Talus fracture and partial displacement, healing advice and support

Paul Hutton wrote:

Just did this number a few days ago. My first ankle fracture, so, no wisdom for ya! But, I've had many injuries in the past that involves fractures in other places. I've never really had such a bad recovery that I haven't been able to move as well as I wanted, or get as strong as what I worked for. The human body can accomplish so much! Tenacity is key!

Just now realizing that 6 months have elapsed as of 9-03. I've been climbing around on silly things lately. Still not quite confident enough to go throwing friction stems and drop knees at the local gym. My Achilles tendon shows calcification in x-rays--the doc said it can possibly rupture if I work it too hard. Can't support my whole body weight on my toes when going up stairs. I'm very antsy to tie in and get some exposure, and I love having the fire for this still! I've been climbing since 2011 and have accomplished so many different things on the rock, and climbing has influenced my personal conduct and decision making in great ways over the years! I hope to make an epic comeback, but more importantly, enjoy the experience as more than just getting really strong. To take a step back when I'm rushing to take action on something I'm super psyched on. Preparation is key. I was practicing jumaring on an I-beam in a warehouse a few days ago, and was constantly thinking about my accident. I was very present in what I was doing and executed everything and kept my cool perfectly! Hope this helps others that are struggling stay positive and stay on track!

Tiffany Richard wrote: I came across this thread looking for information on the recovery process. I'm 8weeks out of surgery with 2 screws. I fractured my talus vertical with some displacement and had a few chipped bone fragments removed. I'm having some concerns with the pain I'm having and was wondering if anyone else has experienced this.

When I injured my ankle it felt like my foot wasn't attached to my leg. After surgery I noticed early on that the top outer side of my ankle had alot of pain. That pain has not improved at all. I have a very unstable feeling when there's no support on it. The best way to describe it is, it feels like it's dislocated. I have no control over my ankle movement. It kinda hangs there at least that's the feeling. I'm also having sharp pain in my heel. It intensifies when I rest my foot on a flat surface. I have 4 more weeks till my CT scan to see if I can put weight on it. Has anyone else experienced this feeling? I'm wondering if its normal or if something isn't aligned right.

These are the x-ray done by the hospital.

Tiffany, sounds a lot like my post op course.  I had a subtalar dislocation, talar dome and calcaneus fracture fixed with 3 screws after a lead fall back in May.  During my 6 weeks of non-weight bearing, my ankle movements were awkward and my calf and foot ached like crazy.  My doc said the awkward movements/pain had to do with muscle atrophy and inflammation, and persisted until these last few weeks as my muscles have rebuilt.  I’m currently dealing with some plantar fasciitis due to over training, but i’m back in the gym climbing and leading easy stuff.  Again talk to your doctor about what you’re going through, they might want to get an x-ray to verify placement.  Best of luck and hang in there!

I made it to the top of the Flat Irons this weekend via the trail!  It's been a very long road to recovery and I still have issues but at least I can get out and do my soul some good.  It felt great to be outside and just watching people on the face had me excited to climb again.

Thanks Sarah and everyone. I just broke my talus bone climbing (lead fall, hit a ledge) in far away Turkey three weeks ago. I had emergency surgery that day and a week in hospital with IV antibiotics (open fracture). We are back home in BC now and reality is setting in. I was just fishing for recovery times and outcomes and it helps to have some realistic recovery goals. My fall cut short our one year family climbing trip only four months in. We were having so much fun and I feel guilty to have f*%$#^d it up for my wife and son. I am trying to get motivated to get some exercise and get the blood flowing but the couch is feeling too good. Just patiently trying to see where this bump in the road will take me. Right now I am gonna pick up my guitar. Heal well warriors. Spark

Sparky Steeves wrote: Thanks Sarah and everyone. I just broke my talus bone climbing (lead fall, hit a ledge) in far away Turkey three weeks ago. I had emergency surgery that day and a week in hospital with IV antibiotics (open fracture). We are back home in BC now and reality is setting in. I was just fishing for recovery times and outcomes and it helps to have some realistic recovery goals. My fall cut short our one year family climbing trip only four months in. We were having so much fun and I feel guilty to have f*%$#^d it up for my wife and son. I am trying to get motivated to get some exercise and get the blood flowing but the couch is feeling too good. Just patiently trying to see where this bump in the road will take me. Right now I am gonna pick up my guitar. Heal well warriors. Spark

Really sorry to hear about the bad luck Steve.  The good news is I think you could pick the trip up where you left off next year, depending on how motivated you can stay with training!  The couch feels good, but be wary that every day you arent weight bearing, your leg and ankle are going to start to degrade.  As someone who just hit the 7 month post op mark, I wish I had been more motivated to train anything else I possibly could while I waited to heal.  Im pretty behind the ball now, and just getting back to top roping 5.8 in the gym where I was leading 5.11 prior to my injury (shattered talar neck snowboarding 03/19)  Over compensate as much as you can with core and upper body training, because it will be pretty much all you have when you get back.

Bone supplements seemed to help me, as well as dry needling and accupuncture, so recommend that for swelling and inflammation.  Otherwise, keep your family informed, keep planning for next year, and you will be ready to go next season.  Hopefully you had a good surgeon/surgery, and just make sure to hit the PT as hard as you can pjhysically tolerate.  Dont waste time getting ahead of mobility and reducing the scar tissue as much as you can. I think you can safely assume 6 months to full heal, at which point you should be able to trust the bone to be as strong as it would have before.  Im not sure if there is more pevelancy to re-injure it if youve already done so once, but my x-rays all show a full heal, with no signs of weakeness.  I just got back to bouldering and am getting confident with 5-6 foot drops right now, just working it back up to 15's.  But, as far as I can tell, as long as I dont impact it again in a way that would break the bone anyway, Im not going to re break it just by landing, etc.

Good luck!

Hey guys, wanted to share my story and hope it helps.
September 15th I was in a car accident, I fell asleep while on my way home from work. I wasnt found till the next day and then taken to the ER. I had shattered my talus and needed surgery.
September 17th (also my 29th birthday) at 5 am I was prepped for surgery and going to get 7 screws and 2 plates put into my right ankle. I had spent the day before talking to doctors, hearing how I would not be able to walk the way i always have, and how it would take years to heal.
I was in surgery for most of the day, and waking up was a challenge. I learned how to walk on crutches, and was sent home. I only remember 3 days at the hospital but my mom says I was there for over a week.
I got home, and for a the first few days I stayed on the couch and thought about all the things that I wouldn't be able to do again. A week after getting home I started to noce my toes as much as I could, and moving my ankle in the cast.
My first month appointment I got put in a walking boot, it was hard seeing all the staples in my ankle and the incision. I knew I would walk again and I made a plan. After I got home I regularly took my boot off to move my ankle as much as I could, just not to the point that it hurt. By the 2nd month I had pushed my self to the point that I was walking without crutches.
By the 3rd month check up came I was walking in regular shoes.
I know this is extremely rare, but when I was healing I read stories of how long it took others to heal and I wanted to share mine.
Work on it!! Keep pushing, it will get stronger, I couldn't even walk a year ago and today I went on a 12 mile hike and climb with no pain. Only time it hurts is in the morning and when the weather changes.
Stay focused and work!!! It really does pay off :)

I am 4 months post injury.  I fell backwards off a curb and somehow ended up with a subtalor dislocation and a fractured talus.  Had a few procedures including a bunch of metal put in and was in the hospital for 9 days followed by 6 weeks non weight bearing.  Lots of worry about compartment syndrome, blood clots and infections but none materialized.  I started PT Oct 12 and was completely unable to walk.  Pain was unbearable and my foot had no feeling in it.  Within 6 weeks I was back to work, still using a cane.  And about three weeks ago I stopped using the cane.  It hurts on rocky terrain, better with certain shoes than others and walking barefoot is awful.  Hang in there, it's a complex injury and the healing process is tough.

Hi guys,

I'm now six months post op (I shattered my ankle after I missed the pad bouldering and had a lot of fragments of the centre of my talus removed, dislocation fixed with two pins). The ankle's a bit bigger than the good one but not by a huge margin.
My range of motion is almost as good as it was, except inwards (attempting to get the soles of each foot to touch). I've been top roping for 5 or so weeks and just been given the clearance to do steep leading with safe/small fall potential. No bouldering for a few more months I think. And I think it's for the best I avoid trad for the minute. 

I've also been cleared to hike but I find on very uneven terrain is too difficult for it at the moment because I can barely walk on it after an 8 or so mile hike. I think it just needs the practice to the uneven trails though. I can't run or jump on one foot yet but I think it's coming soon.

It's very exciting to feel like I'm on the way back to normal :)

Been watching this thread for the past few weeks and figured I’d jump on in.
Currently 4 weeks post injury and 2.5 weeks post op for talar neck fracture and dislocated subtalar joint.  Docs never told me my classification but after researching it looks like a Hawkins II as the tibiotalar joint stayed intact.
My injury was from snowboarding but not the typical hard landing from a jump; I was riding in the trees when I slid out on some logs under the snow.  Unfortunately I slid feet first into a tree, taking most of the impact on my right foot.  My left binding snapped clean off the board while my right stayed strapped in so there was some twisting involved as well. Pain was sharp at the time of injury but not excruciating.  After getting a sleigh ride down the mountain from ski patrol they removed my boot which hurt a lot but same as the initial impact, it subsided shortly after. Don’t get me wrong it still hurt, but it wasn’t unbearable.
Went to an urgent care for X-rays that evening and was told it “looked broken” but they couldn’t be certain. Had a follow up with an ortho PA the following day who said it was definitely broken and ordered a CT scan to better see the damage. CT came back worse than expected and after meeting with the surgeon surgery was scheduled for the day after Christmas. 
The surgery went well from all accounts. 6 screws, 1 plate and almost 3 hours later I was sent home in a hefty splint.  They we’re anticipating having to do a bone graft with cadaver bone but didn’t end up needing to, so that’s a positive. I opted for the nerve block ahead of surgery which kept my entire leg numb from the knee down for about 24 hours after surgery.  This helped me get home, comfortable in bed, and get some food in me before the worst came. About 30 hours after surgery the nerve block began to wear off and pretty quickly. For the next 12 hours it felt as if someone was steamrolling my ankle, but once I got the meds ahead of the pain it almost totally stopped.  I took small oxys (5mg) for maybe 3-4 days, then Tylenol for another few days after that. I haven’t needed any pain meds for a least a week and a half. I have been told throughout this that I have a very high threshold for pain so don’t be alarmed if you’re hurting worse or longer than I was post op. I did almost fall over one day maybe 3 days post op and instinctively put a bit of weight on my foot. It actually didn’t hurt at all but was very alarming and worrying. 
At 1 week post op they removed my splint, took another round of X-rays, which looked very good, and put me in a hard cast.
At 2 weeks post op they removed the first cast, and removed all the staples from my incisions (one down the right side and one on the left but more centered).  That didn’t feel great but being put back in a cast without the staples to push into my skin was much better than before. I didn’t count but I had at least 10 staples on each side, likely more on the outside where the incision is longer.
I still have some swelling in the ankle area as well as the foot; I fractured my cuboid as well so the foot swelling makes sense.  I have all feeling back in my foot except the tops of my 4th and pinky toes and a bit of the top of the foot in that same general area.  This is likely due to either the swelling near my cuboid or damaged nerves from the surgery.  Pre op I had full feeling in my entire foot so this makes me think nerve damage, which my ortho think will resolve in time. 
And so here I sit playing the waiting game, which is arguable the hardest part. Unanswered questions, uncertain timelines, tons of pow that I can only dream about riding; but I’ve become very focused on doing whatever is needed to achieve maximum recovery. I have begun an anti inflammatory diet, cutting out booze, red meat, fried foods, and limiting bread, cheese, and anything processed.  In the 4 weeks I’ve been non weight bearing I’ve actually lost weight so the diet is working in that regard at least. This week I started back in the gym with mainly upper body and non weight bearing strengthening exercises for my bad leg to try and retain any muscle I can (leg lifts in all directions, and some glute work). One bit of cardio I have found is single leg rowing. I put my right foot up on an exercise ball and row with my left foot only.  Short spurts of 1000m is enough to get the heart pumping without spending too much time with my right leg straight (begins to tire the hip flexor if done for too long).  My gym also has a SkiRG which I can do seated for some extra cardio if needed. Getting back moving around even in my limited ways feels very good both physically and mentally.  
Mobility wise, I have the full arsenal. For about 4 days post op I was relegated to crutches only.  I wasn’t moving around much at that point anyway so it wasn’t too bad.  Was cleared to use to knee scooter (conservatively) after that. And after about 1 week I was using my iWalk pretty regularly (almost exclusively now). The iWalk is really a godsend for me; being able to use my hands to carry things is a game changer especially around the house (laundry, cooking, dishes, etc.) and using my right leg when walking with it helps keep some muscles in my quad and glute. 
I got my injury snowboarding and that’s no coincidence.  Pre injury I was a very heavy rider. In 2019 I snowboarded every month of the year and since moving to Colorado 5 years ago there hasn’t been a winter season under 35 ski days for me. Last season I began splitboarding and riding backcountry which was a revelation for me. I’ve never been so happy walking up a hill in snow, seeing remote areas of mountains I’ve never laid eyes on before; the untouched ride down helps with motivation a bit :) Summers are usually filled with hiking backpacking and fishing alpine lakes and streams above 10k so my mobility and stamina are probably the 2 physical attributes most important to me.  
Thus, I am very worried that this all could be taken away from me.  After reading countless experience stories and researching way more than I should, I feel like the positive outcomes are more abundant than the negatives, but I still worry that I may never be able to skin up a mountain, ride down, hike 10 miles up 3000’ elevation gain to reach my hidden cutthroat lakes, or enjoy backpacking like I used to.  In fact, so much of who I am (or was) is wrapped up in those activities that I’ve had a really rough time being grounded the past month. While scary and downright depressing at times, this undoubtedly fuels my focus and determination to put all I have into my recovery.  
The ortho PA who has been managing my post op treatment seems incredibly positive; says my talus fix and joint reduction both look very good; when I ask about AVN she nearly scoffs and says I’m young (31) and have great blood supply and that I shouldn’t worry about it; and seems very hopeful that at my 6 week follow up appointment I will be put in a walking boot and cleared for at least some weight bearing.  Part of me wants to believe her totally, while another part of me is skeptical and will “believe it when I see it” or don’t see it in the case of AVN.  
So that’s my story up to this point. Fingers crossed for a smooth road going forward. I know I’m still just starting down this long road that is talus recovery but hoping that improvements will continue to come with the effort, focus, and determination put towards it.

I had the same talus fracture and 6 weeks after plate and screws installed started a month of PT and then climbing...was physically weak but after a couple months it was as if I’d never had the accident (other than I was a bit more careful) and strong as ever...I’ve never felt any doubt of the strength of the fix...

donaldm wrote: I had the same talus fracture and 6 weeks after plate and screws installed started a month of PT and then climbing...was physically weak but after a couple months it was as if I’d never had the accident (other than I was a bit more careful) and strong as ever...I’ve never felt any doubt of the strength of the fix...

I wana be like you Donald!! Fingers crossed for a similar experience. 

Artem Vasilyev wrote:

Holy fucking shit! Pardon my french, but holy fucking shit! 

Are you okay!?

I'm alright bud, i had yesterday my last check with the specialist (2 and a half years after the 2nd op) and i was finally discharged from their service. I am in their eyes officially healed and free of any issue worth following up in the short/medium term. I have come back fully into my sport (bmx racing) and been doing everything I need to for my training (squats, plyometrics, single leg squats, single leg box jumps...you name it) and i have no issues at all (i've been british champion in my age group since then). Yes I won't lie and must admit my range of movement only reached 90-95% but it is enough for what I need. Also the balance is noticeably less solid than with the non-injured leg but nothing alarming.

Getting up in the morning and jump out of bed is a distant memory as nowadays i need like 10 secs of standing up until the blood flow "wakes up" my ankle and then i can walk on it normally otherwise it could be painful. That's pretty much it. Like loads of people said in here, the more you do to improve healing the better chances that you will come back to normal. I was doing push ups, planks and abs on the 4th day post operation to provide blood supply. I was told "your injury is Hawkins IV or beyond and there are 90% chances that blood supply won't be re-established and that you will lose that bone" to which i thought "f**k it, we will give this body some blood supply". Just keep doing all you can, sleep a lot and eat well, the body will behave as expected then. Good luck people and stay strong! 

Hello everyone!
it’s awesome to see a forum out here with other people who’ve experienced this crazy fracture. My best wishes to everyone and his/her recovery.
So..I fractured my talus last July while tumbling during a gymnastics session. I went to the ED right away and had a CT done and they found a lateral process talus fracture. I was temporarily casted and went to the orthopedic surgeon the next week and got put on the schedule for an ORIF. I had my surgery and was told to be non weight bearing for at least 12 weeks!! I could have died, just knowing I was going to be off work for that long and just dependent of other people to get through day to day life. Anyways, I made it through the treacherous 16 week period that it ended up being of not being weight bearing in the aircast to actually being able to gradually wean applying weight onto my foot. This process took about a month to fully be able to alternate feet in the boot. Following the X-ray in October, I got the clear to start walking on it normally with the help of an ASOS brace. A few weeks later, after a very long time off work as an ICU nurse, I returned back to work.

Basically every morning I dread having to make the first few steps because they will either be painful or just very wobbly until I walk on it for a few minutes. So after I work my first, second, and third 12 hour shift, the pain felt in the mornings becomes more and more intense and throughout the day I’m withstanding the discomfort as I’m taking care of critically ill patients and kind of sweeping my own concerns under the rug. It’s only after the shift is over and I return home to take off my shoes where I feel immense tightness and pain until I soak/ice/elevate it for a few hours.

So It’s February now and I’m 7 months post-op and 3 months from being completely out of the boot and I’m seeing some progression in my abilities, like I lightly jog and squat and turn on it but I’m still finding myself having these moments where after just a couple hours of sitting down studying, I go to stand up and it feels like it does in the morning time where I have to warm it back up. Also, I’m still finding it hard to find that bounce in my foot that helps in allowing me to walk smooth and go up and down stairs. I know this one hell of an injury but it just seems like it’s taking forever to feel somewhat normal again.

Does anyone out there have any suggestions? I’m considering going back to physical therapy although it seemed that I had mastered all the basic ankle rehab exercises according to the therapist.

Thanks for any feedback! 

Hey Sammy,

Sounds like your injury was pretty similar to mine. It's been about 14 months for me, and the ankle still sucks a bit, but even this far out it continues to improve. I have a pretty sedentary job, but after a day of hiking or climbing things still get a bit painful for the 24-48 hours after. During this time I can "warm it up" and be totally fine walking around, but stairs or fancy footwork aren't as fun. I have a little routine of gradually weighting the ankle in the morning while sitting and then standing, but the first couple steps do still suck. But this is all noticeably not quite as bad as it was 2 months ago.

Checking in with a PT doesn't seem like a bad idea. If I weren't so cheap I would definitely do that. My balance and strength are pretty decent now, but I feel like I'm floundering a bit trying to get back the last 10% or so.

Sarah Trudeau wrote:

Hey mountain project community,

I fell on a lead climb nearing 4 weeks ago now, hitting a ledge and fracturing, partially displacing my talus bone. I underwent surgery 8 days ago, where they placed two screws and a plate. Maintaining strength in a positive mindset and the motivation towards healing. And erring on the side of optimism and luck that I'll reach a fully recovery, with little to no lasting pain throughout my future. Mentally I've taken on channeling my active energy towards other means of productivity, i.e. I've made a copious amount of beanies. :P

Understanding this injury is very serious, the healing that follows is also taken as such. I've been focusing on making all efforts towards a successful recovery. Rest, water, stretches for tightening muscles, massaging for clotting and nerves, gentle exercises to keep abs/back strong, and a very strict, balanced diet. I will be casted in a week (4 weeks in a cast), and then PT, which will also be taken diligently to the full extent. 

Fully accepted and prepared for a long road ahead (6month-1year+). Such is the beauty of life, the challenges we face, make us stronger and wiser to carry us into the next.

Anyone else sustained a similar injury? Recommendations? Words of encouragement that I will be able to return to climbing/running/snowboarding? 

I have no expectations for my recovery, just the will to keep me heading towards an optimistic outcome. 

Much joy and play amongst the mountains everyone! 

Kindly,

Sarah

I broke and fractured my talus in a car accident in 2005. Ended up with a few pins and a band. The doctor told me if it had been any worse he would of had to fuse my ankle bones and I would have no range of motion. I was down for a little over 12 weeks after surgery on crutches and then a boot for 3 weeks after. I was supposed to do a minimum of 3 months physical therapy twice a week I being in my early 20's and thinking I was smart stopped going after 2/3 weeks. So now 15 years later I walk weird no so much a limp but definitely noticable. I have never ending pain and constant swelling. I can move my foot left and right but up and down is a struggle. Stairs are taken one step at a time and not alternating as most people do. Uneven ground is terrifying and slow moving. There's no speed to me at all...imagine a little old lady with a walker slow. Mostly though it's the pain that's a real struggle. Make sure you take your physical therapy serious

It's been almost a year since my talar dislocation. I've been working a job that involves looking for unexploded ordnance on what used to be a desert training range for the air Force in the Sonoran Desert. 7 miles a day, and subject to all kinds of terrain. It's been a challenge every day, for the past 3 months. My climbing is definitely getting better–I was projecting a gym 5.13 on Saturday. Still sore and stiff first thing in the morning. I haven't made a climbing gear error during my recovery! Emphasize acknowledgement of the tie in knot, enjoy the climbing! I've taken several lead falls now–not a scratch. I went to see a doctor since moving from MO to AZ. They say my skeletal structure looks fine. Just that arthritis is remarkable. And they see the limited range of motion with pain. They've recommended a cortisone injection. An MRI has been ordered, before anything goes further

I celebrated my one year anniversary by flying to Paris and then enjoying a few days in Amsterdam.  Actually a work trip but walking on the darn cobblestone streets was painful at times but happy to hit a milestone.  Went climbing outside for the first time since the accident and lead an 11a but not clean.  Scared the poo out of myself on an 11c and had a terrible second day but at least I was outside and enjoying the fresh air.  Met a dude that had a very similar injury from a fall on top rope solo.  He's younger and stronger but neither of us can run so good folks to hike in bear country with.  Those on the beginning of this journey hang tough it gets better.

Blakevan wrote: I celebrated my one year anniversary by flying to Paris and then enjoying a few days in Amsterdam.  Actually a work trip but walking on the darn cobblestone streets was painful at times but happy to hit a milestone.  Went climbing outside for the first time since the accident and lead an 11a but not clean.  Scared the poo out of myself on an 11c and had a terrible second day but at least I was outside and enjoying the fresh air.  Meet a dude that had a very similar injury from a fall on top rope solo.  He's younger and stronger but neither of us can run so good folks to hike in bear country with.  Those on the beginning of this journey hang tough it gets better.

How do you hurt yourself while TR soloing??

I think his anchor knot didn't hold on the first draw but not sure.  I didn't completely understand his set up as I don't TRS.

Hi,

I race motocross professionally, & unfortunately came short on a jump almost 3 weeks ago. I dislocated my ankle, shattered my Talus & Broke my cuneiform in 3 spots. Underwent surgery 2 weeks ago. I received a plate & 8 screws to piece my Talus back together.
I am currently in a moon boot, and will be getting stitches out in 2 days! I am wondering if anyone can help out who have had an injury like this to when I could potentially be able to walk on it and begin therapy! I have commitments to be back on the bike so I will be pushing to do whatever it takes to make the recovery time as short as possible. Below is my fracture & post surgery images.would love to hear your guys thoughts
thanks