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Fractured Ankle 70+ year old
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Poster:
A snowHead
Poster:
A snowHead
Not me, Dad on holiday in Madeira (well technically they have sleds or something there so vaguely snowsports related
). Local Orthopod clinic wanted to operate tonight for pinning then intensive physio but poor English & overall insurance company communication issues meant they opted for cast which was other option given. Any downsides to this approach? They have top orthopedic centre of excellence near home so I'm hoping GP can refer to Fracture Clinic there on return and if surgery is necessary I'd be happier it be done there than unknown surgeon on an Atlantic island.
Main concern to me is that he gets best opportunity for full recovery as reduced longer term mobility could be start of a slippery health slope
Any medics willing to stick their neck out and provide advice on an informal basis (PM more than welcome)? They are already going back to doc for Heparin tomorrow. Anything appreciated. Trying to get hold of scans of Xrays so can kick start the process with his GP etc.
Thanks
Obviously
A snowHead
isn't a real person
Obviously
A snowHead
isn't a real person
fatbob
,
The answer lies in the soft tissue injury.
A minor relatively undisplaced fracture of a single bone( usually the outside bone called the fibula ) can wait.
A more serious fracture involving both sides with displacement and/ or instability will have much more soft tissue damage, this will manifest itself as swelling and bruising. It is of course difficult to assess with the cast on. Soft tissue swelling is less well tolerated by the elderly especially if they have diabetes or poor circulation. So the decision to wait is not straightforward.
However as long as there is no puncture in the skin, the ankle is reduced ( positioned back where it should be) then he could elevate for a few days to help the swelling come down then fly back. I would feel more confident about the surgery being carried out back home by a competent surgeon than having it carried out in another country. It is quite important that you are able to communicate with your surgeon! I've seen more problems from surgery being carried out overseas than from waiting but there are some circumstances where there is little option. Sorry I can't be more specific.
Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
Jonathan Bell
, Thanks for the pro view. Today from further consultation with the local GP who is UK trained sounds like it's lateral malleolus fracture without much displacement and the desire to plate was to allow earlier mobility for an elderly patient. They are pushing for repat now so fingers crossed.
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Poster: A snowHead
). Local Orthopod clinic wanted to operate tonight for pinning then intensive physio but poor English & overall insurance company communication issues meant they opted for cast which was other option given. Any downsides to this approach? They have top orthopedic centre of excellence near home so I'm hoping GP can refer to Fracture Clinic there on return and if surgery is necessary I'd be happier it be done there than unknown surgeon on an Atlantic island.
