Sprained ankle questions

[moosemama]

Hi

I went for a walk early on Saturday morning.
Halfway to the next village my ankle suddenly went out from under me with a loud crack (you could have heard it several feet away). The pain was so bad that I felt like I might throw up (I usually have a high pain threshold). Anyway, I managed to drag myself across the road, clamber onto a wall and call my Mum for help. (Knew dh would still be snoring and he'd have to get 3 dc's out of bed and into the car to come and get me anyway.)

So, I wanted to just go home and ice it, but Mum insisted I went straight to the MIU at the local hospital. Fortunately, at 7.30 am they were really quiet and I was seen pretty quickly.

I was examined by a nurse practitioner. All the sort of ligaments etc she tested were just a bit sore/tender, but when she pressed the bone on the outside of my ankle I nearly hit the roof it was so painful.

Had 3 xrays taken and she showed me them. There is a chip fracture on the side of my foot lower than the ankle, which she felt was probably an old break as it is smooth along the edge, but looks as if it might have been pulled away again by the ligaments. She said she couldn't see any other signs of a break, so to treat it as a sprain, rest for 24 hours, elevate and ice every 2-3 hours, then start trying to walk normally after the 24 hour period, but not too much and no more long walks for a few weeks.

It did swell up quite a lot on Saturday, but only around that outer ankle bone and just behind/underneath it and the swelling has reduced since then.

Now when I walk, it doesn't hurt, but as soon as I sit down again or put my feet up that bony area on the outside of my ankle is really painful. Its like a really sharp shooting pain that doesn't subside and at its worst still makes me feel like throwing up. If I sit still and get comfortable for a while, it still hurts, even if I haven't moved it, but the pain comes in flashes rather than being constant and there is an underlying throb/ache that's behind it.

Everything I've read seems to imply a lot of swelling and/or bruising plus weightbearing pain for a sprain and my pain just doesn't seem to fit with that.

So, does anyone know whether or not there is a chance there was a hairline crack that they missed, or is this sort of pain normal for a sprain?

Also if there is a chance of a crack, is it worth me going back or are they just likely to tell me to rest it anyway?

TIA

Anyone?

Go back, it sounds more like an avulsion fracture then an old chip. An avulsion fracure is where the ligaments are stretched so much that they pull the bit of bone where it's attached away, if it's not delt with then it damages the ligament. I'd go back and get it checked again, just incase.

Thank you bdcfb.

That's what I was thinking, except the bad pain I'm getting isn't where the 'supposedly' old chip was. Based on this diagram, the chip is off either the side of the calcaneus or the cuboid (not 100% which, but down the right hand side somewhere along there) and the pain is essentially at the bottom of the fibula.

Do you know whether with an avulsion fracture is it more likely to hurt whilst weightbearing or when there is no weight on the foot?

It depends on the ligament affected. If it's a main one then it'll be painful when you weightbear,

en.wikipedia.org/wiki/Dorsal_metatarsal_ligaments There's more then a few ligaments. People can get free bits of bone though but if you'd have had a previous fracture you would have known about it. You can also get transferred pain that doesn't necessarily come from where the pain origionates from IYKWIM.

Just found this xray online. The chip is in a similar place to the one in my foot, only mine was bigger and more defined. It was sort of hinged at the rear/ankle end and pulled quite far away from the main bone at the end nearest the toes.

The nurse said it couldn't be a new fracture as it looked too smooth, but I honestly can't ever remember hurting that foot, other than a broken toe from falling off a balance beam waaay back in secondary school (think 24 years ago) and surely they would have picked it up on the xrays then, as I had my whole foot and ankle xrayed from every angle that time.

Actually, just realised - think 29 years ago!

Been with dh 24 years and he can't ever remember me injuring that ankle either.

Does it hurt in the area where the chip is if you press it?

Not really, just a bit tender. Whereas I can't bear to touch where the ankle bone sticks out. In fact, I'm too frightened to even try touching it there again. [big wuss emoticon]

I guess I'm just worried that I'll go back and they'll say she was right, its just a sprain and I am just a royal pita.

a fracture has a jagged edge, an acessory bone has a smooth edge.

I think you do need to go back, it sounds like a fracture to me but without seeing the films it's hard to tell. The fact that the radiographer did three views rather then the standard 2 indicates they queried something.

Thank you for your help. I guess I am going to have to go back.

Is it ok to go straight back to the hospital, or should I go via the GP now its a couple of days since the accident?

It's OK to go back to the hospital, the GP will just send you there anyway so it will save you time.

I hope you get it sorted

Thank you, you're a star.