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Osteocondral lesions of the talus in a 12 year old


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Old 05-17-2011, 08:16 AM   #1
darboymom
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Osteocondral lesions of the talus in a 12 year old

Very active son just diagnosed with this in right ankle because of pain he has when trying to run (only hurts when on ball of foot). Had a knee injury in January and was on crutches for 6 weeks, then PT, ect. for that. Ankle pain presented itself 6 weeks ago when he was allowed to begin running again, and he was given exercises to strengthen muscles of ankle which did not help. Xrays and MRI just this week show OCD.

Basically told 6 weeks back on crutches, then 2 months light walking, few more months of easy exercise and maybe he can begin sports again in about 7 to 8 months.

Not what we expected to hear. Anyone have experience with adolecent OCD?
Confused since he was already Non-weight bearing on that ankle for 6 to 8 weeks in Feb. and problem then showed up. No one said that this will actually "heal" the problem. Will he be able to return to running and sports in the future? He is only in 7th grade and hearing no soccer, football, or track has really crushed him. Is this basically a wait and see healing process? Any info would really be appreciated. Thank you!

 
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Old 05-17-2011, 07:26 PM   #2
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Re: Osteocondral lesions of the talus in a 12 year old

Darbymom, welcome to healthboards. I have been researching treatment options for my own (adult) ankle OCD. If you search the here in the foot section, there are at least a few other threads from parents of kids who had OCD. One is "SkatersDad."

The medical literature says that adolescents can sometimes heal an OCD without surgery. If it were my kid, I would try the crutches, feed her Joint Juice (or a similar glucosamine/chondritin supplement), and get another MRI in 3 or 4 months. If it looks better, continue with conservative (non-surgical) treatment and MRI again another 3-4 months after that. If it looks same or worse after 3 months, consult doctor about surgical options.

In the meantime I would also find an orthopedic surgeon or podiatrist who
1) Has experience treating ankle OCD;
2) Has experience treating kids; and
3) Does sports medicine
If you can find that perfect experienced pediatric sports medicine foot and ankle specialist who answers all your questions, has kids the same age, and is in your health insurer's network, super! If not, try to get 1&2 or 1&3.

I say there is a >99% chance your son will return to sports but it might take up to a year and it might require surgery. There is also a small chance he won't be able to return to all the same sports he does now.

 
Old 05-18-2011, 06:33 PM   #3
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Re: Osteocondral lesions of the talus in a 12 year old

Forgot to add something. If doctors think the OCD involves displaced piece or cartilage or bone, they might suggest surgery over wait-and-see. The surgery could either fix the loose piece in place or remove it, and if they remove it they might clean up the OCD site and possibly do microfracture.

 
Old 05-19-2011, 01:44 PM   #4
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Re: Osteocondral lesions of the talus in a 12 year old

Thanks for the reply. MRI shows nothing is loose so they are not looking at surgery yet.
Will have a new xray in 3 months, but so far not an MRI. I am thinking they hope to see if blood has started moving into the OCD area and will go on from there. Just so frustrating because he suffered a knee injury back in January (and probably this also) and was NWB for almost 8 weeks and then did PT. The OCD has already had almost 4 months to heal, but when Son mentioned pain he was sent to PT to "strengthen" the ankle muscles six weeks ago instead of staying off it. Good luck to all who are dealing with these problems!

 
Old 05-24-2011, 01:31 PM   #5
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Re: Osteocondral lesions of the talus in a 12 year old

I don't know enough to say if PT was was a good idea, bad idea, or just the standard first line treatment for ankle pain after NWB.

My only advice would be that if your circumstances (location, health insurance) allow it, to get a copy of the MRI/X-rays on a CD and go consult an orthopedic surgeon who specializes in feet/ankles or podiatrist who has sports medicine and/or pediatric experience. If it were my daughter, I wouldn't want just a regular pediatrician or podiatrist determining the treatment, because--despite all our postings on this topic--OCD of the ankle is not a very common injury compared to sprains, shin splints, bunions, hammertoes, plantar fascitis, etc.

 
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