I've had multiple fractures of the talus (neck and dome) after initial surgeries (talar Hawkins IV in 2000), following development of AVN.
Each time my surgical team goes in and repairs the damage with a bone graft. Each time undue pain, bruising, swelling indicated I'd rebroken the bone.
As my docs put it, I'm in near-constant state of talar collapse, with smaller portions breaking occasionally, sometimes the chip is visible on an xray, sometimes not. If the defect is large enough, into surgery I go.
If you're concerned consider a docs visit with xrays compared to your son's old views.
Good luck to him!
Hello.
Four years is a sufficient time for the bone to heal. It is either a pain of a nerve damage or ligament injury. It could also be due to reduced blood supply to the talus bone and subsequent damage. Your concern of a recurrence of talus fracture is apt, but it is not the bone fracture per se that is causing the pain.
Regards