undisplaced fracture neck of talus
i had RTA on 22 feb.2010 and had right radioulnar and left plecranon fracture and plate fixation was done for both. Other i had left side undisplaced talar neck fracture .For this below knee plaster was applied for 6 weeks.After 4 weeks of plaster i walked with high walking frame bearing weight only on left toes and right foot. bt i walked only for few minutes for few days and after that didn't walk.After 6 weeks f plaster i m using below knee slab till now. I did ankle exercise after 8 weeks of fracture for few minutes.for 4-5 days.but witheld exercise after that. I have not done any weight bearing yet on my left foot. but i started ankle exercise abut 2 month back and having range of motion with only abut 10 degree lack in dorsiflexion and plantar extension. MRI done after 10 weeks of fracture revealed MARROW EDEMA. CT SCAN done after 14 weeks of fracture revealed HEALED FRACTURE AND DECREASED ABSORPTION IN TALAR DOME - S/O ? EARLY AVN. For this repest MRI was done and revealed - SIGNIFICANT REDUCTION IN MARROW EDEMA AND NO EVIDENCE OF NECROSIS Then again i hav got done MRI yesterday i.e abt four and half month of fracture.
This MRI HAS GIVEN REPORT - ?STAGE 2 TRANSCHINDRAL TALAR DOME LESION WITH RELATIVE FLATTENING- LOSS OF TALAR DOME HEIGHT AS WELL AS DIFFUSE MARROW HYPERAEMIA WITH SUBTLE ASSOCIATED FLUID IN TIBIO-TALAR/SUBTALAR, INFERIOR TIBIO-FIBULAR ARTICULATIONS
WHAT IS EXPECTED PROGNOSIS .? WHAT MANAGMENT CAN BE DONE AT PRESENT.? IS THERE ANY MEDICAL OR SURGICAL PROCEDURE DONE AT THIS STAGE TO REVERSE AVN..?