Hi all,
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I have a 43YO female patient with Type I diabetes that presented with a lateral ankle injury sustained 4/12 ago.
The injury occurred when the patient was o'seas the day before she was due to partake in a week long walk. The area was iced but certainly not rested as she continued with her European holiday for another few weeks.
Upon returning home, she was referred by a physio for ultrasound that showed a Grade 2 tear with avulsion of the talofib lig (which, at this stage was 6/52 following the incident). Physiotherapy continued for 6/52, at the end of which the patient reported no improvement to discomfort so stopped going.
When she saw me for her 6/12 diabetes assessment and general check she reported no cessation in lateral ankle pain and some swelling. The symptoms aren't severe, just annoying. I referred for a second ultrasound which showed similar findings to the previous scan (done 3/12 ago).
My questions are these:
Can we expect any healing at this late stage?
Is the fact that the patient is diabetic having an impact on the healing (current vascular and neurological findings unremarkable) or is this lack of healing common with this type of injury + length of time before treatment sought?
Is surgical intervention recommended or are conservative measures successful?
Prolotherapy/PRP successful?
Any other treatment recommended?
Thanks for your time,
Rachael
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