Quote:
Originally posted by ScottyB
Tony,
Sorry to hear your news mate.
A bit of a medical lesson for you. It sounds like an "Aviators Astragalus" fracture
Fracture of the neck of the Talus previously commonly observed in World War 2 pilots who crash landed their damaged planes on returning from bombing raids. The injuries were caused by the upward thrust of the rudder bar causing dorsi flexion of the foot and forcing the talus against the tibia.
Probably best if they do screw it in place, They have a tendancy due to the poor blood supply to become unstable again if they do not realign correctly and start floating about which can be a pain.
Looking at the bruising fella it may be a possibility that you have ruptured your ligaments as well (If you look at the photo showing the lateral side of your foot (That's the outside) you have classic signs of pooling below your ankle (malleoli) may be worth pushing for an MRI scan as well to ascertain if they need repairing, if they are completely ruptured it is more of a deal than your fracture.
The 3 most common ligaments which are damaged are as follows:
anterior talofibular (ATF)
calcaneofibular (CF)
posterior talofibular (PTF)
and are often graded as per the severity of the rupture:
Grade I ligament stretch (microscopic tear)
Grade II ligament partly torn (Docs call on whether to opt for surgery)
Grade III ligament completely torn (requires surgery)
Don't let them fob you off that the CT would have picked it up as MRI is best used to highlight ligament damage. I see this time and time again they concentrate on the # and miss serious ligament damage which can be even more complicated to repair causing the patient longer recovery times.
Another way of looking at it is the mechanism of injury. If the crash involved such force that the Talus was # then it should be ringing alarm bells that ligaments stand a very good chance of being ruptured as well as they are designed to give first.
Lastly mate follow their advice to keep the swelling down. Probably along the lines of the old "RICED" principle.
Rest
Ice
Compression (Which is your temp plaster for now)
Elevation
Drugs (No not weed and pints of Fosters! The anti inflam's they have probably given you)
Any problems drop me a line.
Regards
ScottyB |
Well, I was back with the consultant today and the CT scan shows that the bone is as perfectly aligned now as it was before (and that included a drunk and fell over moment on Friday night) so she decided not to put a screw in. I thought that was a positive to be honest! We did replace the temp cast and were going to put the proper one on but it's still too swollen so I've got another temp cast on.
The consultant is pretty cool and I think she'd be open to a discussion about the ligament damage. We both knew there was ligament damage but I didn't say anything more on it and neither did she. I have to see her again on Friday as we're planning on putting the proper cast on then so I'll bring it up with her then.
I'm not on any anti-flams and I'm only taking pain killers before I got to bed at the moment. The pain seems to have subsided a fair bit so hopefully the swelling will to. I'm trying the Peroni/Grolsch method at the moment ...
19-Sep-2005, 01:54 
That's a poofy injury this was severely nippy!!!
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