Shattered Talus Report / Analysis

Status update:

After breaking talus on 9/3/11, I have been weight-bearing the past two weeks. I was told by the MD that once I was able to walk w/ a normal gait, I could discontinue using boot. Well, of course I made sure I was walking. I even went out dancing and the next day road a bike. Although it was extremely stiff all this time, I was in some serious pain and swelling 48 hours later. I am still perplexed by the amount and of pain and swelling caused by "over doing it", but I have never had an injury like this before. I officially start PT tomorrow and I am back were I started.....but without crutches!

It has been encouraging hearing all these other recovery stories~

At this pace, I will be climbing before the new year!

Took a lead fall in JT coming up on two yrs ago. Dislocated my calc and broke my talus in a 20 footer. The first surgery put five screws in the talus and I was on the "scooter" for over four months. Finally to a walking boot for several months and PT. Had to have surgery again 9 months later to remove a bunch of bone that decided to grow where it shouldn't. AVN is some scary s%*t!

ankle after falling 20'

Climbed Dark Star this last August car to car. Hang in there!!!

Also, hiking in gravel and on talus is still difficult and don't expect your range of motion (inversion/eversion) to be much. Like others have said, PT, PT, PT. When you think you've done enough, do more.

Hope this isn't too graphic... ;-)

broken talus

Just got back from a climbing trip in red rocks and the ankle is climbing fine. Stiff in the mornings upon waking, but no big issues. Hope others have had same success that I have experienced.

Congrats Ben, Glad to hear you've healed up! Still waiting to get my cast off, I guess what Im trying to say is, im jealous...

I'll add a less than cheerful data point to this thread. I fractured my calcaneus and cracked my talus in an unroped, 12' fall 10 years ago at the age of 57. I needed two operations a year apart to sort out the mess -- the first to correct the displaced fractures of the heel and the second to remove a metal plate that was impinging on a tendon and making walking difficult. Despite the surgeon's cheerful prognosis, approach hikes or backcountry ski trips on rough terrain left me in disabling pain at the end of the day (and for another day or two afterward) so I consulted a local podiatrist. After x-raying my ankle, she diagnosed the problem as severe traumatic osteoarthitis of the subtalar joint and said that little or nothing could be done to correct the condition. She was right -- I've had to give up ski-mountaineering, backpacking, and approaches longer than, say, the distance from the old McGregor Ranch parking lot to the Bookmark and Bookend.

Oddly enough, the arthritic ankle had very little impact on my actual climbing. Until I had a knee replacement last fall, I was able to lead multi-pitch 10s and 11s with no more than a dull ache in my ankle. Now I'm waiting to see how a metal and plastic knee affects my hiking and climbing.

Brice, good luck to you. It sounds like you have the right attitude and you're in the right hands.

A general thought to all of those who are considering ignoring the doctors advice. Unfortunately, this is, as has previously been mentioned, a very serious injury with potential for life changing complications. It's one thing to break your wrist or have the flu or something and push it when you're told not to. Worst case scenario is you take a little longer to be back to normal, but at least you had fun doing it...right?

In the case of talar injuries, if you end up with severe avascular necrosis of the talus, there is no recourse. The bone will be removed and you'll end up with an ankle fusion. At that point nevermind not being able to run, you definitely won't be able to climb and probably will have trouble walking. That is not the worst case scenario. It's not uncommon for the end game of AVN to be a below knee amputation. The thought of not running or a long recovery might be daunting, but you are still young, and still healthy. There are many ways to continue to enjoy the outdoors. If you end up fused or amputated, your options become seriously limited, and those procedures will dramatically effect not only your hobbies and passions, but your daily life!

If you're unhappy with your recovery plan, seek a 2nd opinion, but don't ignore your surgeon. He is likely very smart, educated and experienced and does have your best interest in mind.

For reference, I am not a doctor, but I am a biomedical engineer and I design orthopaedic implants for the foot and ankle. Specifically devices to treat ankle fusion...

Good luck to you.

-James

I'm happy to report I returned to running at the 6 month point from my fall. I have run a few times in the last week, and while my right ankle hurts and swells, further improvement is on the way. I saw the surgeon yesterday, and my X-ray showed no signs of AVN. There is a delayed risk of it up to 10 months out so I have one more X-ray. I don't know how the doctor fit that many screws in such a small bone without destroying the blood supply.

I have stopped worrying about what might happen though and have concentrated on doing what I want to do. I started climbing at the gym with the cast at 4 weeks and started leading sport with a stick clip at 5 months. I led 3 gear pitches of a slab at Looking Glass last weekend and got in 4 days of skiing this winter.

The ankle does hurt, but the pain is in a lateral tendon on the outside of the foot. The doctor said to get a wobble board thingie that was developed to treat weak ankles.

I did a lot of reading on the Internet while I was in the hard cast. There are a lot of positive outcomes for talus breaks. There is at least one friend of a friend who supposedly climbs 14 with a fused ankle.

All I know in the end is that I'm 47 with a stiff ankle. The injury has taught me never to take mobility for granted again. Live each day like it is your last and don't dwell on negative possibilities.

Stuart, Sports Authority sells "wobbly board thingies" (a disc with a curved bottom) for around $35. My physical therapist recommended it as one of my post-knee replacement rehab exercises. Good luck.

I'm not qualified to give you a medical opinion (although it strikes me as odd that your doctors are leaving bone fragments in the arthritis-prone subtalar joint), but I can confirm that weight-bearing three months after surgery to repair displaced fractures of the calcaneus and a cracked talus was extremely painful.

If feasible, ask for a second opinion from a well-regarded orthopaedic surgeon in Oslo or elsewhere in Norway before travelling to the US for surgery. Unless your Norwegian medical insurance covers out-of-country surgery, surgery coupled with a brief hospital stay is likely to cost a minimum of $10,000 USD. Good luck.

Great, thread. I broke my talas on a lead fall to a ledge. Poor reading of multiple xrays and my bull headedness, no surgery. I have a floating bone piece and pretty bad osteoarthritis , one doc said it was from the trauma and surgery would not have mattered, but would have preferred the choice. I would tell anyone who hits a ledge, to get a CT scan and/or MRI, takes a decent doc to see some of this shit on an xray right away due to swelling. Anyway , it's been a year, back to rock climbing and have hit some harder routes on Shasta and 2x rainier. Real heavy boots are the key for me, and Ibu for the way out. I just got a cortizone injection for my last attempt on Rainier (turned around for someone else in party (400ft shy)), i can say it helped alot and will consider for my big projects, much better recovery. Usually i am dying after a big slog with 70lb pack and thousands of feet, but this time not so bad.
I am fairly new to rock climbing, so hard to gauge impact, I am climbing better than i did before the accident, but this is due to learning. Some days my ankle gets tired and sore, i think a lot of this has to do with rebuilding the strength. Hardest part of this injury is getting in enough training , can't run and afraid of the stair machine. Lots of Mountain biking and surfing , but hard to replace the calorie burn and quickness of running, definitely put on some weight. I need to see another specialist, the thing im struggling with at the moment is how hard to push it, I still have some projects i want to do and need to raise the fitness bar.

oh man this is a crazy but really helpful formum. I just shattered my talus 5 days ago. Yes,shattered. As in the doc said "I count 3 big pieces and about a dozen or more tiny little pieces." I still wasn't sure the implications of a talus fx so I was kinda like..great, well can I climb again in like a few weeks or so? Sounds like it's gonna be a long road to recovery...

recovery is a long and rocky path, but its the only one....so give it your best shot. its my second year back to climbing status post talus fx (see my previous posts). things were quite grim after my fx with the delay in dx, tx, and all the horrific things to read about on the internet.

consequently, the most challenging part for me has been getting back on the sharp-end and climbing again. its taken many leads for my psyche to get into a good place, if not better. i am more cognizant of everything....almost to a fault, but i am climbing smarter and harder.

yes, i do have more pains in my ankle and approaches and descents are taxing. i no longer run (not that i enjoyed it that much), but no cycle for cardio training. i know that i have osteoarthritis and running or other "high-impact" activities will exacerbate my osteoarthritis. so, i have decided that i want to enjoy climbing to a ripe old age. therefore, im not "running it-out", like i used to. im not taking big risks. but im still climbing and having fun

your attitude through recovery will determine much...

If it's any consolation, I'm two summers past my Talus fracture. I'm back to leading sport routes in the 10's and trad routes in the 8's and 9's. I ran two trail half marathons this past summer. I did have a follow up surgery to remove scar tissue and add mobility last Nov. The scar tissue that remains still causes limping in rest periods following exercise, but once the foot warms up it is pretty functional for anything I want to do now.

My talus fracture is still getting better, 14 years after the fall, as I wrote upthread.

Not sure if that a good thing (it's still getting better) or a bad thing (it still limits me somewhat). But i'll take the optimist point of view...it's a good thing!

Oddly - there is a medical paper calling this the "snowboarders fracture." From the looks of this thread, it could also be called the climbers fracture.

Anyway, good luck with the recovery to all.

Thanks for the reply guys...it's really comforting to know that there are climbers like me who have gone down the same path. I unzippered a pitch so as they say...could've been worse right. i'm going to buy a hangboard to keep the tendons strong.
peace,
Dom

Just fractured my Talus two weeks ago, wow the surgery hurts a heck of a lot more then actually breaking of it. It's been a week and I still can't stand up on my crutches with out the ankle swelling up. Funny thing is, I actually broke it snowboarding. The first thing I thought about when I felt it break was how this is going to effect my climbing and will I be alright for this summers climbing season. I've also just hurt my shoulder a few months ago, the doc says it's bursitis...hopefully it just goes away. Feeling pretty discouraged right now, but it sounds like there's a lot of other people on here that have gone through plenty of other injuries.

Good luck to everyone else out there are on the road to recovery!

Bryan-
Sorry about your accident. I'm sure it depends on where you break it and if it was displaced or not, etc. but just as a time frame for you, I am quickly approaching months 3 since the accident (I did wait a week for surgery though). I am now walking around with a boot and only use crutches here and there. maybe another month until walking again without the boot. so 4 months total until walking since my accident. I'm hoping 5 or 6 until surfing and climbing again. good luck. I totally shattered mine though so maybe yours won't be as bad? just take it really easy and once you go from a cast to a boot I would start asking about PT. Are you using a bone stimulator? these are great if your insurance will cover it. because of the threat of AVN (avascular necrosis) with the talus I would look into it.
good luck,
Dom

I have a similar story to probably many people here. I was indoor bouldering (that's rock climbing with no ropes for those of you who don't know) it wasn't a very hard wall but I was tired from climbing for a while so I lost my grip almost at the top of about a 10ft wall. So I fell and some how my right foot went snap on the landing and twisted to the right. Once on the mat I didn't actually realize the extent of my injury until I tired to get up. Once I looked at my right foot it had swollen almost instantly to the size of a softball. My friend rushed me to the emergency room near by and I found out that I had shattered my talus bone. The image I saw later of the bone just looked like a bunch of little pieces of confetti. Thankfully the bone didn't move out of place just completely shattered.
So I to went to see many different doctors until I got my podiatrist who recommended we don't do surgery cus the bone wasn't out of place. After 3 months of being in a cast my doctor told me I should start putting weight on the bone.

Sadly that proved to be a very bad idea. My bone that healed resplit and I was forced to go back to square one. No weight and elevation at all times. I also started bone therapy 30 mins a day where I put my foot in this machine that helped to stimulate bone growth. Now the bone growing didn't actually hurt but I was incredible uncomfortable.

All in all I'm just saw my doctor and it seems that the part that resplit still hasn't filled in again after another 3 months. So to sum it up I've been in a cast for 6 months now and still looking at another month in a cast. Surgery might be in my future unless my bone shows some growing process.

Not many people can really understand things like this that people go through. This journey has been very difficult basically rearranging your whole life. The first couple months were by far the hardest. The emotion toll it takes is like walking through a tunnel with no light at the end. Everyday you have to tell yourself things will get better and so days you believe it and other days you don't.

So here I am still hoping for the best on this 6 month long life changing journey. Wishing everyone going through similar problems that they don't lose hope.

First of all, thanks to everyone for this thread...I'll add my story to the list here as well. I broke my talus bone on a lead fall to a ledge almost a month ago now. The real shit kicker here is that I broke it two weeks before going to Yosemite for my wedding (my fiance was none too pleased). Initial trip to the ER was a mis-diagnosis as a sprained ankle, they didn't spot the break in the talus due to the angle of the x-rays. I followed up with an ortho specialist and they spotted the bone was slightly out of place. The MRI revealed that I had done a good job of shattering my Talus. It ended up in 3 major pieces, and some conffetti in there for good measure.

I had an ex-fix put on temporarily to allow for the swelling to go down and so that we didn't have to call off the wedding. 2 weeks ago I had another surgery which removed the ex-fix and added 2 screws to my talus (ORIF open reduction and internal fixation). The thought of avascular necrosis (AVN) scares me...at a relatively young 30 years of age, I have a lot of plans for that ankle and would be devastated if I were unable to enjoy hiking and climbing.

I have the stitches from the surgery removed soon and will hopefully continue to heal up. Right now I don't know specific expectations with my recovery.

Self Rescue & backpack splint

self rescue

Exfix
exfix

Post ORIF
ORIF

Long overdue follow up. I have been weight bearing since September, back to short to moderate hikes (about 7 miles), and mountain biking. Due to my chaotic summer (traveled abroad, moved across country) I have not yet started PT, but will start soon. I am not back to climbing yet as I am still getting settled here in Salt Lake but plan to get into a gym over the winter.

Ultimately my healing went better than expected. The talus head/neck was intact so there is low likely-hood of AVN, probably get some serious arthritis in a few decades though. The two screws fused my talus well, and I have not had any complications yet...just a looong recovery.

While all broken and on disability, I had the fortune of staying at my parents camp on a lake, and would routinely swim over 1mi. around a small island (with a spotter) to keep in shape and prevent atrophy. I highly recommend anyone to swim as much as possible as soon as the surgery scars heal up.

Good luck out there!