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From: john@ur-tut.UUCP (John Gurian)
Newsgroups: net.med
Subject: Re: Injured feet & varying medical advice
Message-ID: <4@ur-tut.UUCP>
Date: Sun, 2-Mar-86 13:50:41 EST
Article-I.D.: ur-tut.4
Posted: Sun Mar  2 13:50:41 1986
Date-Received: Tue, 4-Mar-86 04:09:33 EST
References: <283@twitch.UUCP>
Distribution: net
Organization: University of Rochester School of Medicine
Lines: 31

> About 5 weeks ago, I fell and injured both feet.  They
> ended up underneath me.  I went to a hospital and they
> Xrayed one foot and decided that I had over-extended a
> muscle on the top of the foot, pulling away a small chip
> of bone (<1/4 inch).  The emergency room physician was
> not an orthopedic expert, but told me of the chip and
> suggested that I see an orthopedic surgeon.
> 

Sounds like you sustained an "avulsion fracture" where the bone is pulled
off (avulsed) by the connecting tendon.  Usually, it's not that big a deal;
the bone chip avulsed is usually just reabsorbed and the tendon will heal
on its own.  It will probably take a few weeks, depending on how much of
the tendon was left attached to the bone - usually only a small portion
is avulsed.  You should probably take the advice of the second orthopod,
as his management seems more prudent - remember, primum non nocere, and
as the book "House of God" pointed out, "Do as much nothing as possible"
is usually the safest treatment for most medical conditions.  Usually,
pain is a pretty good indicator of how much you can walk on it.
	If you look at the X-ray yourself, you can probably see a small
white "density", as it's called, sitting in the dark joint space between
the two bones.  I'd still be demanding answers from the orthopod that's
following you on the indications for the two differing management plans.

Remember the old adage: "To be an orthopedic surgeon, you have to be as
strong as an ox, and at least as smart as one".

-- 

-- John Gurian
-- !rochester!ur-tut!john