Foot / Ankle :: Early Weight Bearing After OCD Talus Microfracture?
Nov 10, 2014
I am 6 days out from microfracture surgery on my left talus to correct an OCD that is actually 25 years old. Back when I was 13 I was diagnosed and went the route of NWB for about 12 weeks rather than surgery. Although I always had a less than fantastic ankle and some arthritis through the years, it was not until this summer that I went back to an OS due to shooting pain and locking in the ankle. The same lesion showed up on MRI/CT, about 1.1 cm x .6 cm still partially attached but with fluid gathering beneath it. OS assumed it was flapping, thus pain some days, no pain other days. I decided to go ahead with debridement and drilling, and so far seems like it went smoothly. The OS said that the piece was indeed very loose but that actually meant that it was easy to remove and they cleaned out the bone and drilled. So far I'm actually surprised that I haven't been in too much pain, I barely took the Percocet and stopped completely just 2 days later. Now I am trying to flex the ankle as much as I can (in a hard splint/wrap that OS does not want me to remove until follow-up on Monday) and it's not too bad. I do have 2 concerns I was hoping OCD veterans could answer:
1. My OS, who is actually the second surgeon I saw about this and chose to go with him because of his experience, believes in early weight bearing after this type of surgery. I've been reading/lurking a lot of threads on here about OCD surgery recovery and haven't come across anyone who did this. I see him on Monday, which will be 12 days post-op, and he plans to put me in a boot with a small amt of weight bearing at that time. Anyone else do this? He even says that in the meantime, I can put the foot flat on the floor and stand with a small bit of weight on it, as long as I don't walk. As in, if I'm standing brushing my teeth, put the foot flat on the floor, and that this hard half-cast should loosen up as I continue to do this. I'm scared to try it! I suspect THAT is when I'll really feel pain.
2. Until yesterday I didn't feel my incisions at all. Now I'm getting a sort of zing pain in one spot that I think it where he said an incision would be. It's sort of stinging. Is this normal? I can't remove the dressing so I have no idea what it looks like under there. Is it possible I popped a stitch? How long are the incisions? They should only be a stitch or 2 long, correct?
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After being NWB for 7 weeks, I've struggled with the PWB phase in that I am moving through it very slowly. I'm 5 weeks into it since my cast was removed and only recently mastered using a walker. It took me forever to get me off the knee scooter and on 2 feet. Last week I thought I was ready to move to using a walking cane and over the weekend used it a little bit while out. I am now in excruciating pain. I haven't really struggled with horrible pain thus far so I am a little concerned. I realize moving from a walker to a cane is increasing the amount of weight on my foot, so is that probably why I am in so much pain? I am now back to using the walker and feeling a bit discouraged that I couldn't handle the cane. I am further discouraged that I am moving so slowly through the PWB phase. Many talk on these boards of it taking only a couple of weeks before they are fully weight bearing, but I am in week 5 and I don't see being close to that yet. Any words of "your experience isn't so abnormal" would be helpful.
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I had three procedures two weeks ago - microfracture for talus, brostrom
- gault repair and debridement. Am supposed to be NWB for 6 weeks, but my crutches slipped in rain yesterday and I put weight onto my ankle. It is hurting again now, although been ok for the last week and a half. I am so worried that I have undone all the healing and will have to have it all done again. Has anyone else done the same and been ok?
Is there anything I can do before my next appointment with the surgeon in four weeks time?
Also last week had the lighter cast put on and it was so tight and painful that after two days the plaster nurses just cut in straight down the middle, but left it on my leg. This seems to be counterintuitive that this will still work? Has anyone had the same?
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Had surgery earlier today to remove a 2 cm lesion removed from the Talus. I was given some pain meds, and they help a little bit but I cannot get comfortable to fall asleep. My foot burns, throbs..and I just cannot relax.
Anyone have any tips on how to get comfortable?
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I was diagnosed with small (<1cm) OCD of the tibial plafond and lax lateral ligaments. I am now facing a microfracture and a Brostrom is about a month. Has anyone had both procedures together and what was your experience?
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3 months ago I got injuries at work, and at first didn't think it was bad... Fast forward to now. I'm almost 3 weeks post op for the ocd lesion in the round bone on my right ankle. My OS said it was a 12x7 lesion, and he done the debridement and microfracture. I fell on day 4 after surgery and landed on my right foot. I was put in a plaster cast on day 5. I fell again just a few days ago, and landed on recovering foot, since then i have had the a lot more pain, in the exact spot before the surgery and at the surgery site. Could these 2 falls in such a short time messed up the surgery? And what happens if the surgery doesn't work? All I want to do is get better so I can get to work, but I work at a factory and I stand on my feet 8 to 12 hours a day 6 to 7 days a week.
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Four months ago I had microfracture surgery to repair cartilage damage in my big toe joint. Recovery has been very slow due to swelling. I began experiencing overheating in that foot just a few days following surgery. While my foot also gets quite warm if I stand or sit for too long, these more dramatic episodes occur only at night.
By overheating, I mean that the surgery foot turns bright red, and gets exceptionally warm... the big toe joint area gets downright hot to the touch (there is no infection present) and feels as though there is a space heater sitting about an inch in front of my foot.
The episodes originally occurred every night and lasted up to 2 hours before normal temp. returned. Gradually, the duration has shortened to 30-45 minutes, occurring only 3-5 times a week. The only way I have found to prevent this from happening (and it only works sometimes), is to leave my bare foot uncovered when I go to bed - no blankets or sheets over it.
Has anyone else experienced something similar? Nobody can seem to explain why this is happening - it delays my sleep well into the night and is definitely not helping the residual swelling I still have to subside.
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I broke my tibia and fibula while playing soccer 7 weeks ago. I had an IM nail and 4 screws put into my tibia. I recently had my full leg cast removed at 6 weeks, and the doctor told me I could start partial weight bearing (25-45 lbs).
My question is, when the doctor said 25-45lbs, is that because that is the most that my bones can take? Or can my bones take my full body weight at this point? Is my doctor simply taking into account the fact that my joints and my muscles will be very atrophied (which is true)? So can I simply start bearing my full body weight as soon as my joints and muscles let me?
I also got a walking cast, but I do not enjoy using it. Do I have to use it? I can just be careful when I'm outside.
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After surviving the longest MN winter ever, and being extra-careful out on the ice, I tripped on my stairs INSIDE last Thursday. My initial concern was my throbbing left shin, but the right foot ultimately won out, sending me to my GP on Friday morning. X-rays were performed and the fracture was discovered. I was placed into a moon boot, warned that surgery "might" be necessary due to the location of the fracture, and sent home sans crutches, knee walker, or anything else, to await my consult with the orthopod on Monday.
During the vast expanse of free time I had, I rediscovered this site and many others, and also emailed my cousin who is a physician, and managed to get myself totally confused as to the best course of action concerning the healing process.
Long story short, orthopod said fairly clean (though spiral) fracture, very minimal displacement, and recommended no surgery, NWB for two weeks, and a follow-up x-ray on the 17th to see if any bone 'tackiness' is evident (judging from what I have read, this seems highly unlikely).
My concern now is that practically ever since the fall, I have had little to no pain in my foot while bearing weight on the moon boot. My MD cousin said, as did some posters here, that weight bearing stimulates healing and bone growth. So... not to second-guess my ortho, but I am wondering whether I am doing myself and my foot a disservice by NOT putting weight on it. It seems to be getting stiffer and sorer (when I gingerly test my weight on it on occasion) ever since I have started using the crutches and the knee walker. Am I doing the right thing? Is the ortho being too cautious and conservative, or am I being too impatient and skeptical?
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I had a horse fall and have managed to fracture my left tibia in a spiral complex formation.
They decided not to operate and I have now been in a cast for 7 weeks and have another 3 weeks until my next visit to the fracture clinic
Has anyone else been in a cast this long and non weight bearing? How long until I will be able to ride again once the cast has come off?
I am getting really bored at home now because my work won't let me return until I am walking and the doctor keeps signing me off!
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I am 7 1/2 weeks post of from Flat Foot Surgery and the outside area of foot from where my incision ends from the double calcaneal osteotomy up to my little toe the soft tissue is halfway numb and very painful. Has anyone else experienced this and if so how long did it last.
I am not sure how long it takes the soft tissue to heal to a point where it does not hurt when you are not walking. Or is what I am feeling nerve pain. I started PT this week and am PWB. My doctor thinks I will be in a shoe in 3 weeks and I don't know at this rate how that could be possible. I am icing a majority of the day for sure after I do my PT exercises.
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I had an OCD 15mm by 13mm removed and microfracture to my ankle last Tuesday (6/25/13). I have been sitting with my leg up on the sofa since.
I have been placed in crepe bandages while the wounds heal and go back to get the stitches out 2 weeks post op. I was wondering what they will do dressing wise at the 2 week stage. i'm non-weight bearing for 6 weeks but I feel really vulnerable with my foot just in crepe bandages. Will I be provided with an air boot or something or is there any ideas as to how to protect it?
After the 6 weeks NWB what happens? I'm guessing physio and PWB with maybe a boot?
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So I had ankle arthroscopy with microfracture for an OCD in my left ankle on 13 Apr 16.
On discharge from hospital I was told by the physiotherapist that the surgeon was happy for me to walk on the ankle as soon as I could. I thought this was pretty crazy but surgeons know best right? It seemed at the time that the only reason I was given crutches was because I had been given a local anaesthetic nerve block in my left leg in addition to the general anaesthetic and therefore could not put my foot down as it was numb, although I still felt pain in the area of surgery which again I thought was odd. I was not given any form of cast or boot.
Between discharge and my post op review I stayed mainly non weight bearing but after a week or so I started trying to partial weight bear and tried to walk without crutches. My ankle was not happy about this one bit! And so I reverted to non weight bearing, hopping around everywhere on crutches.
At my post op review I saw a podiatrist and voiced my concerns that I could not yet walk and was still feeling pain. I then saw a different surgeon to the one who performed the op, who confirmed that his patients are always given an aircast boot and told to non weight bear for 2 weeks post op!! He then gave me a boot and told me to wear it for a maximum of 2 weeks and then to try to walk again. I am now at that point and I cannot walk and I am still in pain.
Does anyone have any advice/opinions on this?
Those who have started to walk, did you have pain at first and just carried on through it?
I'd be grateful for any comments, good or bad. I can be quite pessimistic at times but I'm afraid I may have hindered my recovery my following the initial instructions.
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I had ankle debridement and microfracture 2 years ago and still have significant pain in the ankle. Some previous activities are limited due to the pain. The next step for me would be an MRI and then possibly another microfracture or OATS or an ankle fusion. Are there people who have "been done this road" and took the next step? What did you do and how successful has it been?
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I'm 13 days post op from ankle microfracture and debridement of a small OCD lesion and so far it's been an emotional roller coaster being NWB and all. Saw surgeon Monday and got stitches out and permission to start 25% WB with crutches and also ROM exercises. Was super excited and felt things were finally looking up, wasn't having much pain with WB, though ROM seemed somewhat limited and ankle seemed weak. Yesterday while doing ROM, was flexing foot up and down and went a little further than I prob should have when flexing it towards my body, I felt I was strong enough to move it further but apparently that was a very bad idea because it immediately hurt very bad at the site of the OCD (or at least where I think it was - medial) and it's been achy there ever since. One over stretch couldn't ruin my new cartilage could it? I'm freaking out, I don't think I can go through another surgery.
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I had microfracture/debridement for an ankle OCD of the medial talar dome of my right ankle at the end of April 2010. Other than my doc having issues with the cartilage flaking off when he tried to clean things out - all went well. At least I thought so at the time.
Went through several months of PT and it seemed pretty good.
About 18 months post surgery, I was having issues with the ankle. My doc at the time suggested a shot of cortisone - which I agreed to - but didn't really help. He then suggested I might look into other options - all of which my insurance considered "experimental" and would not pay for. So I limped along.
Finally, last month, while stretching my ankle gave a loud "pop", hurt like the dickens and swelled up. So, I finally felt "pushed" to go to a new doc my primary highly recommended (and who was covered by my new insurance).
Wonderful new doc. Admitted he felt OATS was not a step for me since my OCD went off the side of the talus. He was going to send me to someone who specialized in cadaver plants - but first - a new MRI.
New MRI was good, but with the high powered system, my ankle was in bad shape - felt like it knocked something loose in the joint. I called the new doc to ask if that was a possibility. He called me back himself and said he already had the results of the MRI and he now felt comfortable recommending re-doing the microfracture/debridement again over the cadaver implant. As he said, if the m/d failed we could still do the other at a later date.
So I have an appointment on Monday to actually SEE the MRI results and discuss/set-up surgery. My biggest challenge - choosing a time frame.
While I would love to do it immediately and be done with it - our county fair is in a month and as a Division Chair, I know I wouldn't be able to do my job in any way (climbing and setting displays) - and my kids are all Division Chairs on their own, so I really don't have any help to rely on. Then there is the wedding of my adopted son five hours away the first weekend in September....My oldest son suggested I wait until after the wedding - which is fine - except for the fact that it's football season and I'm running for public office and have a campaign to very literally run! LOL. Maybe being on crutches for the busiest part of my campaign will get me a few sympathy votes - because I think I will talk to the doc about saving the surgery for early September.....which will put me able to walk somewhat normally maybe by Christmas.
So - I am back to this adventure again. Has anyone had to do it a second time with the same ankle?
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Surgery was 13DEC. Today is the 15th day post op for a right ankle arthroscopic debridement, microfracture, and lateral ligament Brostrom procedure.
Last night due my "support" person taking a "personal day" I took it upon my self to take out the trash. I had my first post op this past Monday and the stitches were removed. I'm suppose to be NWB for 6 weeks post op and as of Monday wearing my aircast 24/7 except for showering.
I'm now wondering if I screwed the microfracture up. There is no increase in pain or swelling.
Small background- My husband is my support person but he has decided that he wants a divorce and a social life. Since my surgery he has found it necessary to stay the night at a hotel for at least 4 nights and be gone all day. His response is that he isn't here to babysit me or sit with me 24/7. We have a 6 year old home on winter break as well. We are in Minnesota with no family close and of course it's the middle of winter.
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Figured I'd try to recount my experiences on here. Surgery was totally fine -- was unaware of everything. Believe I was given a nerve block so I still can't feel my left leg, but trying to get ahead of the pain with Rx from doctor.
Currently elevating leg and will try to move as little in next two weeks I have off from work as possible. Went to the bathroom today even and am still paying for it a few hours later.
Staying positive -- that's the most important thing!
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This forum has really helped me come to an understanding of my ankle, and hopefully I can pay it forward. Late June of 2012 I stepped on a guy's foot while playing basketball (just running down the court, not landing from a jump). After many a misdiagnosis and tons of different treatments 17 months later, I'm left with surgery or live with the pain. I have opted for surgery as I can't continue to play basketball as I am now. The surgeon is doing a microdrilling, aided with bio cartilage and bone marrow to be extracted from my heel, to fix my 10x6x7mm OCD. I am also having a Brostrom procedure concurrently to reconstruct my outer ligament. This is my first time having surgery so to say I'm nervous is quite an understatement. The surgeon thinks I can return to work (at the library) 10 days later as long as I remain NWB. I'm 28, was in great shape before the injury but not any longer. 10 days sounds VERY optimistic from what I've read online. If anyone who comes across this post has any advice, opinions, words of wisdom, questions, please don't hesitate. My surgery is on Wednesday, Nov 20 of 2013 and I plan to update throughout for those who may be interested.
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By way of background, I was a long jumper/triple jumper on the track team in college and banged up my right ankle pretty badly a couple times, though nothing that resulted in long term pain. In January of this year I stupidly jumped off a rock on a hike and sprained it more severely, likely magnifying an already existing OLT.
(note this was right after the injury, pre-crutches, when there was still a lot of edema)
I'm now one month removed from a 6 week NWB stint on crutches for a 1.2cm OLT on my right ankle. I've been doing PT, yoga and general strengthening for about a month. I can jog with minimal pain and can walk/bike without any pain, but I cannot play the more intense sports I love like basketball, flag football etc.
I have a follow up appt with my orthopedist in a couple weeks, and am debating microfracture. I want to play basketball again, but I am worried about the long-term uncertainty of the procedure. Is the potential upside of the surgery worth it, given the current state of my injury?
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I am just writing with the hope of getting some more help/assurance re the Gould brostrom (or as my letter has now pointed out Arthroscopic debridement and lateral ankle reconstruction - unsure if this is the same of different?) procedure which I am due to have in just over 2 weeks on the 22nd June.
I have been very unsure for a while now as to whether or not to go ahead with it but have decided to take the plunge, however I still have my doubts!
I injured my ankle initially around 5 years ago (ruptured ATFL showed up in MRI scan) and almost had the surgery back then, only to decide not to go ahead with it. Since then I have rolled over and sprained it on multiple occasions, and have felt it become increasingly weak to the point where I have very little confidence in its strength. When playing football I now wear lace up supports, which are strong enough to prevent the rolling, but obviously doesnt deal with the root cause and there is a still a feeling of achiness and limited movement. When not wearing my ankle supports I would say its at least a 50/50 chance I'm going to roll over on my ankle every time.
I can still run and go about my everyday life virtually without any issues (feel twinges but nothing major unless recently sprained) and the views of the consultants varied from the cautious 'maybe only have it if you're playing high level sport' ( which I'm not but just play football weekly for my local team), to saying yes I go for it as its clearly getting weaker and weaker and becoming more of a frustration.
I guess alongside asking for advice as to what to expect post op, I am also seeking assurance that by going ahead I am making the right decision (bearing in mind surgery is considered last resort and rehab process is lengthy).
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