Broken Ankle - Member Case Study

author : AMSSM

comments : 0

It sounds like your ankle has seen plenty of mileage and, by the description of your surgeon’s plan, that you have damage to the articular cartilage that caps your talus bone.

Question from Pauliman:

I have repeatedly broken my left ankle (and sprained it many times). The doctor gave me Elodac (a blood thiner), and it improved. He suggested that I should have the bone drilled to try to get the surface to smooth out, as the MRI was not so good. Is the operation complicated, what is the recovery time, and are there other alternatives (since it worked better while on Elodac, but now that I am off it, it hurts)?

Answer:

It sounds like your ankle has seen plenty of mileage and, by the description of your surgeon’s plan, that you have damage to the articular cartilage that caps your talus bone. Other terms for this cartilage damage include osteochondritis dissecans and osteochondral lesion. This cartilage is important in protecting the bone from the impacts of walking and running. In its absence, you will feel the pain that you describe, and may develop progressive symptoms of stiffness, decreased range of motion and occasional locking in your ankle. It makes perfect sense that your symptoms improved with a non-steroidal anti-inflammatory medicine (such as Etodolac, also known as Lodine), as this family of medications treats both inflammation and pain common to this condition.

If these injuries are identified early in their course, some may respond to a period of casting. However, it is quite common, as in your case, that they have been present for a longer time. Accordingly, non-steroidal anti-inflammatory medications are often helpful. Special consideration should be given to your footwear, training frequency and training surfaces to minimize impact. A custom orthotic may also be helpful if it can be used to adjust the distribution of the load your ankle bears with activity.

If you require surgery, an arthroscopic procedure can be performed in most cases to remove any loose debris, address any additional bony changes as a result of your multiple injuries, and to try to stimulate healing at the site of the articular cartilage damage. Drilling shallow holes in the bone underlying the defect may stimulate this healing. While this procedure is not exceptionally complicated, your recovery after surgery will most likely take 3 or more months.

Scott W. Pyne, M.D.
Head Team Physician
United States Naval Academy
Annapolis, MD
 

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date: April 24, 2005