you also still see the break in the Xray, for so long, if it is healing correctly?

RESPONSE

Hi Cortney,

Under ideal conditions, a broken ankle that did not require surgery should be well on its way to healing after almost three months. This does not mean that you might not have any pain or swelling at this point, but the amount of pain and swelling should be much diminished compared to lets say the amount of pain and swelling you had six weeks ago.

Ideal conditions include the fact that you have listened to your doctor and wore your cast or boot the whole time, you are not a smoker as smoking can delay fracture healing. This also assumes that you are reasonably young with good circulation coming into the ankle and you do not suffer from any metabolic diseases which could delay fracture healing.

This also assumes that your type of fracture might not have been better served by surgery. I have no way of knowing.

Bone does take upwards of one year to fully remodel as your doctor told you, but it does not mean that you should be in the same amount of pain over this period of time.

In uneventful fracture healing, you should see gradual improvement in your condition as the weeks pass by. I usually tell my patients to ask themselves each week, if they are feeling better then the week before, and if the answer is "yes" then they are doing just fine. If you find that you cannot answer yes to that question, then there may be a problem.

If the most recent x-ray reveals the same degree of fracture as the original x-ray then that would also mean there is a possible problem. A fracture line does not necessarily have to be completely closed by three months, but in a normal situation it should show significant improvement over the intial x-ray.

So, if you are still having significant pain and your recent x-ray does not look much better then the original x-ray, something needs to be done.

You might want to speak to your doctor about a bone stimulator which is a device that helps mend broken bone. It is a painless device that can be very effective. I have used them over the years and found them to be very effective.

The problem worsens if the bone fails to heal itself. You would be left with what is known as a non-union and more then likely have chronic pain in the ankle. There are various types of non-unions but suffice it to say, this condition might lead to surgical intervention with the insertion of hardware in an effort to get the fracture to stay closed.

If the best advice your present doctor can give you is that it might take upwards of a year and you are finding that the pain and swelling is not really diminishing, then the best advice I could give you would be to seek a second opinion from another doctor in your area.

Marc Mitnick DPM
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