Shepherd fracture one week ago

Patient

Q: I have a Shepherd's fracture: posterior process of the talus (it happened a week ago) Please could you tell me whether I should be mobilizing when not weight bearing? I would also like to know whether I can weight bear if it is comfortable - I have a boot and crutches but find it easier without them Thanks

Doctor

A:    Generally the treatment of a foot fracture depends upon what bone is broken, the mechanism of injury, the underlying medical condition of the patient, and whether the fracture is open (the skin is broken) or closed (the skin is intact). The Shepherd fracture involves the posterior or back part, of the talus and is seen in athletes who dance or kick. The treatment is immobilization in a cast. Immobilization of the fractured foot helps to control pain and inflammation. Anti-inflammatory medication (“Advil”, “Motrin”) can be useful with pain control by decreasing inflammation in the area. Nondisplaced neck and body fractures are treated with a short leg cast or fracture brace and no weight bearing for 6 to 10 weeks and depending on the bone healing showed in the follow up xrays partial and progressive weight bearing is allowed. Posterior process (Shepherd) fractures treated with immobilization and partial or full weight bearing generally have a good outcome, with the possibility of some residual pain and stiffness.

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