I am writing about my ankles because they are the cause of my present inactivity – I am sitting in my kitchen with my feet up on a chair, having taken analgesics (both paracetamol and dihydrocodeine). Having had four operations on my right ankle for osteoarthritis, hree in Hull and one here in Sheffield, I had a fall (due t,;

en my left ankle was very twisted to the horizontal pointing to my right foot), which,, with my right foot, I quickly returned to its normal position, but was sent to A&E the next day.

At A&E they did x-rays, and decided there was a fracture, so plastered the ankle and admitted me to the ward There, an orthopaedic registrar pronounced the x-rays to be normal, removed the plaster, and sent me home in a large boot. A week and a half later, reviewed at the fracture clinic wuth new, weight-bearing x-rays, they clearly saw a fracture, technically a “Maisonneuve” fracture, comprising a nondisplced fracture of the fibula and tibio-fibular joint, and the deltoid ligament.

I think the lesson from this mix-up is to pay attention to the “history” (the patient’s story) – I really did see my foot at right angles to normal, and reduced the dislocation there and then. When asked if it was very painful I had replied, “I don’t remember” which may have de-valued the testimony, But I had just fallen down, in a bus shelter, and may not have felt much pain,

Mr Chris Blundell, my orthopaedic surgeon who did the last operation on my right ankle, did the surgery yesterday, screw fixing the tibia-fibular joint and the detiod ligament. He advised me hat I could weight-bear “immediately”. The nerve blocks done by the anaesthetist were active until about 3am this morning, when I was woken with pain, and, despite paracetamol and dihydrocodeine 30mg, walking is pretty painful. I have been referred to the wonderful Sheffiled Enablement Team for chronic neurological conditions, and also to Community Physiotherapy.

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