Tib/Fib Fractures

I slipped on ice 14 months ago and received an oblique fracture of the junction of mid/distal third of tibia w/a second fracture in the tibia involving posterior malleolus.(approx. 40% obliquely fractured)I also fractured my fibula &tip of malleolus was quite comminuted. ORIF of tibia w/insertion of an IM nail was done within 48 hours. Fibula did not heal so had bone graft and plate put in 5 months after accident. The fractures are now healed but I'm left w/severe pain and 0 dorsiflexion. Radiology reports said I had avascular necrosis of talus (after CT ) Foot/Ankle specialist disagrees.My original Orthopod wants to take hardware out and thinks my pain is RSD.After researching RSD I have a hard time agreeing w/that diagnosis. I am at a loss. Any advice would be so greatly appreciated.

[Dr Vinod]

Hello!

One of the problems commonly associated with certain severe fractures of the talus is that the blood circulation to this bone is damaged, leading to partial death of the bone.
If this does occur it is commonly associated with the development of arthritis of both the ankle and or the subtalar joint, as well as the collapse of the bone.

There are surgical procedures that can be performed if avascular necrosis develops to try to improve the blood circulation to the talus bone as arthritis may set in. Discuss all options with your orthopedician and take a second opinion for a proper diagnosis.

The problem if you have avascular necrosis of the talus is that blood supply does not always return, and there are very few ways to improve the circulation to the talus.

Take care!

[PedroH]

Thank you so much for your response. One thing I failed to say was,my Dr. says I did not have a broken talus.Is it possible that I did have a broken talus that has not been seen? I also have a thickened achilles tendon w/0 dorsiflexion and supposedly that was not injured either. I live in Canada so getting 3rd opinions don't really happen and wait times are lengthy.Should I be asking for an MRI or is that even possible with all the hardware I have? Thanks again for your time-it's giving me hope again.

[PedroH]

Hi!       For the past week or so (especially in the morning)I'll be just walking in the house and all of a sudden as I step down I get a severe pain in my ankle that takes my breath away and makes me sick to my stomach.It almost seems as if my ankle locks for that second. Anyone have any ideas? I'm getting so frustrated!       Thanks for your time!

[PedroH]

My surgeon recently informed me that I did infact have a brake in my ankle joint but it was not displaced therefore he did not believe that that was causing me any pain 15 months after my slip and fall.Now,he believes I may having a bad reaction to the metal hardware?! What are the symptoms of this? I am at whits end with the pain and my leg shrinking to nothing. Please,any advice would be grealtly appreciated!