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Open Reduction and Internal Fixation of a Talar Fracture
WHAT YOU SHOULD KNOW:
- Open reduction and internal fixation (ORIF) of a talar fracture is surgery to repair a broken talus. The talus is a square, flat bone on top of the calcaneus (heel bone). It connects the calcaneus with the tibia and fibula (lower leg bones) to form the ankle. The talus connects your foot to the leg, and helps transfer weight through the ankle joint as you walk. ORIF is usually done when the fracture is large, and when nerves and blood vessels are also damaged. It may also be done when fractured bones are not in their normal positions or are broken into several pieces. A failed attempt to repair the talar fracture without open surgery may also need an ORIF.
- In ORIF of a talar fracture, your caregiver may use wires, screws, plates, and pins to align the broken bones. These special tools are used to hold the pieces of bones together while they heal. Your caregiver may also place new bone into spaces between or around the fracture. After surgery, you will need to have a cast or splint that covers your lower leg, ankle, and foot. Physical activities will need to be avoided for some time until your bone heals completely. It may take months to get full function and motion of your leg, ankle, and foot after this surgery. With an ORIF, your talar fracture may be treated and usual activities may be resumed.
- Keep a current list of your medicines: Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists. Use vitamins, herbs, or food supplements only as directed.
- Take your medicine as directed: Call your primary healthcare provider if you think your medicine is not working as expected. Tell him about any medicine allergies, and if you want to quit taking or change your medicine.
- Antibiotics: This medicine is given to fight or prevent an infection caused by bacteria. Always take your antibiotics exactly as ordered by your primary healthcare provider. Do not stop taking your medicine unless directed by your primary healthcare provider. Never save antibiotics or take leftover antibiotics that were given to you for another illness.
- Pain medicine: You may need medicine to take away or decrease pain.
- Learn how to take your medicine. Ask what medicine and how much you should take. Be sure you know how, when, and how often to take it.
- Do not wait until the pain is severe before you take your medicine. Tell caregivers if your pain does not decrease.
- Pain medicine can make you dizzy or sleepy. Prevent falls by calling someone when you get out of bed or if you need help.
Ask for information about where and when to go for follow-up visits:
For continuing care, treatments, or home services, ask for more information.
- Ask your caregiver when you should return to have your wounds checked and stitches removed. A brace that allows a little leg motion may be placed on your leg. Your caregiver may also teach you how to use crutches. Crutches will support and decrease the stress on your ankle when walking. Ask your caregiver for information about leg movements and the use of crutches.
- Avoid doing hard activities, including playing hard or contact sports for some time. You may be able to do more as you get stronger and as the pain decreases. Do only the exercises advised by your caregiver, and do them only as often as your caregiver suggests.
- Do not let your affected ankle get wet unless your caregiver says it is OK. Ask your caregiver when you are allowed to bathe, shower, or swim.
- Place an ice pack on your ankle for 15 to 20 minutes every hour for up to 24 hours. You can make an ice pack by putting crushed ice in a plastic bag and wrapping it with a towel. Do not sleep while using the ice pack because you can get frostbite. Do not use it for a longer time than instructed by your caregiver.
Wearing a cast or splint:
Caregivers may want you to limit your ankle or foot movement for some time. This will keep your broken bones from moving while they heal. It may also decrease pain and make you feel more comfortable. A cast or splint may be made of plaster or fiberglass.
- Follow these instructions if you have a cast:
- Check the skin around the cast every day. You may put lotion on any red or sore areas.
- It is important not to get the cast wet. Before bathing, cover the cast with two plastic trash bags. Tape the bags to your skin above the cast to seal out the water. Keep your foot out of the water in case the bag breaks. If a plaster cast gets wet and soft, call your caregiver. You can dry the wet part of the cast using a hair dryer set on low or no heat.
- Do not push down or lean on any part of the cast because it may break.
- Do not scratch the skin under the cast by putting a sharp or pointed object inside the cast.
- Follow these instructions if you have a splint:
- If your splint is too tight, your toes may be numb or tingly. Gently loosen the splint so that your toes are comfortable.
- Do not push down or lean on any part of the splint because it may break.
CONTACT A CAREGIVER IF:
- You have a fever.
- There is a bad smell coming from under your cast or splint.
- Your skin is itchy, swollen, or has a rash.
- You have chest pain or trouble breathing that is getting worse over time.
- You have any questions or concerns about your surgery, injury, medicine, or care.
SEEK CARE IMMEDIATELY IF:
- You have increased pain or swelling in your ankle area that does not go away.
- Your cast or splint gets damaged or breaks.
- Your cast or splint becomes soaked with blood.
- Your cast feels tight and you have more swelling in your foot or toes.
- Your skin or toes on the injured ankle turn blue or white or they feel cold, numb, or tingly.
- You suddenly feel lightheaded and have trouble breathing.
- You have new and sudden chest pain. You may have more pain when you take deep breaths or cough. You may cough up blood.
- Your leg feels warm, tender, and painful. It may look swollen and red.
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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
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