My ankle sorta looks like this inside....

MRI Results

In 2006 while I was in the Army I fractured my ankle... but there was more. More damage was done to my ankle than they knew. After 4 long years and more pain than I have ever been in, there is finally resolution to my pain. Well the pain is still here, but I now know what's wrong.

Last week I saw an ankle and foot specialist. He ordered an MRI. Tuesday I had an MRI and had to wait 3 long days for the results. Today was the best day of the week! I got my MRI results!

Drum roll please...

I have a torn ligament! I have had this torn ligament for 4 years! Surgery is the only thing that will make it better. I can wait for surgery and let it get worse and more painful or I can schedule my surgery and have it fixed. So now it's just a matter of figuring out when I can have my surgery. It's an outpatient surgery. 60 minutes... 2 weeks on crutches... physical therapy at 4 weeks... and 2-3 months for a full recovery! I can't wait!!

Ankle - Talus Fracture

Background

Fractures of the talus can be divided into types based on the 3 main anatomic divisions of the talus: body, neck, and head. Fractures of the body of the talus are further subdivided based on whether they traverse the main portion of the body or are fractures involving the talar dome, lateral process, or posterior process. Mechanisms of injury, treatment, and prognosis of the different types of talar fractures are markedly dissimilar.

Talar body fracture, anteroposterior radiograph. There is a sagittally oriented fracture through the body of the talus and disruption of the tibiotalar and subtalar joints. The injury was from a motor vehicle accident.

Talar body fracture, anteroposterior radiograph. There is a sagittally oriented fracture through the body of the talus and disruption of the tibiotalar and subtalar joints. The injury was from a motor vehicle accident.

Fractures of the lateral and posterior processes of the talus, axial computed tomography (CT) scan. These fractures were associated with a talar body fracture.

Fractures of the lateral and posterior processes of the talus, axial computed tomography (CT) scan. These fractures were associated with a talar body fracture.

For excellent patient education resources, visit eMedicine's Breaks, Fractures, and Dislocations Center. Also, see eMedicine's patient education articles Ankle Fracture and Broken Foot.

Frequency

United States

Talus fractures reportedly make up 3-5% of foot fractures. However, they are probably underreported, especially osteochondral fractures and fractures of the lateral and posterior processes of the talus, which are radiographically difficult to detect.

Approximately 50% of fractures of the talus involve the talar neck. The most common fracture of the talar body is the osteochondral fracture, followed by fractures of the posterior and lateral processes. Fractures of the main portion of the talar body and of the talar head are uncommon.

Mortality/Morbidity

Fractures of the talus can lead to avascular necrosis (AVN), arthritis, and, when unrecognized, chronic pain and nonunion. These develop as follows:

• AVN of the body of the talus - This condition develops primarily after a displaced fracture of the talar neck—which disrupts the blood supply to the talar body—has occurred. The risk of AVN can be estimated by the Hawkins classification (discussed below). An adequate blood supply to the talus can be inferred when a Hawkins sign is present (see Image below and Image 24 in Multimedia).^1,2,3

Anteroposterior radiograph. Following open reduction and internal fixation of a Hawkins type II fracture, a Hawkins sign (arrows), indicating intact vascularity, is seen over most of the talar dome. Laterally, however, the Hawkins sign is absent. The lateral portion of the dome is sclerotic, representing a small focus of avascular necrosis that has developed there.

Partial Hawkins sign, anteroposterior radiograph. Following open reduction and internal fixation of a Hawkins type II fracture, a Hawkins sign (arrows), indicating intact vascularity, is seen over most of the talar dome. Laterally, however, the Hawkins sign is absent. The lateral portion of the dome is sclerotic, representing a small focus of avascular necrosis that has developed there.

• Arthritis - A common complication following talar fracture, talus-related arthritis can involve the tibiotalar, subtalar, or talonavicular joints. Exact surgical reduction is a goal in the prevention of posttraumatic arthritis.
• Chronic pain and nonunion - These complications are not infrequent following undetected talar fractures. Osteochondral fractures of the talar dome, posterior process fractures, and lateral process fractures may be difficult to detect radiographically; clinically, they may be mistaken for ankle sprain. Patients with an undetected talar fracture present later with chronic pain and often with nonunion of the lateral or posterior process, at which time the fragment may require excision. Undetected osteochondral fractures may progress to loose bodies within the joint.

Age

Fractures of the talar dome, lateral process, and posterior process occur primarily in young athletes. Other talar fractures occur at any age, usually as a result of motor vehicle accidents or falls from a height.

Anatomy

The talus is unique in that no tendons attach to it. It is held in place by ligamentous and bony structures. The talus articulates superiorly with the tibia, medially and laterally with the medial and lateral malleoli (respectively), inferiorly with the calcaneus, and anteriorly with the navicular.

The talus can be divided into 3 main parts: body, neck, and head.

Body

The body, which is the largest portion of the talus, is divided into 4 parts, as follows:

• Dome - The dome articulates with the tibial plafond. Although termed a dome, it is shaped like a pulley, being convex from front to back but slightly concave from medial to lateral. Plantarflexion and dorsiflexion take place at the tibiotalar joint.
• Central portion - The central portion has articular facets medially and laterally that articulate with the malleoli, as well as an inferior articular facet that articulates with the posterior facet of the calcaneus. Inversion and eversion, as well as plantarflexion and dorsiflexion, take place at the posterior subtalar joint.
• Posterior process - The posterior process of the talus projects from the posteroinferior aspect of the talar body and is nonarticular.
  • The flexor hallucis longus (FHL) tendon courses between medial and lateral tubercles of the posterior process. Fractures of the posterior process can affect the FHL.
  • The posterior process of the talus can be present as a separate ossicle, the os trigonum.
• Lateral process - The lateral process of the talus protrudes beneath the tip of the fibula. On a lateral radiograph, it forms a wedge shape at the anterior aspect of the posterior subtalar joint, with the apex of the wedge pointing inferiorly. The posterior subtalar facet extends into this region, and fractures of the lateral process often involve that joint.

Neck

The neck of the talus is roughly cylindrical in shape and is considerably narrower than the body. The talar neck is separated from the calcaneus by the fat-filled sinus tarsi.

The main blood supply of the talar body enters the talar neck from the sinus tarsi (a fat-filled space between the talar neck and the calcaneus) and proceeds retrograde to supply the talar body. Thus, fractures of the talar neck can compromise the vascularity of the body of the talus.

Head

The head of the talus is convex anteriorly and articulates with the navicular. Abduction and adduction are the primary motions at the talonavicular joint.

Presentation

The mechanism of injury and clinical presentation of each of the 6 main types of talar fracture vary markedly. For purposes of conciseness and clarity, they are discussed below in the Radiograph/Findings section.

Preferred Examination

Plain radiographs of the foot and ankle are used to diagnose talar fractures. The views obtained depend on the particular fracture and are discussed separately (see below). Computed tomography (CT) scanning is used to evaluate displacement and to plan surgery. CT scanning and magnetic resonance imaging (MRI) are used to diagnose clinically occult fractures.^4,5,6

Limitations of Techniques

A close, directed scrutiny of radiographs is needed to detect many talar fractures. Fractures of the lateral process are especially difficult; they may be visible on the anteroposterior (AP) ankle radiograph, the Broden view (45° internal oblique), or only on the lateral view of the foot.

CT scanning and MRI are used to detect radiographically occult fractures of the talus but must be performed with high resolution and attention to patient positioning. MRI can be difficult to interpret if planes orthogonal to the long axis of the talus are not used. CT scanning should be performed in the coronal and axial planes; otherwise, fractures may be missed.

Info found at:
http://emedicine.medscape.com/article/396568-overview

Busy Week

So it's been a busy week and I haven't had a chance to write a new blog. I've been packing, working, being a mom. It's been a crazy week. I'm glad it's the weekend, but it's been just as busy. Why is it that short weeks are the busiest? Last weekend was Memorial weekend, so that means only a four day work week. Work was normal... busy. I was really looking forward to Friday. Not for the normal reason of the week end, but because I finally had my appointment with the orthopedic surgeon.

I really like the orthopedic surgeon! He was super nice and super informative. I of course had to have more x-rays done, but after that the doctor saw me. Apparently I have very loose ankle joints, which is not good. The fracture I had in my right ankle was actually to my right talus body and not the talus neck... I don't really expect anyone to know what that means, I don't really know what that means... but it's not good. It's one of the reasons that my fracture never showed up on any x-rays and will never show up on any x-rays. The doctor ordered an MRI and then I have to see him again. Depending on the MRI results, the doctor says I'm running out of non-surgical options. I just want my ankle to be better. I don't care how it happens. Surgery or no surgery, I just want it fixed.

Friday also happened to be my little brother's 19th birthday! I can't believe he's 19 now. He's married and has his own life now... it's crazy! Everyone is growing up! My little sister is coming to visit in a few weeks. She's going to spend 5 weeks here! I can't wait.

So Saturday, I was really looking forward to sleeping in, yet my body didn't agree with that. 5am my eyes opened and I just couldn't go back to sleep. I tossed and turned until about 9am. Not fun. I got a bunch of house work done today. A bunch is a little bit of an under statement. I did 3 loads of dishes, 6 loads of laundry, cleaned up the kitchen, made dinner, and folded all the laundry too. Whew, I got tired just typing everything I did today. My husband is at drill this weekend, so I had plenty of time on my hands. Hopefully he appreciates everything I did.

I really need to find time to work on my book. I feel like my head has too much in it right now. I won't be able to concentrate. I can barely concentrate to write this. My anxiety had been a little high lately... I hope it's just stress from getting ready to move. Well it's getting late... bye!

*Memorial Day Weekend*

Memorial Day Weekend! Most people look forward to Memorial Day weekend because it means an extra day off work. I too am one of those people who enjoys the long weekend. However, there is a much bigger reason behind the whole day. Memorial Day is the day we remember the those Americans who gave their lives for our Freedom. Without them we wouldn't have that freedom. I want to thank all the Veterans who serve our country - past, present, and future. Too many people go without remembering the Hero's of our country.

Well our weekend was a good one. We spent time with our family. We started the weekend off by having movie night at our house with Edd. I made dinner and then we watched some movies. First we watched The Little Mermaid 2, then Pocahontas 2, and after Sage went to bed we watched Zack and Miri make a porno. It was hilarious! It was fun just being at home and having dinner and a movie.

Saturday we were going to spend the day at the lake, but Christine got free tickets to the Twins game from her work, so we all went to the Twins game instead. It was Sage's first game and she had so much fun. She of course enjoyed the ice cream, popcorn, and a hot dog too! It was the hottest day of the weekend and we got super lucky and our seats were in the shaded section. I'm not a real big baseball fan, but I enjoyed the game. After the game we headed over to Buffalo Wild Wings to watch the UFC fight, but just ended up waiting for an hour and a half and then we walked over to Applebee's. Christine and the kids came over after dinner for cake, which ended up being around 11pm, so we made it a sleepover.

Sunday morning, after our sleepover, we made breakfast. French toast, eggs, and delicious breakfast potatoes for everyone! We spent the rest of the day with Christine and the kids too. We made a trip over to their house and met their new kitten, Peaches. Sage just absolutely loved Peaches. It was also the perfect day to finally fly Sage's dragon kite and have some ice cream. Another fun day and Sage was completely worn out, just as much as I was too.

Monday, the wonderful extra day off work, was spent packing and cleaning. We're moving to a bigger apartment in early July, so we're getting all packed up now. It's nice to have a weekend that is busy and spent with people you love. I spend most weekends wishing I had something to do... so this nice long weekend was the just the weekend I needed. Perfect.

Motherhood

Yesterday I read an article about how moms are so judgmental of each other. I started thinking if I was that way... and I think I might be. I don't want to be and I don't do it on purpose. I guess it's just human nature. I'm going to work on that. Anyways... I brought this up because I don't want to be judged as a mom.

My daughter is two and people say it's not longer terrible two's but it's terrible three's. I beg to differ. Sage, my daughter, has been throwing the worst fits, hitting, yelling, and just generally not listening. Does this have to do with my parenting style or is it just the age? Or maybe she just does it to get attention from mommy and daddy, because she doesn't act out in front of other people, usually. Even when we're at the store, doctors office, or a restaurant and Sage decides to throw a fit, I feel like I can't even discipline her without being judged by everyone that is nosily watching. If I give her a smack on the butt people are going to think I'm hurting my daughter or something. Society today is so hypercritical about disciplining it's ridiculous. You can't even give your child a spanking without someone calling social services or throwing the whole situation out of proportion.

It's pretty tough sometimes. I try not to use spanking as a corrective action. You can't say, "Hey - no hitting" and then spank your kid. I try to give her other forms of discipline. I explain to her that it's not nice to hit and that we need to be nice. I take her hand and rub it on my face to show her to be nice. It seems to work for the most part. Other times my husband and I have tried putting her in her room for time out. It is just a matter of finding what works. I don't really think there is a definite soluntion to child discipline. To each their own.

Now back to what I originally started with - being a judgmental mother. Why is it that when you are a mom and you see another mom doing something (with or to their child) you judge them? Or if you hear something bad happened to a child you just automatically assume the parent is to blame. It's really not fair. I don't want to be judged as a mom, so I shouldn't judge other mom's either. So please don't judge me. Parents put enough stress and pressure on themselves. It is not the easiest thing in the world to have a kid. You are the person responsible for teaching them everything they know. You are the person who forms them and makes them the person they are. It's a very big responsibility. I can't speak for other parents, I can only speak for myself, but I am doing my best! I am doing MY best!

My new favorite quote is from that article I read (link below). "The best gift people can give a mother is to tell her she's doing a good job." Just remember that.

Link to the story I read:

http://www.usatoday.com/news/health/2010-05-25-mommywars25_CV_N.htm

Who ever thought I'd want to be a writer?

Well this is my first blog and I feel like I got sucked into the abyss that is today's trend, blogging. It's hard to find anything to do these days that is not what everyone else is already doing. I started this blog because I want to write... about what? Anything and everything! I don't want to keep a journal or actually write stuff down in a notebook, I tried that and typing is much easier. So here I am.

I don't know if anyone will actually follow this blog or if it will be interesting to anyone but myself. I just want to be able to express myself and I think this will be fun. A little bit of background about me, in case you don't already know me. My name is Mallori and I am a 22 year old wife and mother of a 2 year old. I live in Minnesota, work a full time job, and am a full time wife and mom. I'm a busy woman.

I think I've always had a bit of a passion to write. In high school English wasn't my favorite subject, but I always loved writing assignments. Growing up I kept a little journal, wrote poems, and little stories, and generally enjoyed writing. This year I began writing what I hope will one day become a book. It's of course still in the beginning stages, but it's all mine, and I enjoy reminiscing while writing it.

I never thought I wanted to be a writer, but the more I write, the more I want to keep writing. I hope that my family and friends might enjoy this blog and be able to stay connected with me since I live so far away from them now.

Well... that was it. My first blog. Stay tuned there is more to come later!