Question: Hello, I fractured my talus in a fall a few weeks ago. I walked on it for 4 days because it didn't hurt...the swelling and discoloration is finally what drove me to have it checked by an orthopedist. My question is this: is the "neutral position" essential for the bone to heal in the correct position? I ask this because every time I have a cast on or a boot on and it puts me in that very rigid position, I get horrible burning and pins and needs in the soles of my feet and intermittent numbness in my toes. I only find relief when I have the boot/cast removed and I allow my foot to relax into it's natural position (which rotates outward and is at about a 55-60 degree angle) for a period of time. I don't want to risk my talus not healing but I don't want to be in constant pain or damage something else in the process. My thoughts are that I should listen to my body. I'm 100% non-weight bearing now, by the way. I have a boot on now because they felt I was not tolerating the cast well. Thank you so much for your time.

ps. I will be honest...I remove the boot when I'm stationary at my desk or in my bed to give allow all the blood to move and nerves to settle down, but I do wear the boot when I'm up and moving around to protect it.

Thank you so much for your response. I don't have an xray. I will try to get one if I can, but yes, I can confirm that they did tell me the fracture was stable. The injury took place on October 25th. Is the purpose of a cast/boot to keep me from moving my ankle and protect it from further injury? Not to actually "hold" things in place?

I'm not asking for permission to keep taking my boot off, but rather to fully understand my risks if I choose to continue taking off my boot (to rest and elevate it, to sleep, take baths.)The only time I'm in pain is when I'm wearing a cast or the boot, so it's hard not to justify to myself removing it. What could cause complications at this point?

I may have gotten my terminology mixed: the position they keep putting me into with the cast is not my natural, relaxed position, but a strict 90 degree angle. It's when my foot is at this 90 degree angle I seem to have the most problem with pain, numbness, and pins and needles.

It does help, immensely...thank you. The boot is back on and I will do my best not to remove it. I have a follow-up appointment with my orthopedist Thursday. I will discuss with him a more comfortible angle for a cast if he feels that is still the best course of action. I'm thinking the last cast had to have been too tight. Thank you again!