Weight bearing after talus fracture

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Hi everyone! I broke my talus body 15 weeks ago so doctors out my leg in a cast for 12 weeks and no surgery needed because fracture was undisplaced. I removed cast 3 weeks ago. I went many doctors and did CT 3 weeks ago it showed partly consolidated talus fracture and disuse osteoporosis of the ankle joint. It still healed and not fully healed yet. Doctor said its okay I may start to use my ankle and weight bearing gradually and talus fracture takes a year to heal fully. Guys is it normal to walk and bear weight on my partly healed talus bone. Now I am cycling and walking with a one crutch. Non pain. When yesterday while I am cycling I put my leg on the ground in order to stop the bike and bear full weight suddenly I felt sharp pain then it went down immediately. Now I am tring to walk. Doctors said no boot needed because osteoporosis will heal when you use your ankle. Guys give some suggestions about this please!

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  • Posted

    Hi Whizjoe,

    It's likely that the sharp pain was caused by a combination of tendon and /or muscular strain while you moved your foot to the ground quickly. A partially healed talus can take a while to fully heal sure simply to blood supply. The talus doesn't have a particularly good supply of nutrients.

    Weight bearing on it at this stage is fine and should serve to heal it a bit faster than non weight bearing (although the jury is out on that still).

    You don't mention your age but I would guess you are 50+ because you are talking of osteoporosis. I would take a daily calcium magnesium and vitamin D supplement to assist in healing.

    Don't try to run before you can walk though - talus joints are notoriously slow to fully heal. What you are experiencing is normal.

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    • Posted

      Thank you Gillyjoo! I am 24 years old male. Doctor said osteoporosis caused by disuse of long time. I am taking CalciumD3 daily and biophosenat one in a week. One more question when I can walk normal i am afraid of bear my fully weight and try to walk. But no pain. Gillyjoo do patients run again after this kind of issue??
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    • Posted

      And what about osteonecrosis. Will it may come even the talus heals fully?? Now CT doesn't show avn.

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    • Posted

      Don't be afraid to bear weight, but just do it slowly. Use crutches for support and walk using them to bear most of the weight. Each day put a, little more weight through your legs and less through the crutches. Get enough sleep. Don't smoke at least while you're healing. Eat well. Keep your weight at a healthy level. These things will all help. Osteoporosis is where the small holes in the bone (bone looks a bit like a sponge) get bigger (making bone weaker). The more weight you put through the bone (without breaking it of course) the more these holes are filled with bony material. At your age osteoporosis shouldn't be a problem so exercise. Do pilates. Do resistance training especially using your legs. Do lunges etc. But initially use the crutches and gradually increase more weight through your legs and ankle each week. Don't try to do too much too soon, but do enough that your body adapts to the resistance you're putting it through. Remember that you're feet and ankles have incredible mechanics through a mixture of various joints, tendons, ligaments, muscle and bone - all work synergistically to enable you to walk. It normally works so well that you take it for granted. Keep your muscles strong and don't forget to exercise your lower back - if these muscles atrophy through lack of use then you'll find your ankle problem is the least of your worries.

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  • Posted

    AVN is very unlikely at this stage. Your doctor should be able to tell you more.
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  • Posted

    Thank you once more! Yeah I try to do slowly and gradually. I asked from my two doctors about avn they said it doesn't happen on injury like this and my broken talus body heals well but takes some time. But I heard from some people had avn after two years or more years even the talus healed. I dont understand this one. Gillyjoo my muscles got smaller especially my hip and lower leg muscles does it mean that they are atrophied? Will they get normal if I use them and exercise?

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  • Posted

    AVN can take a long time to fully show because bone takes a long time to die and become brittle as a result. I feel fairly confident that you don't have it though. It only happens when the blood supply is really broken to the talus. At your age its far less to worry about. I had mine completely severed and they rerouted the blood supply from elsewhere to my talus. 20 years later and my ankle fusion worked fine (which it wouldn't have done without a good blood supply). If your ankle is healing then it means there's a good blood supply to it - it won't heal without blood.

    Yes, muscle size decreases work atrophy. As does strength in them. Use them and they'll build back up. That's nothing to worry about.

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    • Posted

      If patient walks and uses ankle with a pressure doesn't it affect to the blood supply of healing talus (not totally healed)??

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    • Posted

      Exercise and resistance "work" such as walking/running etc only served to cause your body to adapt. The more exercise you do the more oxygen your body needs. That need will be translated into a building of more blood vessels to provide that O2. Hence if you exercise it'll help your talus heal. Just don't over do it - if it doesn't ache a little bit then you've not really done much to help but if it hurts then you've done too much. Find your middle ground.

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    • Posted

      Thank you! Can healing talus rebreak from the same spot during healing time by damaging it? Doctors said it has healed with all needfull degree. It has only left armouring the outside of the bone and fullfiling the breakline and it takes a year to achieve this process.
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    • Posted

      Bones don't heal from the outside inwards. They heal all over the break at the same time. The process starts with callus formation which over time hardens. Callus is a cartiliginous tissue which is softer than bone and has some bend in it. It's unlikely you've broken the same area however it is possible. You'd know if you had though because you wouldn't be able to put any weight on it (without a great deal of pain). If you want to put your mind at rest then go get an xray but it must likely won't show you anything new. If the doctor said it's OK to walk on then it means the healing process is good.

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