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    Surgery needed?
    mideasthoosier posted:
    I twisted my ankle 5 weeks ago. I went to the ER, and after they took an x-ray of my ankle, said it wasn't broken, just a bad sprain. They put on an air cast. I returned a week later to the middle east where we live, and had it looked at here (it wasn't getting any better). They did further x-rays and found 2 metatarsal breaks, as well as torn ligaments and tendons. (On the inside of my ankle.) They then proceeded to put on a cast. After 5 weeks, there is still considerable swelling and pain (cannot put any pressure on it), and if it is not elevated, immediately starts to swell, and turn purple/blue. The healthcare system here is not as advanced as it is in the States, and I'm wondering if I should see a specialist back in the US? Should it be surgically repaired? (I would return home to have any surgery...) Please advise. Thanks so much!
    David Berkoff, MD responded:
    Not sure how they diagnosed torn tendons on an Xray but either way with that much disability and swelling you need to have another look. When in a boot then a cast swelling is not uncommon. Once you get it moving it will likely start to turn around much quicker. That is if it is stable enough to handle that. There is also a condition called Reflex Sympathetic Dystrophy or RSD which can cause out of proportion pain and disability from relatively simple injuries like and ankle sprain. I would get an orthopedic or sports doc to take another look at this and help get you back on your feet.

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