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Fractured Talus refuses to heal...why? And is there anything to do at t...
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Fractured Talus refuses to heal...why? And is there anything to do at this point?

Last year (April Fool's Day 2011 to be exact) I fell off the back bumper of my car (approx. 2ft. off the ground). It was a fluke accident and I was just messing around. I immediately when to the emergency room with my pain on a scale of 1-10 probably being a 7-8. In triage the nurse was very rough with it and moved it all over the place (hurting me so bad that it threw me into my typical pain resonse...a horrible full blown migraine...which led to puking.). She said that is was definitely NOT broke...she knows when an ankle is broke and there is no way mine is. They agree to do x-rays anyways. The x-rays came back and the DR. said that she didn't see any actual breaks. She said that there WAS a shadow,but they really didn't want to do an MRI (because of radiation?!).
                   The emergency room was quite busy and I think they really wanted me out of there. So after sitting in the emergency room for several hours they finally sent us on our way with small fabric brace for my SPRAIN and instructions to try to walk on it as soon as I could. And to follow up with my primary.
The next couple of weeks it hurts like he**. I am not a wimp. It hurt bad. My entire right leg was a purplish/black from the bottom to the top. I went to my regular dr. (that is actually a dr.'s assistant if I remember correctly). She said that the very bad discoloration was likely that bad from a torn ligament...not a sprain. She said that she wanted me to start physical therapy for it,but decided to order an MRI just in and to see if the main ligament there was torn (can't remember the name of that big ligament).
So...back to the hospital (this was probably around the 15th of April. Finally on the 20th of April (yes...19 days after the accident) I get the MRI results back which finds that my main ligament is completely torn in half as well as many of the smaller ligaments, my TALUS bone is completely broke in half through and through (though only slightly displaced) and two chunks of my leg bone were ripped off with the ligaments. Awesome.
So almost three weeks of trying to WALK on my "SPRAINED" ankle and just about killing myself to find this out really put on damper on the whole already painful situation.

They opted at this point to not bother with surgery because of the time lapse and to just try casting it. They said if they HAD caught it right away they would have absolutely put at least two screws in it. It is a bone that easily dies though and they didn't want to mess with it?

Fast forward...I progress from 3 different casts over about 8-10 weeks and then get placed in a walking boot (at which point I actually end up starting physical therapy) and then an airboot for about a month (also during physical therapy). During this time I was seeing (I say this very loosely because I never actually SAW the DR. I was supposed to see...only his assistant...and only once) an Orthopedic surgeon. His nurse's assistant INSISTED on taking new X-RAYS...even though we explained that the ones from the hospital did NOT show the break and we provided her with copies of all of them. But anyways...she got them back and surprise surprise...they didn't show the break. So she ordered a CT scan and when the results got back she barely glanced at them. She then proceeded to explain to us that I had a VERY SMALL crack on the back part of my talus and that it was really no big deal and to just start walking once I was done with the casts/physical therapy. This was not true which I found out when I finally switched to a better Ortho specialist. They found that my talus was completely broke in half horizontally.

So once the casts were off I started the physical therapy. I have to say...I had an EXCELLENT PT that really watched my back and tried to help me out. The only person through this entire ordeal that I can actually say that about. The DR's were all about covering each other's backs and downplaying the events. PT went well and I progressed at a good/normal pace all the while the pain never leaving.
There were several MRI's and CT scans that were ordered during this time and all of them came back with the conclusion that the talus bone was NOT healing although there were still no signs of necrosis. It was still only slightly displaced.

At the end of PT...my ankle was still not at all healed,but I COULD walk on it. It was still painful,but my flexibility was great. I was then told to go to a specialist to have foot pads put in my shoes to possibly relieve pain. Custom orthotics really. While checking over my feet he said that I have very abnormally loose ligaments in my feet/ankles making them very flexible. Which is probably why it seemed like I did so well in PT. He said that could have played a large part in my talus broke so easily from such a little fall.
                    So at that point I am maybe...7-8 months into the break. I can walk. It hurts all the time...and still wakes me up several times a night. I am no-meds unless I'm dying person so I just get over the pain. I am also realeased back to work although I was told that I need to/should change professions (I am an elderly caregiver) to stay off my ankle and to not deal with any heavy lifting. I was told to NEVER jump,run,skip,hop,etc.etc.etc. Basically I could walk,but my ankle was not healed and could be displaced or broken again (even though it's already broke in half?).
Winter was absolutely miserable...it was stiff,would NOT warm up,and hurt very,very badly. I tried heating pads,hand warmers in my socks,several layers of socks,rubbing it...nothing worked. It felt like ice all the time. It was also often a grey/white/purplish color...especially at night.
             So NOW (8/12)...I am a few months over a year in. It is still broke in half....it still hurts almost all the time. It clicks with almost every step. I recently went to a neuro to see if the nerves were still working because it is staying several degrees cooler than my other foot and staying a whitish color. He said my nerves WERE still working and that there was really nothing he could do. He decided to try me on a calcium blocker (which my double help my supraventrichular tachycharrdia anyway) which would hopefully open up my veins and allow more blood flow. I tried them for about a week and was getting really,really lightheaded and very tired. I already have very low blood pressure and these pills were not helping at all. So I haven't been taking them. My ankle is cold all the time..hurting all the time. I guess my main questions....Is there ANY chance if it hasn't healed yet that it could heal in the future? Is it absolutely too late for surgery? Would surgery even help at this point? I was told I could never run,etc. again...is this pretty accurate? Sorry for the rambling...and thanks in advance!
            
4 Comments Post a Comment
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Avatar_m_tn
oops...sorry...I meant to write it was broke VERTICALLY all the way though...I don't know if this makes any difference. I'm going to try to add a link for the most recent MRI pictures...
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Avatar_m_tn
all right..here are some photos of my last MRI.

http://s1167.photobucket.com/albums/q632/TalusTroubles/

Anyone??? :)
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Avatar_m_tn
HELLO, I KNOW WHAT YOU MEAN, DR. ARE SO BUSY AND THINK THEY KNOW WHAT IS WRONG OR NOT WRONG WITH US BY JUST LOOKING AT US, MAKES U THINK THEY ARE MIND READERS? WELL, TO GET TO THE POINT, I FELL IN MY PLACE AND WENT TO MY REG, DR. AND THEY TOOK AN X-RAY AND SAID I HAD A FRACTURE AND THEY PUT A BOOT ON MY FOOT AND SAID STAY OFF IT AS MUCH AS U CAN? WELL TWO WEEKS I WENT BACK TO MY REG, DR. AND HE SAID I HAVE TWO FRACTURES IN THE TALUS AND HAVE CARTRIDGE   SOMETHING. THEY TOLD ME TO MAKE AN APPOINTMENT WITH A FOOT DR. OK, THAT IS WELL AND GOOD BUT NOW MY APPOINTMENT IS IN OCT, WHAT AM I SUPPOSE TO DO NOW? MY FOOT HURTS AT TIMES AND NOW IT HAS 3 DARK SPOTS UP THE FRONT OF TH FOOT? I WANT TO KNOW IF I SHOULD OF HAD A CAST IN THE BEGINNING? THIS QUESTION IS VERY IN PORTENT TO ME, CAN U ANSWER THIS PLEASE? MARTHA
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Avatar_m_tn
HELLO, I KNOW WHAT YOU MEAN, DR. ARE SO BUSY AND THINK THEY KNOW WHAT IS WRONG OR NOT WRONG WITH US BY JUST LOOKING AT US, MAKES U THINK THEY ARE MIND READERS? WELL, TO GET TO THE POINT, I FELL IN MY PLACE AND WENT TO MY REG, DR. AND THEY TOOK AN X-RAY AND SAID I HAD A FRACTURE AND THEY PUT A BOOT ON MY FOOT AND SAID STAY OFF IT AS MUCH AS U CAN? WELL TWO WEEKS I WENT BACK TO MY REG, DR. AND HE SAID I HAVE TWO FRACTURES IN THE TALUS AND HAVE CARTRIDGE   SOMETHING. THEY TOLD ME TO MAKE AN APPOINTMENT WITH A FOOT DR. OK, THAT IS WELL AND GOOD BUT NOW MY APPOINTMENT IS IN OCT, WHAT AM I SUPPOSE TO DO NOW? MY FOOT HURTS AT TIMES AND NOW IT HAS 3 DARK SPOTS UP THE FRONT OF TH FOOT? I WANT TO KNOW IF I SHOULD OF HAD A CAST IN THE BEGINNING? THIS QUESTION IS VERY IN PORTENT TO ME, CAN U ANSWER THIS PLEASE? MARTHA
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