Ankle Avulsion Injury

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I rolled on my right ankle in September. It was treated as a bad sprain.  X-rays showed an avulsion fracture at the ankle end of the fibula. The bone fragment which was pulled away by the tendon was supposed to fuse back and heal. I wore strapping and a moon boot ( and a splint for driving) for 4 weeks then a soft splint and began strengthening exercises. It swelled whenever unsupported and became more painful. X-rays showed it hadn’t unionised or healed. The ligaments and tendon were still showing damage too through scans. So I went back into the moon boot ( soft splint when driving) and am awaiting for a orthopaedic surgeon appointment to discuss options but probably surgery if some type. It has however become more sore with sharp pains far more often. I have a new job to start at the end of January. My plan was (unless the surgeon said I would be causing more damaging waiting), to strap and splint up my ankle and begin the job for a month before taking time off for the surgery. I’m a teacher of special needs students so have to be actively on my feet all day. Any experiences similar or knowledgeable advice ? Thanks. 

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6 Replies

  • Posted

    Good day Carol.

    June of 2016 I was playing softball and heard my ankle go pop, I had 2 doctors tell me it was a minor sprain and eventually was told that I had an avulsion fracture .

    March of 2017 i had surgery on my medial malleolus for a non union.

    Every injury is different , And I hope that your healing process gets better and that the surgeon has some good need for you!

    • Posted

      Thank you ! I had no idea it was going to be so involved complicated and painful! If you waited that long for yours to be properly diagnosed and operated on I’m guessing no more damage was done by the waiting process. 

      How long after surgery could you walk ?

    • Posted

      I used a walking boot and crutches for the first 2 months and then was told that was no good for my foot, so i walked on my foot from September to March.

      When I was released from surgery I was released as partial weight bearing, and walked on my foot with crutches the day after surgery.

      Hopefully I csnbhekp you in some way lol!

  • Posted

    Dear Carol,

    You had a most unfortunate experience with your ankle injury.

    I would get a second opinion if your orthopedist wants you to undergo surgery. Avulsion fractures with a loose bone fragment do not always need to be addressed by surgery. Please do your due diligence research online so you don't face persuasive prospective surgery recommendations unarmed with information.

    My guess is that your torn tendon is the crux of most of your woes. I would get an update of its healing progress (or non-progress) via diagnostic scans, and work with a foot and ankle specialist (not a surgeon) who is familiar with soft tissue injuries involving ligaments, tendons, etc.

    There is some good advice on this forum about recovering from ankle sprains and injuries. Please avail yourself of this good information. It's free.

    Since your occupation requires you to be on your feet all day that will be an added challenge to recovery. If you can get reassigned temporarily to a sedentary position in your school district (until your recovery takes hold) I think you will do much better in terms of long-term success.

    Your future ease and comfort in mobility hinges on making good decisions on ankle treatment and recovery now.

    Best wishes.


    • Posted

      Thank you for your reply. Appreciate all information and yes I will endeavour to get another opinion. I’m in Australia though and all Orthopaedic specialists seem to be surgeons. Podiatristsvtreat tgese injuries rock and there are Podiatry Surgeons but I’m finding it hard to find a dr who doesn’t operate in this field. I originally went to and was treated by a physio. He thought it would heal and did a good job but should have sent me for more X-rays and scans earlier. 
  • Posted

    I experienced exactly the same type of fracture (Weber A - stable) this past September. The fracture was diagnosed the day after it happened (I was able to walk on it and also thought it to be only a bad sprain), and I was treated very conservatively. I was put in a slab cast at first and after a week I was placed in a moon boot. I was NWB for 4 weeks, do ROM exercises only. I transitioning to full weight bearing in the boot from 4 to 4.5 weeks. I was freed from the boot at 6 weeks (I started PT at 6 weeks also) and driving at 7 weeks (my broken ankle was my gas/brake foot). 

    I have a desk job, so I was lucky to be able to work from home which permitted me to be non-weight bearing and resting as ordered by my doctor.

    I have had an excellent recovery. I'd put myself as about 95% back to normal now (I walk without a limp and am able to hike again (14 kms is my maximum distance so far). I have some stiffness and very minimal swelling.

    It sounds to me like your original PT had you doing way too much too soon. The chance of a non-union was the reason given by my ortho doc for the conservative NWB period imposed on me (it was originally going to be 6 weeks, but it was reduced to 4 weeks as I was showing such good progress with my ROM exercises and minimal pain levels). I'm not sure what the best approach is given the fact that you now have a non-union situation on your hands.... getting that resolved needs to be the priority. I second Kevin's suggestion that you should try for a sedentary assignment and get yourself a second medical opinion. 

    Best of luck and good healing vibes coming your way! smile


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