Ankle Injury

by John
(Ontario, Canada)

Hi,

I have sprained my ankle twice playing tennis and fractured the Talas once from a sky diving accident. My latest MRI report says the following:

The anterior talofibular ligament has thickened, in keeping with prior low grade sprain.

Both the deep and superficial fibers of the deltoid ligament are markedly thickened.

There is severe chondrosis of the lateral margin of the talar dome, associated with subchondral marrow edema and a geographic sclerosis measuring 1.3cm x 0.6 cm. No evidence of osteochondral defect.

My CT scan reported the following:

Osteochondral lesion of the lateral talar dome with osseus bridging consisten with stability. Lesion is 1mm proud to the articular surface.

I'm given the option to just do physio and hope my mobility returns to nomral or undergo arthroscopic surgery to remove the lesion which is causing pain and clean up all scar tissues from prior injuries.

I'm leaning towards doing surgery for long-term benefits as I'm 40 and would be able to recover relatively soon.

Any comments or suggestions would be most appreciated.





It's a tough decision, John. Personally, I'd go for six weeks of conservative mobilisation of the fixated and degenerative joints first. Nothing lost waiting six weeks. Daily alphabet exercises of the ankle, ice...

If there's no sign of improvement, then by all means the surgery.

It's just that the risks of surgery are much greater, not least the anaesthetic. Good surgery can be great, but bad surgery...

With conservative treatment there is very little risk of worsening the condition, and a delay of six weeks of no account.

Perhaps look for a Fics trained chiropractor who specialises in feet and ankles.

Let us know in a couple months how you get on.

Dr B



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