Prognosis - Right Ankle?

[dibblego]

Hello everyone,
I have quite a detailed and somewhat remarkable story, so I apologise for the verbosity.

I suffered an inversion sprain of the right ankle on 29 July 2007. I was kicking a football when I came down incorrectly. I was a very committed squash player at the time of the injury and I continued playing a few weeks after my injury right up to May 2008. This seems to have been a big mistake. I first approached doctors around December 2007 after the pain (which I found difficult to localise, but pointed to the medial area as the most prominent) refused to go away and was given a cortico-steroid injection. This gave a very minor improvement for a few days before returning to its previous state of pain and dysfunction.

I was never diagnosed as to the grade of the sprain, however, I have sprained my right ankle 5 times (4 previous to 29 July 2007) and my left ankle 4 times. I can say that without a doubt the pain on this last occasion was significantly higher than the other 8 times. To give a measurement, I think it was slightly more painful than having a ruptured appendix (if you've had that before, you'll know it is painful).

This short story may or may not be relevant, but during the few months after the injury, I became very sick as I pushed myself to quite silly limits. Eventually I landed in the emergency department after losing my vision (I had extremely tight muscles) and drifting in and out of consciousness. I was never treated for that, except for painkillers, but a comment en passant about magnesium supplements by a friend saw my symptoms - that I'd had for many weeks - alleviated quite a lot and within a few days (but never fully fixed to this day). I told this little part of the story because my intuition is that it had something to do with my ankle injury (Mg deficiency means?).

My continual complaining over the weeks and months to doctors about my ankle eventually saw me at an orthopaedic specialist who determined that I need a Brostroem Repair and a medial ligament repair. This occurred on 15 September 2008. After I started FWB a few weeks later I had incredible pain that had been exaggerated by the surgery. I could not localise the pain at all and my entire foot was on fire. I complained to the surgeon to this extent who ordered another MRI but could find no abnormality.

I approached another surgeon in Sydney (I live 1000km north of Sydney) who determined that an arthroscopic debridement of tissue in the medial, anterior and lateral area would help. It did - my foot is no longer on fire, but I am back to the point where I was before the September surgery (kind of).

This is where it gets interesting. In fact, my tissue impingement is better than it was before the September surgery, but my painful limp and "bent leg" is much worse since the September surgery. It is now very exaggerated.

Importantly, I have recently been able to localise an intense pain to a very precise point through my skin. This point is about 80mm proximal to my lateral malleolus. I recognise this pain very clearly as "bone pain" rather than tissue pain. Applying pressure to it gives me that sickening feeling and a slight sweat (if you've had bone pain, you'll know what I mean). The pain continues down from this point tapering off slowly until I get to the lateral malleolus where I have a dull pain. Moving up toward the knee, the pain tapers off quite quickly where I feel no pain at all after about 50mm.

After much reading and prodding my leg, I believe I fractured my fibula on 29 July 2007 and that this fact is the cause of my ongoing problems. That is, poor healing as expected given that I continued to train on the injury for months after. I also think the fracture is toward the front and behind (based solely on the pain) of the bone. I am going to see the Sydney surgeon on Thursday, but I am quite worried. Let us accept that my prediction is right (and that it can be indicated on an MRI) - what are my chances of a full recovery, with corrective surgery (I expect is the treatment?) 17 months later? Will I ever walk properly again? What are my chances? I was once a professional athlete (it's depressing).

I have some interesting links on this matter below for anyone interested. I have no idea how to read an MRI, but there appears to be some white discolouration on an image taken on 29 January 2008 (6 months after the injury) in the area that I feel pain. Maybe it's just normal - I don't know.

I should point out that I am not a medical professional and that my knowledge of the ankle anatomy and conditions of the ankle comes only from reading a lot of material over the months and medical journals (my partner is a midwife in a large hospital so I can get access). Thanks for any advice.

In this image, the black dot is the centre of my bone pain. The MRI is part of a set of images taken 29 January 2008.
http://public.tmorris.net/image/ankl...omparison1.png

Here are all the images taken 29 January 2008 in DICOM and PNG format. I have an MRI taken in October 2008 but not in electronic form.
Index of /image/MRI-20080129/DICOM/ST000000

Here is a measurement taken of one of the images using the DICOM software.
http://public.tmorris.net/image/ankle/wtf/measured2.png

Again, any advice is appreciated. Thanks.

Similar Threads:

• prognosis of proprioception loss following sensory axonopathy
• Ankle help....
• TKR prognosis
• Please HELP(ankle)
• hemiplegia: prognosis

[dibblego]

Here is my story: Ankle Injury - Tony Morris

Comments are appreciated. Please help.

[Julesel]

I am sorry about your luck. I actually had the Brostrom-Gould Procedure done about two weeks ago. Before I had the procedure, I had sharp pains that went up my leg and the pain and the intervals between pain and relief kept getting worse. I had an MRI done in April and it just showed the ruptured ligaments that needed repaired. It did not show what the surgeon found inside my ankle. When the Orthopedic surgeon cut me open, he found that a tendon had broken off a piece of my fibula and it was still attached to the tendon. This piece of bone started to calcify and was creating a pearl inside my joint capsule. This was most likely the cause of my horrible pain and strange swelling. This swelling would come and go and would get worse as the day progressed. Anyway...the point of my story is that MRI's do not always show everything and sometimes the doctor has to cut you open before he can find out what is wrong. Maybe some sort of scope or biopsy would be a good idea in your case. Good luck