Question
Hello Dr.Katz,
Fractured my ankle {lower fibula} back in September 8th this year. Ortho doc
said it was cracked / not completely broken. After 10 weeks in a boot the
x-ray still showed minimal healing. Now I am going into my fourth month.
Ortho doc wants me to put weight on it gradually through therapy even
though the most recent x-ray still shows a crack / slow healing.
This seems illogical to me. If the bone has not completely mended why am I
being asked to put weight on it ? I am a big guy at 270 pounds.

I went to a podiatrist {foot and ankle} surgeon for second opinion.
He took an x-ray and confirmed that there is a visible crack.
They both agree that my injury is very slow healing. HOWEVER, they both
completely dissagree on my course of treatment.

Ortho doc says to bite the bullet as she put it and move forward through
therapy and see how much weight I can tolerate.

Podiatrist wants me to stop any therapy that places weight on it. He says to
give it more time to heal and suggested bone stimulation.

Both agreed that this type fracture can take up to 6 months. They also agree
that it should not require surgery.

Who's advice would you follow.

Your opinion is appreciated !!!!
Thanks,
Ron

Answer
Hi Ron,

My opinion is that you should certainly use a bone stimulator, however, I would continue physical therapy.  You need a combination of weightbearing in a boot and passive physical therapy that will help strengthen the foot, ankle and leg muscles so that you don't get too weak.  I would also consider a bone scan or MRI with contrast to see if there is healing activity.

Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
www.thetampapodiatrist.com
www.tampacryosurgery.com

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