This is a tibia and fibula fracture in a 49 year old male who slipped and fell on his kitchen floor.
The fracture was not a high energy injury, which is good. The patient was however diabetic, which is bad. Hemoglobin A1c was running just above 8. No history of foot ulcers, but could not feel 5.07 monofilament.
Intramedullary nailing, and fixation of the fibula was performed for the most secure construct. Diabetes was managed aggressively and glucose was kept under tight control. And the patient did very well.
Here are the xrays in the first follow up in our clinic.
And here are the xrays 4 months after the injury: at this point the patient had been allowed to bear weight, and had been walking pain free for one month.
He healed without problems, and he started losing weight and normalizing his health after all the discussions that we had in the hospital. He understood the high stakes, and this injury changed his life for better.