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Talar Neck Fracture - A Patient's Story

February 17, 2010 - 6:00 AM

So, you have an incomplete fracture in your talus bone.

Treatment of a talar fracture is incredibly important and should not be taken lightly.  If you have fallen, been in a car accident, had a sports injury, etc that has even the slightest possibility of involving the talus bone - take it incredibly seriously.  I would even go as far to say, if you have any injury with any part of your foot, from any accident - do not mess around.

The first thing I'd do is see an orthopedic surgeon.  If possible, and time allows, do research and find one that focuses on foot injuries or one that specializes in sports injuries (even if yours is not sports related).  Even if neither of those is available, still go to an orthopedic surgeon.

The second thing I'd do is to get a MRI.  They are more expensive than an x-ray, but severe fractures can be missed on an x-ray based on the complicated shapes and close proximity of the foot bones.  Getting a MRI from the start will show the entire foot from all angles and expose any hidden fractures.

The third thing I'd do is to get a plaster cast, not a removable cast.  While a plaster cast is not as nice as a removable one, it is crucial for healing of a talar fracture to not move, even the slightest.  Since this bone is the hinge of your foot, it is a tricky task to hold still.

The fourth thing I'd do is NOT walk on it.  Just don't do it.  Wait a minimum of 6 weeks, if not a full 8.  Whatever you do, don't rush it.  Foot fractures are not simple to heal.  In the event of any fracture, blood is key in the healing process.  In a perfect body the amount of blood flowing to the foot is actually minor.  With one fracture in a foot bone it is going to take time due to normal limited blood.  In the event of multiple fractures, the healing process is even longer due to the limited about of blood available for healing.  Be patient.

Breaking one's foot is not fun but hopefully by taking the right steps (ha!), it will heal and never again will you take walking for granted.

Now, my friends are probably wondering why I wrote all this out.  OY!  Josh asked me to write this a long time ago as something that someone (specifically a patient) could find on the internet if they typed these issues (talar neck fracture, talar fracture, talus bone fractures) into a search engine: Google, Bing, Yahoo, etc.  I had been putting it off for so long, it seemed fitting to write it on the 1-year anniversary of when I broke my talus bone.

His/our reason for writing this is so we can give direction (via the internet) to patients just starting their own broken foot adventure.  That way, whomever they are can learn from what I went through:

broken foot feb 2009

For those who don't know - I broke my foot falling onto concrete one year ago today. I went to the podiatrist first and got x-rays.  He saw 2 incomplete fractures to my talus bone, one on the right side and one on the left, with a tiny bit of bone holding it together.  After 2.5 weeks in a removable cast, the podiatrist let me walk on it, even though it hurt.  After 8 weeks and me still in intense pain, he said he thought I had a talar dome lesion, but to keep an eye on it.  After 12 weeks and me literally crying while walking, he had me get a MRI.  The MRI showed a 3rd fracture to the neck my talus bone that got missed on the x-rays.  The podiatrist sent me to non-load bearing PT, prescribed inflammatory medicine and put me back in the removable cast. 

Thankfully/Finally, after all we had been through up until this point, this wasn't good enough for my husband.  He had my MRI results sent to an orthopedic surgeon for a second opinion.  The orthopedic surgeon he found, who specialized in foot and sports medicine, said if I had gone to him when this first happened he would have immediately put me in a plaster cast and had me not walk on it for a minimum of 8 weeks.  He then prescribed me to immediately stop PT because due to my fracture being on the neck of the talus, any movement at all was re-breaking the bone, causing continual micro-fractures.  He also had me stop all inflammatory medicines.  Since the foot already has a limited blood supply, I needed all the extra swelling and blood I could get down there to help heal the fracture.  He would have put me in a plaster cast right then but since I had already been in this ordeal for 3.5 months, he took pity on me and let me remain in the removable cast if I made sure to not bend my foot or walk on it for (another) 8 weeks.  After that, it was finally deemed "healed" (with the promise of pain for up to a year.  And yes, it still hurts, 1 year later.  It is my "new normal.") and I was able to go to PT and learn how to walk all over again.  The whole ordeal (only) took 6 months.

Again, the first three months of this injury we had researched every possible which way on the internet, trying to find answers or direction for fractures in the talus bone, then for talar dome lesions, etc.  Hard to believe, but nothing on the internet was giving us any real information or helping my pain.  It wasn't until we met with the orthopedic surgeon and were given more direction that we were able to know what was really going on. 

I know, I know, this is old news to my friends, so sorry. I'll go back to something completely differenter soon.

Response to Talar Neck Fracture - A Patient's Story

  • Diane Combs said on January 7, 2011 - 5:54 PM

    Hi - Im a bit older than you and fractured my talus bone 2 months ago and loved reading your story! I went to an incompetent orthopedic at first who never even looked at my foot .. he just looked at the scan and told his assisatant to cast me. I only had a cast on for 3 weeks. he said it was non displaced. I went to someone else who said it was in fact displaced. who knows. I trust the second guy because he actually looks at my foot I am sad to hear of all your misery with this and hope I do not have pain after a year- I am walking a bit with a boot cast - tried walking yesterday but it was so sore that I decided it must not be healed enough yet and put the boot back on. (Then tripped over a box at work today and wonder if I complicated the fracture- seems ok but sore... I hate not living life to its dullest and this is horrible. Thanks for sharing dear.

  • said on June 13, 2023 - 7:45 AM

  • said on November 7, 2023 - 8:22 PM

  • said on February 14, 2024 - 5:54 AM

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