Right lower leg and ankle
Comparison is made with the previous examination several weeks earlier. Tibial intramedullary nail in unchanged position. There is delayed union of the oblique fracture through the distal tibial diaphysis. Screw and plate fixation of distal fibular fracture unchanged. There is non-union of the proximal right fibular spiral fracture. The ankle joint alignment is normal. No new fracture identified.
Right foot
There is severe patchy osteopenia predominantly in periarticular distribution. No new fracture identified. The overall appearances are most in keeping with reflex sympathetic dystrophy (Sudeck atrophy).