HI I was just wondering if anyone still uses this message board.
I sprained my ankle 8 months ago. Went to the doctor the day after the injury and he told me it was a sprain. Sever pain persissted a little more than a month after the inital injury. I went back to him and he told me to deal with it, it was a sprain and he didn't know what to do with it and he sent me to PT.
I went to PT for about 8 weeks and it wasn't helping, so I stopped going. I then just lived with the pain. I would come home from working 8 hrs or so and I wouldn't be able to walk on my ankle without extreme pain. So about 6 months after the injury I went to see a Sports Doctor. I went in and he told me Osteochondritis in the talor dome, before I even got x-rays. I got x-rays and it confirmed it. He immediatly put me in a walking cast/boot. I then got an MRI and it determined me to be Stage One, the least serious stage. I went back about 5 weeks after getting the boot and my pain was still there. So he put me on crutches for 3 weeks. I went back 3 weeks later and still had sever pain. Then he suggested putting me in a cast for 3 weeks.
I am 2 weeks into the cast and am still having sever pain. He suggested that after these first 3 weeks he might put me in a new cast for 3 more weeks. I've been dealing with all of this for about 3 months not including the first 6 months.
Surgery is the last option and I wanted to know how invasive it was and how soon did you go back to work. I was a dance/gymnast/cheerleader before this, some doctors have told me if i have the surgery of bone drilling and grafting, I will never be able to do the things I love again.

Is this true based on what has happened to you??? And what should I do???

There are a few us floating around still, some doing better than others. Your OCD is a stage one, but I understand that sometimes those can be just as painful as a stage 2 or 3. Obviously you have casted for quite a while, has anyone tried a cortizone shot just to see if it clears up your inflamation before you start thinking more about surgery?

The surgery depends on where the OCD is located on the talus dome and how big it is. If it is easy to access, it can be done arthroscopically, but you will must likely be NWB for six weeks at a minimum. Will you be able to do everything you loved to do before - maybe, there are no guarantees with this surgery - I can't say no or yes only your body and time can determine that.

My OCD was a stage 3/4 on the medial side of the ankle. It was 1cm x 7mm and 4mm deep. I am also older, 42 to be exact, with a previously injured ankle. My surgery was 4/25/06, my ankle continues to improve and I have good days and bad. My recommendation is to find an Orthopedic Surgeon and specializes in the Foot & Ankle.

Good Luck.

Hey,

I believe I did significant damage to my ankle (via bad sprain...lateral/anterior location...ultimately a stage IV injury) back in 1999, then to Podiatrist within 12 months (took that long for chronic pain to begin), who diagnosed as tendinitis (no x-ray, two cortizone shots, custom orthotics). Lived with it (pain really never diminished) for 2 1/2 more years, until went to local orthopedic surgeon in early 2003, who x-rayed/CT Scan and did arthro to remove loose fragment/remove spurs but didn't treat talar dome lesion which was clearly present. Little improvement until got much worse in early 2006, at which point went back to OS who referred me to foot/anke OS. Specialist diagnosed instantly by looking at old x-ray/CT Scan and new CT Scan (commenting "what did the OS do in '03?").

She gave me options of debridement/drilling or perhaps transfer (although she doesn't recommend for my age (46 but still very active) so I had arthroscopic debridment/drilling procedure 10/5/06. Was 8 weeks NWB, and 6 weeks WB since, with physical therapy 2 to 3 times a week for 6 weeks.

What I can tell you is that my pain post surgery and post weight bearing was worst than ever for first 2 to 3 weeks, but has improved gradually since. Pain currently is "different" than what experienced for most of 7 years with defect, but can't say it's lesser pain. I won't attempt any mid to high impact (basketball, tennis, light running) for at least another month and I'm somewhat doubtful but still hopeful that will be improved over pre-surgery.

Like eko said, there really are no guarantees with this injury and surgical results vary based on age, health, your individual body's healing and certainly the skill and experience of your surgeon.

If I were you (or had to do over again), I'd get the best doctor your insurance/time/money can afford (ankle/foot orthopedic specialist or a very specifically-experienced podiatrist, perhaps) and get his/her opinion and recommendation, then spend some more time researching (Google Osteochondral Defect (or Lesion, Injury in place of Defect) of Talus and you'll find a wealth of general information. Act as quickly as you can in order to get comfortable with a decision....hoping/believing that it will get better (without treatment) through PT (unless that's what your new-found qualified specialist tells you) or "over time" would in my opinion be something you'll likely regret.

I knew going in to my surgery that odds were slightly in my favor of gaining significant improvement but also a decent chance that wouldn't improve to level that would allow me to do the active things I love to do (as sounds like you are concerned about as well) but I was willing to take that chance because without something changing, I was definitely not going to continue those activities.

Hope that helps.

Steve

HI....thanks for the replies and your information. It helped me, but here's a little more information on my situation....


Well lets see...I'm 19 years old and have been dancing for over 15 years, so dancing is a huge deal with me and I would like to be able to continue it. I was very active and still am in good shape and health. I have one major problem on top of the ankle thing....my insurance runs out completly at the end of January. So the time is ticking. And the soonest I will be able to get insurance back would be June. I don't think I could live with this for another 5 months or so. So this puts me in a little bit of a pickle.

I believe my injury is in the lateral part of the talor dome. I havn't had inflimation since I had the cast on, and have only had it twice since I've gotten, but the one night my ankle hurt so bad I was gonna cut the cast off myself!!!!

Well my sports medicane doctor did show it to one of his foot/ankle doctors and he didn't think I would need surgery. But I'm not to sure if I trust him, because I knoiw a physical therapist and she said that she wouldnt let him( the foot/ankle doc) operate on her dog, i she had one. So i am thinkin about having the other sports medicane doctor who also does arthroscopic surgery look at it. I might be going to the doctor this thursday instead of waiting until next week tuesday. So I dont' know.

Time is ticking.....

I will talk to the doctor about cortizone when I next see him.

Your insurance situation certainly puts more pressure on you. Without knowing whether your current sports medicine doc has substantial experience with foot and ankle injuries, especially with talar dome bruises/fractures and the treatments thereof, here's what I suggest:

If you have full confidence in your doctor, use him/her as your main resource as to what you should do in the near term (say 21 days, mid-term (3 to 6 months) and longer term (6 to 12 months and later). You are wise to ask around re the competency of the surgeon you are seeing.

If you live in/near a metropolitan area and you haven't already done so, I'd suggest you find a surgeon that's a member of the Americah Orthopaedic Foot and Ankle Society (AOFAS). As the name suggests, these docs have obtained training and experience specific to that anatomy. I'd want to find a doc that has done tens and hundreds of surgeries/treatments on your type of injury, not an "all-purpose" orthopod who happens to have general knowledge and experience with the ankle joint.

Go to web-site at aofas.org, choose "find a doc" and enter your city/zip code and see what docs come up from that search. Hopefully you'll find one/several docs in your geographic area (that can see you yet this month). Finding a doc you trust and can work with is key. He/she should be able to help your sort out your options and make a good decision given your insurance contstraints.

Let us know how it goes.

Finally, are you familiar with or have you considered COBRA as means of extending your present insurance coverage. This may/may not apply in your situation (its coverage is quite broad and is meant to keep someone from losing coverage for up to 18 months after they otherwise would be dropped...employee/individual normally has to pay for 100% of the premium during the extended period) but it's worth asking your insurance administrator if you haven't already done so.

Thank you so much for you information. I did go on the aofas.org website and went to the look for the doc, the site was under construction. I do have confidence in one of the surgeons because I trust my trainer frined. The time frame is what is killing me.
Um I have heard of cobra, but not sure whats all going on with the insurance thing. The one thing I do know is, are insurance or if i get a new one in like June, they don't cover pre-existing injuries, that could be a problem. I am going to the doctor tomorrow and I will keep you guys informed. Thanks again. :)

The website just started working...and guess what doctor was on the list? The doctor that my trainer friend said she wouldnt let him touch her dog!!! yea I had a good laugh over it.

PomPomchicka:

You are correct in the pre-existing conditions aspect when obtaining new insurance. The COBRA laws are very clear and apply, I believe, to employer-sponsored (meaning you/your parents purchase coverage through a group plan, not an individual plan) plans over a certain size (this size requirement is likely relatively small, so good chance that you might qualify).

I urge you really pursue the COBRA possibility with your present coverage. You can go month-to-month for up to 18 months with the same plan and coverage you currently have. It would eliminate your pre-existing conditions concerns (this is major) and buy you more time to make the best decision. I'd think you would want to maintain the COBRA coverage through whatever treatment timeline you end up choosing (to cover post-op, PT, etc). May cost you some bucks in premiums versus what you/your family is incurring now, but may be the absolute best option if you qualify.

So make sure to pursue that with your current plan's administrator...COBRA is law and is very commonly used.

Here is an offbeat suggestion (as I have no idea as to who covers you - you vs. your parents and what complany)...

If you are a full time student (including college) most insurance companies allow your parents to keep you on the policy until 21. Some companies/policies have slightly different rules but it might be worth checking into as COBRA is a good idea, but can be rather pricey.

You can also go to an insurance agent/broker. They can see if they can find a policy that accepts pre-exisiting injuries/illnesses or a policy that only makes you wait 30 days for full coverage. You could get one of these policies then later switch to a more affordable policy once you are all healed up.

Good luck!
jane

Ladies,

Not trying to muddy the waters (it's been a while since I reviewed specifics of COBRA) but COBRA (if your situation entitles you to it) would give you the same coverage as you currently have at whatever the group rate is that you/parents pay for it. The employer can charge a minimal administrative fee (used to be max of 2% of total cost of premium)/

How COBRA becomes pricier, which is what Jane is likely referring to, is that the covered participant would normally be expected by the employer to pay the full cost of the premium (plus perhaps the 2% fee), whereas while an employee, the employer may have paid for some/most of the premium as a benefit to the employee.

Normally, you will be hardpressed to find an individual policy with anywhere close to the same benefits and coverage at or below the group insurance rate. But that is just my experience. Jane's suggestion about staying on parent's policy as student (if that is your situation) is a great one. There are minimum college credit requirements that the insurance company expects you to maintain that you should be aware of.

I should have said it clearer- we paid @$120.00/mo for insurance but when my husband stopped working for that company we had to pay our share plus the employer share. Thus the price jumped to 1250.00/mo plus the admin cost. Needless to say, this was not an option. Found an individual policy offering major medical, etc (no Rx coverage) was only @450.00/mo.

If there is any way you can do the student option, I would check into it. It is the often the best route if you cannot afford COBRA or individual policies. Good catch Steve!
jane

I made your posts into a new thread and split it off from the talor dome bruise thread. In the future, please start a new topic instead of tagging your question onto someone else's old thread. Thank you!

Hi all...I just wanted to let you guys know whats all going on.
I went back to the doctor on the 12th and they did another x-ray because of how much pain I was in. They then put a new cast on and told me my pain should be going away because the fracture had not gotten worse. Its now been abou 2 weeks from that and on Thursday I am getting the cast off. I am still in the same amount of pain and my insurance is running out. So Im not to sure if anything is going to happen. I told my doctor I was done with it all and he told me if I would start to walk on it I would completly ruin my ankle joint...yay for someone who is 19. So hopefully he'll give me some good advice...otherwise I'm done :( thanks for all your help