talus fracture

[cinw1973]

Hi,

I would like some guidance with where I should go next with this.  8 weeks ago I fell and injured my right ankle.  I had xrays of my foot and ankle that night.  Nothing on the xrays.  I was told I sprained it.  8 days later due to continuing pain I had my ankle rexrayed.  Again negative.  I was non weight bearing for 4 days but since then I've been walking on it.  I have since had a MRI done at 6 weeks post injury and at 7 weeks post fall I found out that I have a nondisplaced fracture of the talus.  I was told to continue as I have been.  That I don't need to go back to the air cast that I did have at the beginning.  I used the aircast for about 2 weeks since then I've been using an air
splint.  I can't go down stairs properly.  I still have pain that is managed with ibuprofen.  

Anything I've read online about talus fractures is non weightbearing for 6-8 weeks.  I've been walking on it since 4 days after the fall.  Am I not getting the right information?  I work on my feet 12 hours a day.  I've been on modified hours and duties since I fell.  I can't afford to not have my ankle heal properly.  Is there something else I should be doing or not doing?

[cinw1973]

I was able to put up pictures of my xray on my profile of the fracture.  These are from Monday, 4 1/2 months since the fall.  I was told that the dark spot was from the point of impact and it was fine.  Thoughts?

[cinw1973]

I don't know if I can.  On Friday I will be able to see the orthopedic doc who saw me after my MRI.  Hopefully he will be able to tell me.

[achilles2]

Can you get a bone scan? This can show more detail than an x-ray or MR!?

I hope this helps,
achilles2

[cinw1973]

A continuation of the same problem.  I just repeated the xray of the right ankle and it was dark in the area of the fracture.  I fell March 19 and it has been 4 1/2 months since the fracture.  Should it not be back to normal by now?  I still have residual pain.  I am only starting to be able to go down stairs properly but not consistently.  I feel jarring in my right ankle and return to leading with the left foot down the stairs.  I am set to return to my full duties at work.  I work in a busy area with lots of walking over 12hours.  Any idea why there is still a dark spot?  Did it not heal properly?  Will I do further injury returning to work or not?

[cinw1973]

Thank you for your response.  I will follow up with an ortho and see what they would suggest as a plan.

[S. Kaul, MD]

Hi there!

Well, yes fractures would require a stress free time of atleast 4-6 weeks post the injury for appropriate healing. However since it is already 6 weeks post the injury, non-weight bearing at this stage would not help the fracture heal. At this point I would suggest following conservative management for some time. If the symptoms continue for a prolonged period interventional/ surgical measures may be considered. I would suggest consulting an orthopedician at this time for a detailed evaluation and suggestion of an appropriate management plan.
Hope this is helpful.

Take care!