ankle pain from growth plate fracture
My daughter fractured her growth plate in her right ankle 6 years ago. The orthopedic doctor casted it for 6 weeks and sent her to PT and we have been back to him on several follow up appoints up to about year and a half following her accident. Since then she has had multiple x-rays and MRI's of her ankle and she still continues to complain of her ankle hurting like a "toothache" and it swells all the time like their is fluid built up around it. She is in tears most of the time with it and is now 15 years old. I have taken her to three doctors and none want to perform surgery due to they say she is still in her growing stage. I need help and want her better!
Unfortunately, there is no simple answer here. I will make the assumption that all the x-rays and the MRI show that the fracture has healed, at least on the films.
I think we can assume even with a "healed" fracture, there has been some damage to the growth plate that is not detectable on x-ray or MRI.
So in theory surgery might sound like the next best option. The problem here, as has been pointed out to you by your doctors is the simple fact that the surgical rule of thumb is that you never operate on a bone that has yet to have fused. The problem becomes one where if your daughter has surgery on the right ankle (I assume the fracture was one of the actual leg bones), there is the real likelihood that the left leg bones will continue to form and grow and your daughter will be left with what is known as a limb length imbalance. Her left leg will be slightly longer than the right.
Additionally, stunting the growth on one of the right leg bones could actually throw off the architecture of the right ankle and she would end up with right ankle issues on a permanent basis.
Your daughter is now 15 years old, she is not that far off from fusion of the growth plates. Until that occurs, you and your doctor need to take steps to "protect" the painful area with either strapping, casting, or perhaps even cushioning the heel of foot so when she comes down on her heel it does not send a jarring force into the ankle which will just aggravate it. There is no specific brace, strap, etc. that I can recommend, so I think it will be a case of trial and error until you find something that allows your daughter to walk more comfortably until the time comes that surgery may be entertained.
Marc Mitnick DPMDISCLAIMER