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Old 09-07-2011, 10:57 AM
 
3 posts, read 14,189 times
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I was reading a thread on tibula/fibula fractures and I just wonder whether anybody had a case of fractured tibia and fibula where with the surgery tibia was fixed, while fibula was left to heal naturally. My daughter 39 years old is now after a year and half after the injury and surgery and fibula is still not healed and causing the pain. Can anybody help with some advice or reccommend the specialist to go to? Thank you in advance.
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Old 09-07-2011, 12:32 PM
 
Location: Mostly in my head
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WHere is she located? or how far can she afford to travel?
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Old 09-07-2011, 03:49 PM
 
Location: Georgia, USA
25,154 posts, read 30,047,716 times
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Quote:
Originally Posted by maidi View Post
I was reading a thread on tibula/fibula fractures and I just wonder whether anybody had a case of fractured tibia and fibula where with the surgery tibia was fixed, while fibula was left to heal naturally. My daughter 39 years old is now after a year and half after the injury and surgery and fibula is still not healed and causing the pain. Can anybody help with some advice or reccommend the specialist to go to? Thank you in advance.
It looks as if surgery is the best option:

Fibular nonunion after closed rotational ankl... [Foot Ankle Int. 2004] - PubMed - NCBI

"CONCLUSIONS: Distal fibula nonunion appears to be a relatively common cause of persistent lateral ankle symptoms in patients who do not enjoy a satisfactory recovery after appropriate conservative treatment. The authors believe that the persistent lateral pain in such patients results from micromotion strain at the incomplete fracture union site. Surgical stabilization of fibular nonunion seems to be a reliable means of resolving these symptoms when conservative measures fail."
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Old 09-07-2011, 09:29 PM
 
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Quote:
Originally Posted by suzy_q2010 View Post
It looks as if surgery is the best option:

Fibular nonunion after closed rotational ankl... [Foot Ankle Int. 2004] - PubMed - NCBI

"CONCLUSIONS: Distal fibula nonunion appears to be a relatively common cause of persistent lateral ankle symptoms in patients who do not enjoy a satisfactory recovery after appropriate conservative treatment. The authors believe that the persistent lateral pain in such patients results from micromotion strain at the incomplete fracture union site. Surgical stabilization of fibular nonunion seems to be a reliable means of resolving these symptoms when conservative measures fail."
This article does not really apply to the OP's question....
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Old 09-07-2011, 09:34 PM
 
5,300 posts, read 11,487,118 times
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Quote:
Originally Posted by maidi View Post
I was reading a thread on tibula/fibula fractures and I just wonder whether anybody had a case of fractured tibia and fibula where with the surgery tibia was fixed, while fibula was left to heal naturally. My daughter 39 years old is now after a year and half after the injury and surgery and fibula is still not healed and causing the pain. Can anybody help with some advice or reccommend the specialist to go to? Thank you in advance.
It is not at all uncommon to fix only the tibia with a combined tib fib fracture. However, if the fibula has gone on to a nonunion and is causing pain then it is certainly reasonable to consider fixation of the fibula.

Your daughter should see an Orthopaedic Trauma specialist to discuss options.
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Old 09-07-2011, 10:33 PM
 
Location: Georgia, USA
25,154 posts, read 30,047,716 times
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Originally Posted by bluedevilz View Post
This article does not really apply to the OP's question....

I realize the injuries were different, but it seemed the conclusion was that if nonunion of the fibula occurred surgery was indicated.

Didn't you and I say the same thing?
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Old 09-08-2011, 01:07 AM
 
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Thanks all for the feedback. The question remains about Orthopaedic Trauma specialist for this type of problems. We would come from Europe, so the US location is not an issue.
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Old 09-08-2011, 05:28 AM
 
5,300 posts, read 11,487,118 times
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Quote:
Originally Posted by suzy_q2010 View Post
I realize the injuries were different, but it seemed the conclusion was that if nonunion of the fibula occurred surgery was indicated.

Didn't you and I say the same thing?
I did say that ORIF would be indicated but the article you cited has nothing to do with the practice of leaving the fibula untouched in the first place in the setting of tibia and fibula fracture. The article you posted deals with an isolated nonoperative fibula fracture that goes on to nonunion.

Nonunion of any long bone fracture typically leads to surgery but the OP asked about a different scenario than the one you presented, a scenario that is actually quite common.
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Old 09-08-2011, 05:36 AM
 
5,300 posts, read 11,487,118 times
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Quote:
Originally Posted by maidi View Post
Thanks all for the feedback. The question remains about Orthopaedic Trauma specialist for this type of problems. We would come from Europe, so the US location is not an issue.
Where are you coming from and where are you willing to travel to? You don't necessarily need to travel to the US for this type of surgery.

Davos Switzerland is actually the mecca for skeletal fixation...

AO Foundation

There are also excellent centers in Germany.....

If you want to come to the US there are certainly any number of surgeons that do this type of surgery on a routine basis....

There are some standout Orthopaedic Centers in the US including the Hospital for Special Surgery in New York, New England Baptist Hospital in Boston, Duke Medical Center in North Carolina....
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