Recurring problems following sprained ankle

[arenaman]

Hello, I'm after some advice about what could be wrong with my ankle please.

At the end of October last year I went over on my ankle quite badly whilst out running (foot turned inwards). I went to the local A&E where they xrayed it and told me I had fractured my medal maleolus and plastered me up. They sent me to the fracture clinic at another nearby hospital the next day.

To my surprise the specialist told me that the fracture was an old one, possibly a few months, maybe longer, he removed the plaster and gave me crutches I couldn't quite get my head around this as I'd been running 6 miles 3 times a week over this period without any pain or discomfort or any indication it was fractured, anyway I was just told that this was a sprain and had several sessions of physio and it slowly improved over the next 2-3 months. It was initially very swollen and bruised but eventually eased, i'd say it was at 90% by Jan/Feb 10.

I was able to run a few miles but it swelled up after any exercise (outside of ankle) not a major problem but it was bugging me. In June 10 whilst walking on holiday I gradually developed a dull aching pain in the ankle, quite painful in the end and caused me to limp, It swelled up again and it was basically like it was around Dec 09

My ankle now constantly feels stiff and uncomfortable, I've resorted to training on a bike but it even swells up after a ride (2-3 cm larger circumference than my right ankle)

I went back to the doctor's and I'm currently awaiting an MRI scan

How can it still be wrong after nearly a year? How could I have unknowingly fractured my ankle
previously, are the 2 even connected?

Any help would be appreciated, I'm worrying I may need an op, surely it should have healed by itself if it was going to after a year.

Thanks, Andy.

[Heidi]

Hi
It would be rare for you to have fracturerd your ankle (medial) without any knowledge of it. Saying that, it does happen, albeit very rarely. It may just have been a stress fracture or something which didn't occur after any particular incident, it might have just developed gradually.
As for the more recent injury, ankles can take a long time to heal. I would keep up with the rehab programme as much as possible, trying to strengthen the surrounding muscles, improve balance and flexibility especially in the calf muscles.
Then just await the results of the MRI. These will give an indication if there is anything more problematic in the ankle and whether you need any further treatment. But I wouldn't be worrying about surgery just yet!

[arenaman]

[QUOTE=Heidi;4147]Hi
It would be rare for you to have fracturerd your ankle (medial) without any knowledge of it. Saying that, it does happen, albeit very rarely. It may just have been a stress fracture or something which didn't occur after any particular incident, it might have just developed gradually.
As for the more recent injury, ankles can take a long time to heal. I would keep up with the rehab programme as much as possible, trying to strengthen the surrounding muscles, improve balance and flexibility especially in the calf muscles.
Then just await the results of the MRI. These will give an indication if there is anything more problematic in the ankle and whether you need any further treatment. But I wouldn't be worrying about surgery just yet![/QUOTE]

Thanks for the reply, I actually did go over on the same ankle about 2 months previous to the original incident in the same fashion (no thanks to a pothole) I had mild discomfort and swelling for a day or 2 but it was fine and running within about 3 days. Surely I couldn't have fractured it then could I? The specialist was quite non committal really "suggesting" and saying it was "possibly" an old injury, I didn't really get a definitive answer yet it was treated as a sprain. You can see the line clearly across the medial maleolus but he stated" the edges look rounded and there is surrounding sclerosis suggesting it is a much older injury"

[Heidi]

Yes that could have caused the 'old' fracture. Often a minor fracture is actually less trouble than a severe sprain!

[arenaman]

Scan date received for 5th October, progress at last.

[arenaman]

Just an update, I've had the results of the MRI scan which said

"this man has sustained significant injury to the lateral ligament complex with a rupture of the anterior talo-fibular ligament and the calcaneo-fibular ligament, appropriate treatment would consist of reconstruction of the lateral ligament complex."

I have to be referred to an orthopaedic surgeon now.

Time to google what all this means

[Heidi]

Hi
Its basically a severe ankle sprain with complete tears of two of the three lateral ankle ligaments.

[arenaman]

Further update, I will be having surgery in about 4-6 weeks time, it's worse than I thought it would be. The procedure involves routing the peroneus brevis tendon through a tunnel they will make in my fibular and stitching it back on itself (tendon loop?). It sounds painful

[bonnie]

I hope everything goes ok for you.

[arenaman]

Hello, just a further update

I finally had my surgery on Tuesday (Lee procedure I believe it's called) I can't believe it's taken 20 months from the original incident, though I was offered a date in May but was on holiday.

It's early days yet, no real pain as yet (fingers crossed) I've only had to take 6 paracetamol so far. The worst part is having to have a daily anticoagulant injection for 6 weeks.

I'll update as and when