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Broken fibula and ankle bone

by DS
(India)

fracture of fibula

fracture of fibula

fracture of fibula
fractured fibula
fractured fibula and medial malleolus

Hi, I had an accident 10 months ago and broke my fibula and ankle, surgery was done, screw inserted in the ankle and plate in the fibula. Last X Ray showed broken ankle bone to be healed fully and fibula almost healed. Though the swelling has reduced considerably on the fibula side,but the muscles have concentrated on one area on side of the plate and not uniformly spread.They form a small ball like shape at the end of the day. Also on the skin on the top of muscles feel dry and is less sensitive compared to other less and also numb. Any insight into this?


RESPONSE

Hi DS,

I am looking at your x-rays and here is what I see and what I do not see. First of all, I see no sign of a screw or plate, so I assume you are showing me the pre-operative x-rays that were taken right after your accident.

It might have helped a bit more if I could have seen the post-operative x-rays since your complaints seem to be related to the after effects of the surgery.

The good news is that in your narrative, you make no mention of having any real pain and at the end of the day that is what you should be most concerned about.

Since surgery to correct bone trauma can only be planned out to a certain extent and since your surgeon has to work with what injuries you sustained there is usually a high incidence of mild side effects. This is almost impossible to avoid.

You have a plate in your lower leg. Depending on how large it is, how many screws are used to hold it in place, the angle it sits relative to the bone, there almost has to be some protrusion of the plate which in turn is going to press against the peroneal muscles and create non-symmetry in your leg. Other factors
such as how muscular you are, how much fat you have around the area will also contribute to the problem you mentioned.

The short answer is that there is not much you can do about it, unless somewhere down the road you request the plate be removed. I would suggest to you that the fibula bone is a poorly vascularized bone and most surgeons would probably recommend the plate stay in place as its removal could weaken the healed fracture site and once again cause problems. I would also suggest that if the plate were removed further down the road the symmetry that you desire, might not occur anyway since the changes that have occurred from the plate would probably remain.

Again, most surgeons would tell you that since you ultimately have no pain, the surgery was a success and most would have no interest in removing the plate.

As far as the numbness goes, I am afraid you are probably stuck with that as well. Invariably the incision to reduce the fracture and insert the plate, cut some superficial sensory nerves leaving you with numbness. The dryness you mention may also be the result of the incision as superficial vasculature may have been altered as well.

Now, over time you may see some reduction of numbness since nerve tissue is one of the few tissues in the body that regenerate. It could take a year or two, or might not occur at all.

I do not know what your incision looks like, but one piece of advice I can give you is to keep that area of the leg that feels numb and dry, well hydrated. Apply dry skin lotion two or three times a day. Obviously, that should help with the dryness, but it may also reduce some of the sensation of numbness. You will then have to wait to see if any of your missing sensation returns.

Marc Mitnick DPM
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Oct 20, 2014
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screws have moved
by: Anonymous

hi 2012 i broke my ankle in 4 places plate and screwa where put in place only problems was numness and discomfort. in all concidering the break operation went well it is now 2014 and im having problems when standing and walking i get severe pain in ankle .this is not all the time but the pain comes when i least expect it ,when this happens i canot put preasure on my foot,now i had an xray done and found out the area in ankle ,two screws have come out and artritis in area also .what shall i do will i need another op

Discuss your options with your surgeon. If the fracture is stable and the source of your pain is the loose screws then they may have to be removed. This surgery will not be as nearly involved as the original surgery.

Marc Mitnick DPM

Jul 16, 2014
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Re: Broken fibula and ankle bone
by: Anonymous

Dear Dr Marc Mitnick
I had published a new page with my latest X RAY's some 5 days ago but the page has not gone live yet.
Shall I do the same again

Thanks
DS


Yes, try again

Jul 11, 2014
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Re:Broken fibula and ankle bone
by: DS

Dear Dr Marc Mitnick

Thanks for the detailed reply. I have the post operative latst XRAY's with me which I can send across but could not see an option to upload the images here on this forum.
I would like to share those XRAY's with you and take a final opinion from you.

Thanks
DS


Hi DS,
I think the only way you can do this is to create another "ask the doctor" encounter and then you will have the opportunity to upload images.
Please reference your original post so that I know what I am looking at.

Marc Mitnick DPM

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