Question
Dear Dr. Katz,
I work in the ICU of Hospital. On May 19 2006,the portible X-ray machine rolled over my left foot and hit very hard to my tibia.When the technician heard my screaming and found my foot was under the big wheel,then she pulled back the machine and rolled over my left foot one more time.
My foot had X-ray in June 2006,no fracture found. My employer insisted for my soft tissue injury should be fully recover within two weeks.
From October 2006 to Jan. 2007, my left foot temperature still 86C - 88C and up. My foot has ongoing cramp and seizure.
I tried back to work for few time. Now, 22 months after injury, I still have pain and swollen ankle. I am working for 7 1/2 hours / day, 4 days / week in ICU. My left foot still having pain and my left ankle will start cramping after 5 to 10 times heel drop exercise.
After my day one work, my ankle pain gets worse.
My ankle start to swell up in the middle of my second working day,and very swollen after work.
I off work on Wednesday, I hardly do anything, I rest at all time on that day.
My ankle swell up about 2 cm or more after work on Thursady ,3 cm or more after work on Friday. It took two days to get recover.
My ankle pain is getting worse when I walk or stand too long.
I am taking Tylenol 650 mg for pain for three to six times per day, four to five days per week.
I apply Pennsaid solution 1.5% to affected area twice a day.
I need to rub the whole area two times at once before the pain goes down or gone. The swollen will slightly go down and the colour turn to dark red / purple.
Do you think that my left ankle has Talar dome fracture? If I do, do I need to have operation?
Please give me some suggestion.
Thank you,
May

Answer
Hi May,

It is possible that you have a talar dome lesion.  The first thing to do would be to get an MRI and this will pick up any pathology.  After that a treatment plan can be decided.  It certainly is not normal to still have ankle pain and swelling unless there is a problem.

Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
www.thetampapodiatrist.com
www.tampacryosurgery.com


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