Sports Medicine/ankle

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Question. My 14 y/o suffered an ankle injury during his soccer game. There was immediate swelling and he was unable to bear weight. He took him to be seen within 30 minutes. The x-ray come back as “soft tissue swelling” but no fractures seen. We elevated, iced, rested, ect. Four days later I took him to see an orthopedist. She did an exam and she thought the ankle was broke or fractured, as well. She did an x-ray, spent a significant amount of time reviewing it on the spot and could not find and breaks or fractures. She sent us home in an air boot and stated he could walk in this boot if tolerable. He has little to no pain, except upon palpitation of the ankle. The ankle does remain a bit swollen but virtually no bruising ( unlike mine in the past).  We are to return in 14 days for a follow up and additional x-ray. The ortho stated she wasn’t going to do a MRI because, she would treat a severe sprain and hairline fractures the same anyway. My question is this. After two X-rays, one read by an orthopedist, wouldn’t a fracture be visible? Sorry to be long winded.

Answer
Hi Slayde- if fracture was aggressive,  then yes, we would expect to confirm & see it on the X-rays. If however, especially in a growing 14 yr. old, the hairline break is around a growth center, or very minimal, often it will not be seen initially. This is probably the case with your son. Also, a stress fracture might not show up for few wks . Sounds like the Orthopaedic specialist has treated him properly by putting him in air cast & planning on seeing him in couple wks. For follow up X-ray to make sure of diagnosis. Also sounds like he's making great progress- just make sure he is wearing brace & "not cheating". I also agree that MRI not needed unless problem persists or doesn't improve. Make sure that your son is followed up with proper rehab- best with physical therapy for safe return to soccer when he is ready. Hope this helps- good luck.. Dr. Bob Weil

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Dr. Bob Weil

Expertise

Diagnosis & treatment & PREVENTION of foot & foot related lower extremity sports related problems. Indications & uses of prescription in shoe orthotics. Foot, ankle functional exercises for injury prevention & enhanced performance. Specific specialty in orthotic use in figure skating & hockey. Access to all topics re sports medicine at sportsdoctorradio.com- radio shows & articles re "the physical & mental challenges of the high performance youth athlete.

Experience


Publications
Podiatry Management Magazine, 9/10/10, "Hitting the Airwaves- this podiatrist uses his own radio show to promote Podiatry Podiatry Management Mag-6/-7/2010, "Figure Skating, Olympic Gold, & Podiatry Lower Extremity Review,7/2012, Pediatric Obesity weighs on Bones & Joints Numerous articles,"the sports doctor"- listed sportsdoctorradio.com- news articles 3 years of weekly radio shows, "the sports doctor", listed sportsdoctorradio.com-radio shows

Education/Credentials
BA degree science Univ. Louisville, Doctor Podiatric Medicine, Scholls College Podiatric Medicine, Chicago, Ill.

Past/Present Clients
Treated many athletes in all sports, tennis- John McEnroe, Tracy Austin, numerous members of 85 Super Bowl Bears Evan Lysacek, 2010 men's Olympic Gold Medal figure skating champion.

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