Another Question For The Doctors

[rcecale]

This is an x-ray of a friend of mine's leg that was taken just a day or two ago. It-s fairly obvious there are two pretty severe breaks...even I can see that. I don't know a lot about the details, I only know he broke it when jumped down from his truck...he's a professional truck driver for a living.

While I was talking with him tonight, he told me that the doctor he saw when this happened didn't/wouldn't put a cast on it. Wouldn't give him a walking boot, or even an Ace Bandage to wrap it with.

As I mentioned above, this x-ray is was taken just a day or two above, the scary part is, this break happened back on December 6, 2011!!!

Does this sound like a normal path of treatment? My buddy is scheduled to see another doctor about it tomorrow, but I was hoping to have some advice for the medical part of the brain trust I could pass on to him before seeing him.



Thanks for any answers or advice you may provide!

Randy

[Joeaksa]

Whatever he is taking for pain, can I have some too? That does not look like fun!

[Tobra]

That looks like double fracture malunion of the fibula. Do you know the history, how he broke it, mechanism of injury. You really need more than one view, but I don't like how this one looks.
.
I see an orthopedic surgery in that man's future, something in a plate, or even a nice ex-fix.

[rcecale]

Tobra, he's a pretty healthy guy. Right around 40 years old. All he told me about the actual incident was that it happened when he jumped down from his tractor-trailer truck. I don't know if he jumped from the cab, the trailer, or even the roof. My impression is that it sounded like a break that would happen to a sky-diver if they landed wrong.

I can get more detail from him tomorrow.

Joe, I'd have to agree with you. This looks extremely painful...especially considering the break is over 2 months old. As I stated, this is a very recent x-ray.

Randy

[Tobra]

It might start hurting less over time, as the bone starts to knit in the wrong position.

[rcecale]

Okay, got a little more accurate picture of what happened. Rather than "jumping" from the truck, it turns out that he was about 10 feet up and slipped and fell. In the fall, his leg got caught in something and held him suspended until the bone snapped.

Again, this happened on December 6th and there has been literally no corrective treatment done by his doctor, from day 1. No cast, not walking boot...nothing. After over two months of being in pain, and then finally seeing these x-rays that were taken Tuesday, seeing both fractures still glaring him in the face, he's made an appointment to see a different doctor on Friday.

Here's another x-ray, taken from a slightly different angle that he texted me this morning. In his text he states, "I just want that bone straightened!" No doubt!



Thanks again for all your inputs!

Randy

[Tim Hancock]

I am not a doctor, but it appears the breaks are knitting together (you can make out a mass of bone growing around each break). The resulting "crooked" bone probably wont cause any issues as the other bone takes the brunt of compressive loads. I would be much more worried if the larger bone was healing up crooked like that.

I broke broken my collarbones on several occasions racing motorcross and they always healed up just fine with obviously no cast although they are VERY crooked.

ONCE AGAIN.... I am no doctor and this is just my opinion which is only worth two cents at the most.

[Rikao4]

if the first Dr. did/not do what is told..
your friend may soon own a trucking Co.


Rika

[jyl]

Was there an ability to pay issue? I wonder if there is some other reason for his doctor's action/inaction.

[vash]

i broke my tib/fib. i remember the doc saying that if only the small bone breaks, they typically just let it ride. i was in a morphine haze tho.

i do remember him saying, "son, if you were a horse, i'd shoot you"

[Noah930]

I'm not an orthopedist, so take that with a big pinch of salt. But fibular fractures are frequently treated non-operatively. The tibia is the weight-bearing bone in the lower leg. So if the fibular fracture doesn't involve the ankle joint, it can be left to heal non-operatively. In fact, the fibula is a common donor site for bone grafting; you can whack out a section of the fibula (i.e. to reconstruct a jawbone) and the patient can still ambulate normally afterwards. I would have imagined some sort of immobilization would have been prescribed, but again, I'm not an orthopedist. You can seen bony callus developing around the two fracture sites (looks like a spot weld of bubble gum around the broken parts). That's a sign of bone healing. Your friend needs a second opinion, for peace of mind if for nothing else.

[Mark Henry]

My nephew got his legs smashed bad in a car accident, his fibula will not heal correctly and the doc's say there's not enough bone to screw a plate to in that area.
He's a trucker too, he tried to go back to work but his fibula has broken a few times just getting out of the truck.
Basic he's f'ed, hobbled for life.

[vash]

Originally Posted by Noah930

I'm not an orthopedist, so take that with a big pinch of salt. But fibular fractures are frequently treated non-operatively. The tibia is the weight-bearing bone in the lower leg. So if the fibular fracture doesn't involve the ankle joint, it can be left to heal non-operatively. In fact, the fibula is a common donor site for bone grafting; you can whack out a section of the fibula (i.e. to reconstruct a jawbone) and the patient can still ambulate normally afterwards. I would have imagined some sort of immobilization would have been prescribed, but again, I'm not an orthopedist. You can seen bony callus developing around the two fracture sites (looks like a spot weld of bubble gum around the broken parts). That's a sign of bone healing. Your friend needs a second opinion, for peace of mind if for nothing else.

actually thinking about it more..

my doc went in and rodded my tibia and left my fibula to heal on it's own. i'm fine now. i wont win any foot races or walk with a cool strut..but i'm fine.

[Tobra]

This one looks like the ankle mortise is compromised. There is a tough piece of tissue between the two bones in your lower leg. If it is intact, it holds them together and keeps the fibula fairly straight. Looks to be a lot of angulation there. John Stockton played in the Olympics with that bone broken, but I would not recommend walking on it

[rcecale]

Well, it turns out the "load bearing" point is the key here.

A little more information (sorry it's so sporadic, my buddy is in Michigan so I'm only getting the data in bits and pieces...via text messaging)

He went to the Emergency Room on Dec 6, when it happened. ER doctor splinted it, gave some pain meds and then referred him to an Orthopedic Specialist.

Ortho doc looked at ER x-rays, took some of his own and said that, because it's not a load-bearing bone, they wouldn't be able to do much about it. Ortho doc did express some concern about the calcium deposits around the fractures...something didn't seem right about them. Also told him that bone was healing slower than normal because my buddy is a smoker.

Randy