Patient with multiple sclerosis diagnosis after fibula fracture: Holistic view of a rehabilitation patient

Abstract

Multiple sclerosis (MS) is a disease with chronic progressive neurological symptoms. Multiple sclerosis patients are frequently observed to have balance problems and falls, and these may occur as initial symptoms. Distal fibula fractures comprise a significant proportion of ankle fractures occurring commonly after trauma or falls. This report presents the case of a 49-year old female patient developing right distal fibula fracture after a fall 4 years previously, who attended the rehabilitation clinic many times due to inability to walk in spite of full union of the bone. Detailed anamnesis included frequent falls and loss of balance before the fracture. The patient had upper motor neuron findings identified, and in light of the clinical findings along with cranial MR images, the patient was diagnosed with primary progressive multiple sclerosis. Attending rehabilitation after fractures at young-middle age, patients should be questioned carefully about the loss of balance and history of falling, and detailed neurological examination should definitely be performed in addition to an orthopedic examination.