Clinical Outcomes of Talus Bone Marrow Edema: Comparing Plaster Cast, Crutches, and Walking Boot Treatments.

Abstract

BACKGROUND Bone marrow edema (BME) basically involves localized hemorrhage and subtle compression fracture within the bone. We compared outcomes of 70 patients with traumatic BME of the talus, treated with a plaster cast, crutches, or walking boot. MATERIAL AND METHODS MRIs diagnosed 70 patients with talus BME who were randomly assigned into 3 groups of different treatments: Group 1 (n=33) patients were treated with plaster cast's Group 2 (n=21) patients used crutches, and Group 3 (n=16) patients used walking boots. The outcome variables were AOFAS and VAS scores. RESULTS No significant difference was demonstrated in the pre-treatment AOFAS scores between the groups (P>0.05). The AOFAS scores differed significantly after treatment, with Group 2 had the greatest increase in scores (P=0.002) and significantly higher AOFAS scores compared to Group 1 (100 [79-100] vs 94 [75-100], P=0.001). No significant difference was found in pre-treatment VAS scores between the groups (P=0.007). The post-treatment VAS scores were significantly reduced, especially for Group 2. Within-group analysis demonstrated a significant decrease of VAS scores for all groups (P<0.001). CONCLUSIONS Use of non-weight-bearing crutches for 3 weeks had better clinical results than use of a plaster cast when treating talus traumatic bone marrow edema. This was reflected in higher AOFAS and VAS, suggesting use of crutches is associated with better pain management and improved function.