Surgeon for removing bone after talus fracture wanted!

Hi!

I am a climber from Norway who shattered my Talus in a bouldering accident three months ago. Had a clean non displaced fracture trough the body with minimal involvement of the joints. However I had some crushed fragments of the lateral process, with some small fragment in the subtalar joint.

I was initially scheduled for surgery , but the surgeons decided that conservative treatment was the best option. I am really not sure if this was the right decision. So I have been in a plastic cast for 6 weeks and a removeable cast for 6 weeks. Started ROM excercises after 6 weeks.
Just got the cast removed a couple of days ago and was told to start full weight bearing. Went to the physio the same day, and weight bearing was impossible. He said it was normal, and could take some time for the foot to get used to weight He gave me some excersises and told me to ride my spinning bike as much as possible.
But i cant believe it is supposed to be this painful. Tried to walk in a pool yesterday, and this also hurt like hell on the lateral side. Other than this the ankle feels fine. Almost no swelling, close to full dorsiflexion, but the inversion/eversion is not much.

I have some questions and would appreciate it if anyone had some excperiences/
input:

1. Is it normal to go straight to full weight bearing after three months of non-weightbearing?

2. Weight bearing is extremely painful on the lateral side. I am not able to put 50 percent of my weight on it. It also hurts when i cycle on my exercise bike if i have resistance on. It is a stabbing kind of pain. Is this normal? And how long should i try to weight bear before considering surgery?

3. I am afraid i will need a surgery to remove bone. I have decided to go the US to to do the operation cause of the lack of experience on these kind of things in my local hospital. Basically i am looking for the best surgeon out there and it seems like the US is the place to go...any recommendations would be much appreciated.

Tips for rehab would also be very useful as the only thing the doctor told me was to start walking.

I am really worried about this whole thing and if I will be able to climb and even walk properly again. But seeing some of you guys getting back to climbing and even running is telling me there still is hope.

Any input would be much appreciated!

Maybe get a second opinion from another orthopedist?

It is not normal, in my rather extensive experience, to go from a cast to full weight bearing without a period of weight bearing as tolerated. I was on crutches for 11 weeks recently, with only partial weight bearing at the end, and now 6 weeks later am just now able to stand on the affected foot with full weight. A good radiologist should be able to tell if you have bone fragments that are causing your pain. I suspect that you will not really know the extent of your recovery until a few weeks have passed and you go through more physical thereapy. Good luck!

When I broke my talus and started putting weight on the foot again, I kept my foot in a walking boot also used crutches and gradually stopped and just used the boot. This was probably over a week or two.

Have you been gradually able to put more weight down over time? The first time my foot touched the ground, it was more painful than when I broke it, but this subsided pretty fast and turned into more of a stiffness pain than the shooting stabbing pain.

Sounds like you need a better rehab plan. I did a lot of range of motion exercises. Write out the alphabet with your toes to get your ankle fully rotating around. It's all fine control that you want to get back. Don't give up and do it as much as possible. It pays off in the long run.

Get a therapy band (soft rubber band) to put on your foot to help stretch and rotate it.

Also, it's important to get your toes involved as the ligaments run up and around behind the ankle area. Make sure that lifting your toes while your foot is flat doesn't hurt.

If you are thinking of surgery in the Los Angeles area, check out Kerlan Jobe. They do a lot of work on the professional sports teams in the area (Lakers, Clippers, Kings). My talus surgery was done by Kenneth Jung and he was excellent. I'd highly recommend him.

Best wishes on your recovery.
Jason

how is your foot now doing ?

I broke my talus during a boulderníng fall 11 weeks ago, dislocated talus fracture, fixed with 2 screws.

I walked with crutches for around 10 weeks, climbed a bit after 8 weeks but no walking. I was told to continue walking with crutches and partial weight bearing for 5 more weeks. But it does not make too much sense to me. I'm walking carefully without crutches for 1 week now and so far so good. The foot is soaring a bit, but no pain.

Those of you who had a broken talus too, when did you start climbing again, how long were you walking with crutches. Could it be worsening again by walking without crutches even if I can almost totally move my ancle and easily put all my weight on the injured foot ?

Thanks for reports :)

Ole Marius wrote:Hi! I am a climber from Norway who shattered my Talus in a bouldering accident three months ago. Had a clean non displaced fracture trough the body with minimal involvement of the joints. However I had some crushed fragments of the lateral process, with some small fragment in the subtalar joint. I was initially scheduled for surgery , but the surgeons decided that conservative treatment was the best option. I am really not sure if this was the right decision. So I have been in a plastic cast for 6 weeks and a removeable cast for 6 weeks. Started ROM excercises after 6 weeks. Just got the cast removed a couple of days ago and was told to start full weight bearing. Went to the physio the same day, and weight bearing was impossible. He said it was normal, and could take some time for the foot to get used to weight He gave me some excersises and told me to ride my spinning bike as much as possible. But i cant believe it is supposed to be this painful. Tried to walk in a pool yesterday, and this also hurt like hell on the lateral side. Other than this the ankle feels fine. Almost no swelling, close to full dorsiflexion, but the inversion/eversion is not much. I have some questions and would appreciate it if anyone had some excperiences/ input: 1. Is it normal to go straight to full weight bearing after three months of non-weightbearing? 2. Weight bearing is extremely painful on the lateral side. I am not able to put 50 percent of my weight on it. It also hurts when i cycle on my exercise bike if i have resistance on. It is a stabbing kind of pain. Is this normal? And how long should i try to weight bear before considering surgery? 3. I am afraid i will need a surgery to remove bone. I have decided to go the US to to do the operation cause of the lack of experience on these kind of things in my local hospital. Basically i am looking for the best surgeon out there and it seems like the US is the place to go...any recommendations would be much appreciated. Tips for rehab would also be very useful as the only thing the doctor told me was to start walking. I am really worried about this whole thing and if I will be able to climb and even walk properly again. But seeing some of you guys getting back to climbing and even running is telling me there still is hope. Any input would be much appreciated!

^^^Did you ever get surgery? I'd Like an update. I had a displaced fracture, that was manual set back into place, causing me to not need surgery. Its been almost 5 months now, and I can still only barely walk. I have a lot of pain in between my calcaneus and talus, as well as on the outside ankle area. Ether way, I'm wondering if anyone got the debridement surgery, and How it went.

Caitlin Mac I displaced my talus dec 21 2015. I didn't have surgery and I am still in cast. The doctor decide to use a bone stimulation to help the bone healing. I heard that all displaced talus fracture need surgery. Finger crossed

Gena,
Knowing what I know now, it's best to get out of the cast asap. Every day your in the cast, is another day your scar tissue is getting tighter. I was in a cast for way too long and only have 80% range of motion back and it's been 5 months. I'm now looking at surgery again bc my subtalar joint(joint of the talus and calcaneus) healed incorrectly (because they put me in a cast without surgery) and now they need to cut my calcaneus in half to shift it strait...

If yours was displaced, how did they move it back into the correct spot without surgery? Jc because you are the first person besides myself who I heard of not getting surgery on a displaced talus...
Ether way, id ask to be put in a removable cast and start aggressive pt while non weight bearing..

Caitlin Mac
I was in ER and everybody there told me that this fracture is life changing you need to have surgery done. But it was 4 days before Christmas and they decided to have the surgery 2 weeks later because they weren't a lot of doctors for all that week. They put the bone back together and I didn't feel anything because they put me to sleep. They schedule me for surgery 3 weeks after the day of accident. When I meet the doctor he said you are already late for surgery and don't have any chance to heal and he gave me a lot of chance that I would heel very well without surgery. 2 and a half month later no sign of healing only was well alignment. I had an appointment a week ago they did the x-ray and doctor was surprised the bone was starting to heel. He recommend me a bone stimulation because the talus bone had sing of avascular necrosis . Today is 3 months and a half from accident still one more month on cast with bone stimulation. I pray every day this bone is going to heel. I know with displaced talus you need surgery I was surprised when I read your story. Why they didn't do surgery to you? Keep me posted. I hope everything goes well for you I wish you the best. Gena

gena wrote:Caitlin Mac I displaced my talus dec 21 2015. I didn't have surgery and I am still in cast. The doctor decide to use a bone stimulation to help the bone healing. I heard that all displaced talus fracture need surgery. Finger crossed

So you did this in the future???

go see these folks... kerlanjobe.com/Approach/foo…

Guy,
Do you have direct experience with these guys recommended above? Why do you suggest them?

Gena,

Sorry my previous post was confusing, I was typing on my phone and auto correct changed my words... I edited it, so please re-read what I wrote above. Anyways, I completely understand what you are going through.. This injury is not a good one to have. My advice to you though is to go get a second opinion with a ANKLE/FOOT specialist. Do not got see a general ortho doctor. I made that mistake in the beginning. Even if you are seeing a ankle specialist, try to get a second opinion, Ive seen 4 doctors and every doctor has told me different things... The fist even told me that there was no way I displaced my talus and the doctors (in South Africa) set it back in place so perfectly (which by the way they did with no pain killer or anything in the hall way of the hospital! It was horribly painful).

Anyways Im currently looking for the best ankle surgeon in the USA before I operate because I feel I only have one more chance to save my foot, and I dont want to mess it up... Im sure you have heard that worst case they will fuse your ankle, meaning no more bending... Its worth it to get a second or third opinion to try to prevent that. Might I ask where you live/broke your talus?

Hi Caitlin,

I responded to your other thread as well, but just wanted to say I agree with Guy about Kerlan Jobe. They are one of the top notch medical groups out there for sports medicine.

My surgeon was Kenneth Jung and he was outstanding.

Good luck.

Jason

Guy,
Do you have direct experience with these guys recommended above? Why do you suggest them?

My insurance would not let me go to these people, but I have had 5 friends go there... for elbow and shoulder reconstruction. One was deemed "hopeless"- "you will need to learn how to get along without a working shoulder..." type deal. All of them are back climbing at the same or better then before.

These guys invented the TOMMY JOHN elbow surgery, and one of my friends said it was most comforting to meet Tom Brady in the waiting room...

Good luck with your foot, down time really sucks.

Hi Ole, I too broke my lateral process of talus . could you please share your recovery. I broke it Jan 2020. Doctor advised - let it heal naturally. Minimally displaced, nothing good is going to come with surgery.

Can you please share your recovery progress over the years? It would help my anxiety. Thank you. 

Wow, this is an old thread. I hope I can get some advice and feedback on the same topic. I also fractured my talus, Feb 22 this year (2020). Minimal displacement. I wore a cast for two months and now I'm in a boot, but still can't bear weight. I start physical therapy next week after three months no weight. I'm told it will be another 3 months until I'm 100%--no response to my questions about climbing. I've canceled my climbing trips for June and just hoping I can get on the rocks by July.

I would also be grateful to hear about your experiences recovering from a fractured talus, advice for rehab, and what your timelines for climbing were.

Tanya Bleu wrote: Wow, this is an old thread. I hope I can get some advice and feedback on the same topic. I also fractured my talus, Feb 22 this year (2020). Minimal displacement. I wore a cast for two months and now I'm in a boot, but still can't bear weight. I start physical therapy next week after three months no weight. I'm told it will be another 3 months until I'm 100%--no response to my questions about climbing. I've canceled my climbing trips for June and just hoping I can get on the rocks by July.

I would also be grateful to hear about your experiences recovering from a fractured talus, advice for rehab, and what your timelines for climbing were.

Tanya, you may find this thread helpful. A lot of recovery stories. I looked at this when I first found out my talus was broken (luckily the CT ended up showing that it was just chipped so I had very minimal recovery for talus fracture).

https://www.mountainproject.com/forum/topic/113950384/talus-fracture-and-partial-displacement-healing-advice-and-support

Skylar Williams wrote:

Tanya, you may find this thread helpful. A lot of recovery stories. I looked at this when I first found out my talus was broken (luckily the CT ended up showing that it was just chipped so I had very minimal recovery for talus fracture).

https://www.mountainproject.com/forum/topic/113950384/talus-fracture-and-partial-displacement-healing-advice-and-support

THANK YOU!