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Foot and Ankle Injuries Week 9

This weeks sporting injury consisted of several interesting and possible devastating career changing injuries. 


SprainFoot Fracture 5th Metatarsal Fracture Grade 2 Ankle SprainOn Friday night Tony Parker and the Spurs faced the Kings, in the 3rd quarter going up for a lay up rotated is ankle causing what I appeared to be a Grade 2 sprain. MRI yesterday should just that, 4 weeks off due to the Grade 2 ankle sprain. The major difference with Grade 1-Grade 3 is the amount of ligament damage occurs. There is 3 ligaments that supports the outside or lateral foot, in Parker's case 2 out of the 3 have been injured. Most of the time the ligaments with conservative measures however, there will always be an increase flexibility of the ankle and more prone to future injury. Treating many athletes I and the literature has shown potential injury to the cartilage which can be diagnosed with an MRI. If during the off season a noted increase ligament laxity and ankle pain an option is surgery which includes a lateral ankle reconstruction and ankle scope. This procedure has good success rates.

Ryan Kesler of the Vancouver Canucks was diagnosed with a "foot fracture' on Thursday. It appears the fracture was due to a block shot and not diagnosed until a CT scan was ordered. Here is a good example of the Canadian and US healthcare system. In the US a CT/MRI scan would have been ordered to rule out a fracture after a negative x-ray. On the Right is an example ( not the actual x-ray ) of a stable foot fracture. In our clinic if we are suspicious of a foot fracture after an x-ray is ordered we will assess the area with diagnostic ultrasound to assess any small subtlety. Treatment is mostly conservative with assessed weight bearing and use of a bone stimulator with will increase healing time.

Rasheed Wallace on Thursday had surgery to repair a stress fracture that transition to a full non healing fracture. The reports have stated a "Jones" fracture but I find that hard to believe as a Jones fracture is extremely painful with regular walking let alone a dunk. These fractures are very difficult to heal without surgery and I always recommend patient in high level competition to have the surgery as long term have better outcomes. These fracture that are not cared for properly will take up to 8 weeks just to see 50% change in healing on x-ray. Surgery consists of re-approximated the two pieces and placing hardware to stability the fracture. Sometimes I use of platelets or growth factors are place near the surgery slight to increase healing. My patients are then also given a bone stimulator to further enhance the healing potential. 

I hope the best for these three athletes as these injuries can effect their professional careers if not treated correctly. 

Dr. Darryl Martins, DPM, FACFAS

100 S. Cooper St.



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