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Second opinion, they told him everything looked fine!

Good Afternoon,

My boyfriend was retired from the U.S Marines because he fractured his ankle severely. He rested it out and the bone healed. For a while now he has been living with pain on his ankle when he performs certain activities such as running or playing basketball. Today, he went to the doctors again so they could read him the results of the MRI and they told him everything looked fine!!! We don't get it. How come he is having such bad ankle pains and is there anything to do to correct it?
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replied August 4th, 2012
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Unfortunately, the stresses of the military (and Marines especially) are much above that of what the civilian population requires.

Any time one has an intraarticular fracture (the fracture goes into a joint surface), the chances of traumatic arthritis occurring goes way up. Joints just do not like to be injured. And, the arthritic changes may not show up on any studies for a long time, but the symptoms may occur quite quickly.

Yes, the bones can be put back together (in some cases in anatomic alignment), and the patient will still continue to have pain within the joint. You have to remember, that not just the bone is injured. All of the soft tissues around the bone are also damaged. The periosteum on the bone is ripped apart, the muscles are torn off their attachments, the fascia around the tendon and muscles is torn, the tendons, ligaments, nerves, blood vessels are all stretched and twisted in the injury. In intraarticular fractures the joint surface is disrupted, the articular cartilage is damaged. This all has to heal, and it heals with scar tissue. Unfortunately, it is still not know what generates the pain in all cases.

You do not say how long ago the injury occurred. In some cases, it can take a year to 18 months for a patient to fully recover from a significant ankle fracture. (Which is why, in the military boarding system, there is TDRL status, because it is known that some injuries take years to get over.) But, if it has been that long, then what you have is probably what you have, there is not going to be a significant amount of improvement after that (if therapy has been completed).

However, if your boyfriend is able to run and play basketball, that would be considered a very high level of activity after a significant intraarticular fracture of the ankle.

Again, unfortunately, there are many enigmas in life, not everything can be explained (or fixed). However, he can take the MRI and see another surgeon for a second opinion. But, high level athletic competition just may not be in his future.

Hope your friend finds a solution to his problem. Good luck.
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