lis franc fracture
I suffered a lisfranc fracture on 26 December last year. I had 2 xrays but the fracture didnt show up until they did a scan on the 28 January, nearly 4 weeks after the injury. They decided that i did not need a plate fitted and put me in cast for 6 weeks and then a boot. It has now been decided (8 months after the injury) that they now need to put a plate in my foot as i have a problem with my big toe and my 2nd metatarsol. Why did they not do this at the beginning and is this problem related to the delay in them detecting my injury early onANSWER
Medicine is not an exact science. Medical decisions are made at the time with the best information available to the doctor. I am not going to second guess your doctor; that would not be fair to he or she nor to me.
When a person sustains a fracture
the actual fracture line has to be assessed. In general we look at the degree of fracture (small crack vs. large fracture line). We also look at the degree of separation of the fracture line. If it is too wide then we know that the probability of the fracture healing is reduced.
We also look at the overall health of the individual. If the patient is overweight or is a smoker than we know that the odds of healing are diminished.
The fact that it took a bone scan to find the fracture and it was not even visible on two x-rays leads me to believe that it was a very small fracture and because of that your doctor elected to try the more conservative route.
Unfortunately, any treatment option for any condition in medicine has the potential to fail. Unfortunately for you the treatment regimen selected by your doctor did not work out.
In my opinion, the sign of a good doctor is one who can identify any problems that may arise with treatment and then rectify them.
You can look at this situation another way. Suppose your doctor had put screws and a plate in your foot initially, and you had problems with it, which happens quite often. You would then be faced with having all that hardware removed with the possibility of still having problems with the fracture site.
As I said earlier, medicine is not an exact science.
Marc Mitnick DPMDISCLAIMER