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Broken Ankle
December 2001

Q. I am a 33-year-old male. Over 4 years ago, I suffered a spiral fracture to my tibia, broke my fibula and snapped my talus across the neck. The talus was screwed together and the tibia was originally plated and then fixed with an external fixator. All repair has now finished but I have been diagnosed as having a cross union and pseudoarthrosis at the site of the previous osteotomy and an increase uptake in the antero-lateral aspect of the ankle. Can you please put that diagnosis into layman terms and offer some advise on possibly ways forward. I have no dorsiflextion and suffer extreme pain in the ankle and shin.

A. You suffered a severe injury causing a break of all 3 bones that make up the ankle joint. This requires treatment by an orthopedic surgeon and even in the best of circumstance a little luck would be helpful in the healing process. More treatment is needed from your description, as you are having continuing problems 4 years after the accident. "Cross union" and "pseudoarthrosis" refer to the bones fusing together in an abnormal way; that is probably why you have lost most of the motion in the ankle joint. "Increased uptake" sounds like a scan was done showing metabolic activity in the site of injury as if the bone is still trying to heal. At this point you would probably benefit from seeing an orthopedic surgeon who specializes in treatment of the foot and ankle. Contacting your local hospital or a medical school should lead to some doctors in your area. Good luck!

http://www.aaos.org/

http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=169&topcategory=Foot

http://www.aofas.org/

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