Talus fracture and partial displacement, healing advice and support

Aileen M wrote:

Hello! 

I just very recently broke the talus neck on my right ankle. By recently, I mean tomorrow will be 2 weeks since my fall. Me and my boyfriend had gone to San Diego to visit a different climbing gym and during this visit I fell off a bouldering wall. I was roughly 5-7 feet off the ground, and didn't panic as I slipped because I figured I would get right back up and try it again However, my foot hit a huge jug on my way down and I immediately felt the pain and my foot went numb. Looking back it was a terrifying experience and as passionate as I was about rock climbing, sometimes these past weeks even watching a rock climbing video makes me feel anxious. However, I am sure that will all pass. This happened roughly around 3:30pm on a Sunday and I was in surgery by 7am the very next morning for a Hawkins 2 talus fracture. I had 6 screws put in, and 2 plates. I went home just a couple hours after surgery and was told it was successful and to return in 2 weeks for a follow up. 

These past two weeks have been awful. I am filled with so much fear. I am scared that I will never be able to walk, run, or climb again. This fear consumes me, and I have spent every day since laying in fear and its so difficult to distract myself from those thoughts as I can hardly move. Reading other peoples stories here has helped me a lot and I am very grateful that you all have chosen to discuss your experiences. I will continue to document my progress as well in hopes that one day it will help someone else. I have attached an x ray of my ankle from before surgery. 

Hi Aileen.

I suffered a Hawkins Type 3 Talus fracture in 2008. I fell about 25 feet when I was very new to trad leading. It was my first lead fall. When I stopped falling I was hanging in the air, but like you, I hit a feature somewhere during the fall which caused the fracture. 

First off...It sounds like you have some nerve damage? So did I. If you cannot wiggle your toes on their own power, move them through the range of motion with your hand. No one told me that (and I was too distressed at the time to figure it out on my own) and my toes are contracted now. I can move them but they are permanently slightly bent. Moving them through their range of motion would have prevented that.

It was definitely a difficult recovery, but I was able to follow up 2000 feet of climbing in Yosemite less than 2 years after my fracture. It took me a little bit longer to lead again and I have had to overcome fear issues, but I am very happy with where I am at climbing-wise right now. I don't have full range of motion in that ankle but that is rarely an issue when climbing. I can't hike the distances I did before my fracture, but I have hiked as far as 13 miles in relative comfort. Running remains a bit of a challenge but it is not something I am passionate about so that is probably just because I have not put the work into it.

 Also, I had most of my hardware removed a little over a year after the fracture which really helped a lot.

I have an endless list of things I believe I did right and things I wish I did differently. I have a master's degree in nursing so being able to interpret research has really helped me develop a good knowledge base around this and joint health in general. It has also really helped me to accept what is while still constantly striving to physically improve. Please message me if you would like more information. I would love to help.

Aileen,
So sorry to hear - wishing you speedy recovery and better days ahead! I so hear you about anxiety and fear and not being able to watch climbing videos... I broke my talus neck last May, the same way that you did. I am still very much in recovery and the slowness of the process has been super frustrating - the foot hurts pretty much every day - but I can walk and hike very short distances, and while I do not feel like going back on the bouldering wall anytime soon, I've recently tried top-rope climbing on a very short belay. It felt secure and so, so good to be back on the wall again. Sending best wishes that you get back to doing outdoor things in a few short months.

For me it's been one day at a time process and I have to keep reminding myself to focus on how much things improve rather than what I still cannot do.

Once I moved into a CAM boot, I got the iWalk based on advice on this forum and have to say it was truly sanity-saving. I've also found that walking hurts way less if I do PT regularly (even though PT itself often hurts). And in addition to "regular" PT, I've also visited a climber-physical therapist, who gave me exercises to strengthen my ankle and foot and leg muscles, those have been super helpful in not only improving my ability to stand and walk, but also in building confidence.

Good luck!
Misha

Aileen,

Ditto what everyone else is saying. These injuries suck and feel pretty hopeless early on, but healing and recovery do come. I was climbing 5 months after my injury (with pain and limited ROM) but was just about 100% in a year. The I-walk crutch is definitely the way to go. 

Good luck! 

Sean

Aileen,  I did exactly what you did but Friday night and surgery on Saturday.  A year to the day after I was lucky enough to be bouldering in Fontainebleau, so recovery will happen.  Three years after the surgery I had the metal removed and I am pain-free without too much of a difference.

It takes a lot of time and hard work but you'll get there.  The first four months totally suck but listen to the medical professionals and don't rush your recovery.  By this time next year, you can be out hiking and climbing again.

Sorry to hear about your fall, Aileen. My fracture was somewhat different (I think dome is worse than neck) but I'm back to climbing now. Took me about 2 years before trying it again. At 3 years post-injury / 2.5 yrs post-surgery, I can generally walk without pain but like Valerie I can't really run and my range of motion is limited.

Question for the group - has anyone gotten a Monovisc (or other hyaluronic acid-type) injection? I recently got a new MRI, which showed that my talar dome cartilage has healed "kind of, but not really" (technical description). Doc is recommending we try this injection. I'm fine to do whatever before getting another surgery, but wondering if anyone else has experience with this and if it helped (and if so, for how long).

Thanks!

Fractured my talus in the end of October while bouldering. Same story as a lot of you, at first I was sent home, being told it was just a sprained ankle.

It seems I was lucky compared to a lot of you. There was no displacement, so no surgery was needed. I was in cast for 5,5 weeks and in a boot for 4,5 weeks, so 10 weeks total. 

These last few days after being allowed to walk in my own shoes again have been amazing, but the pain is worse now than it ever was. But I guess that is natural.

I did a lot to stay active while in cast and boot, and I dont really feel a huge problem with the muscles in the leg. But, I cannot lift my heal and stand on my toes/front of foot. My guess is that it's the muscles in the foot that are weak, but when I try I feel a sharp pain, and it does not feel like muscle soreness. Anyone else had this issue? How long time did it take before atleast that issue was back to normal?

I would highly recommend finding a PT person to help you get back into shape.  I'm four years post-accident and I still see a PT person after long hikes or heavy climbing trips.  They really know how things work and what's a great way to get back into shape.

Hi everyone, sharing my story to this thread which has been a super helpful resource throughout my ongoing recovery.

On Thanksgiving of 2022 I fell about 15 feet while bouldering and missed the pads, with my right ankle absorbing the entire impact of the fall. The result was a dislocated ankle, and comminuted fractures in my talus, lateral malleolus and medial malleolus. I was extremely lucky that there was an ER doc climbing on a nearby boulder who was able to reduce the dislocation and splint my ankle within minutes of the fall, and that we had cell service to call 911. Within about an hour of the fall I was in the Las Vegas trauma center, and in surgery the following morning. The first surgery was to place the ex fix, then 5 days later I had ORIF surgery to reconstruct the fragmented bones and install the internal hardware. I spent several more days in the hospital recovering from the surgeries, then was discharged with instructions to be non weight-bearing for 12 weeks. I have had several post op visits since then (just passed the 6 month mark) and will continue to be seen for at least 2 years to monitor the injury.

The hardest part of recovery was the first month or so. The pain was unlike anything I've ever been through, and was constant with spikes of much more intense pain. It was over a month before I could get any sleep at all without the aid of painkillers. One thing that was extremely helpful for comfort was building a mountain of pillows to support/elevate my leg at all times. Also trying to stay busy with anything to distract from the pain that I could do from a seated/reclined position helped a lot. 

After about 2 months the constant pain had subsided considerably, and I was almost completely off of any painkillers. A very helpful item during the NWB period was a knee scooter, as crutches have their limitations (as anyone who has used them is well aware). I was not aware of the iWalk leg crutch until later on, but I would have definitely considered if I had known about it. This was also the point that I started a hangboarding and upper body workout routine, which has been super helpful for maintaining my fitness as well as my sanity. I have never been very motivated to workout off the wall, but have actually found an appreciation for it over the past 4 months, and am stoked to be able to have some control over my climbing ability.

At 3 months I was cleared to begin WB in a walking boot and started PT. It was a slow process, but after about a month of progressing WB I was fully weighting my right foot. I still used the knee scooter in some situations for practicality, and crutches were helpful to help slowly add weight while getting back to walking. 

4 and a half months out I was able to walk 2 flat miles in my walking boot with trekking poles.

6 months out I am able to hike 2 miles in hiking shoes with trekking poles for stability. I have found that approach shoes or other stiff, stable shoes have been the best for getting used to walking again because of the support, as my calf (as well as quad/hamstring) is still quite weak after 3 months of NWB.

At this point I still have a noticeable limp and pain anytime I'm walking, but it is slowly getting better every day. My range of motion is severely decreased compared to my healthy ankle, and while progress has slowed on that front, I am still doing my daily PT exercises and believe that it is improving. My doc has given me the go ahead to do what feels right for me, and while I don't think bouldering will be in my near future, I am excited to get back outside.

As I mentioned, this thread was sometimes more helpful than talking to a specialist, my PT, or anyone in healthcare who hasn't been through this type of traumatic injury. I hope sharing my experience helps someone, and if anyone is dealing with a similar type of injury and has any questions please reach out!

P.S. If anyone happens to have been bouldering in Kraft on Thanksgiving 2022, or know who that ER doctor who helped me was, I would love to reach out to her and extend my gratitude for all she did. Also shout out to Dr Iain Elliott, the most caring surgeon I know!

Anyone have their sub-taylor joint fused?  Decrease in pain?  

Blakevan wrote:

Anyone have their sub-taylor joint fused?  Decrease in pain?  

I have a sub talar fusion...do not recommend. Makes crack climbing damn near impossible. I still do it but it sucks. 

Alec Vela wrote:

I’m about 6 months post op and 3 months walking on it. On days that I do PT, walk, exercise, etc. the following day (mainly immediately out of bed) sucks. I get these shocking pains on the outer ankle side and top of the talus that last a few minutes. They get better as the morning goes on, but still cause a slight limp.

Question: for those that have been here, how long does it take to get to a point where this is more mild and less frequent? 

The pain in the morning is worse during cold weather. I am considering a return visit to an ortho to see if the screws can be taken out. It may be a dumb or crazy idea but I would prefer not to deal with this pain for the rest of my life.

Blakevan wrote:

Anyone have their sub-taylor joint fused?  Decrease in pain?  

I have a subtalar fusion. It did decrease the pain that I was having from end-stage post-traumatic arthritis after a climbing fall December 2021. I had two surgeries. The first to put my calcaneus and talus back together best they could. The second was a subtalar fusion nine months later. Without the fusion I had about 200 steps in my foot before I couldn't bear weight. It was unpredictable when the pain would show up, so I couldn't be reliable on any type of adventure. For me, the fusion is a huge improvement, but I didn't have any other reasonable options. This was a salvage solution. It's a big decision. Fusion is a one-way ticket. I got five, second opinions before taking the plunge. I'm nine months out from the fusion and I'm back on skis (AT boots that open nice and wide) and hiking up to six miles. My limp has disappeared and I continue to make mobility gains. I don't really have any pain.

 

Thanks for the commentary Faith, I think I'll wait until I can't stand the pain.  I'm a few years from my accident and after some type of shot feeling pretty good again.

Beth, I had the metal removed last year and I can say it went from pain every day to no pain at all.  That's until the nasty arthritis showed up a few months ago.  I was full weight bearing the whole recovery from the removal and was back to total normal within a few weeks.  10/10 would totally have the metal removed again.   I actually think I gained some mobility as well.

Hi!

I am really happy that I found this chat.

It's been 30 days since I broke both talus while lead climbing. They operated only on the right one, so I can't walk.

Has anybody had a problem like mine? I am wondering how long it will take me to walk again. After the operation, doctors said 2 months for the left leg and 3-4 months for the right.

Any thoughts?

Thank you!

 

I would listen to the medical professionals and not rush the healing.  I was non-weight bearing for four months and then in PT for a total of ten months.  It's a serious injury and rushing it will only cause further problems.  Your body will determine when you can walk again so please give it time to heal.

Hello talus warriors,

I wanted to give an update of my broken talus January 2022. At start I really had a hard time to stay positive since I thought I would never be able to walk normally again.. today august 2023 almost 20 months later I can tell you it gets better. I don’t think about it as much even though I am very carefull when doing a hike.

Running at the gym hasn’t been on my list for months but slowly daring to run again.

My take aways  of this uneasy journey but believe me YOU WILL GET THERE ❤️:

- be patient  it does not happen in 6 months but rather 12 back to normal 

- Don’t be angry at yourself (I was at the beginning) it faded away by time and instead be compassionate to yourself.

- don’t google away just read what this group has to say it’s a great place to be

Hello iam Onejda(23 years old)

,so happy to read this because iam new in experiencing a broken talus fracture.

I had a car accident on 9 August ,i was with my fiance in greece for vacations and when we were going home after many hours trip we were off road.When i open my eyes i saw my ancle bone out of my left leg,it was an open fracture.

I had the first surgery at the nearest place and later they send me to another hospital to check in.The doctor said i will need another surgery to fix some things.On 14 august i had my second surgery where i had also an external fixator on my leg.The doc said maybe we can take off the external after 3 months if everything will go ok.

Now it has been 1 month and 8 days...iam very anxious and afraid how is going to go if iam going to have an avn..i hope not .It was a 4th degree break of the bone,it was very complicated and the doctors too said we will see how everything is going to be .

So tired in sleeping in the same position because the external fixator wont let me ,and i have had pain everyday and have kept my leg always over a pillow...

If u guys can suggest me something ,please i would love too and in the same time i need it.Wish you guys the best recovery.

I broke my Talus May 2019. My surgeon originally told me I had a life-changing injury. I wouldn’t go back to work. I wouldn’t ride a bike, if I was able to walk it would be with a cane. I had a really hard time staying positive. It took me a year to recover. But now I’m back to most things. The only thing I can’t do is run. day-to-day, I’m fine with no pain at all. I get most of my cardio from mountain biking now, and I’m able to do multi day backpacking trips. I can do up to 15 km a day. The next morning I’m pretty sore and limping but once I get moving the pain goes away. So despite what you’re told there is hope.

Fractured my talus in the first week of January of 2018: minimally displaced acute osteochondral fracture of posterior margin of lateral talar dome; chronic fracture fragment at anterior process of calcaneus.

Had recommendations from 2 surgeons and medical doctor to get surgery, but that the surgery wouldn’t be straightforward, so I procrastinated it and was constantly wondering if I should or not.

By late May that year I was still feeling really doomed and distraught as there was still pain and my activities were limited. From my records, looks like I didn’t top rope until end of May. I was second guessing myself and my decision not to have surgery constantly.

I remember going to Wild Iris that June or July and having to project a weird 10a, I think it was my first lead post-injury.

It was a long process, short in comparison to some others. My ankle / foot would be extremely stiff in the mornings and stiff and swollen from hiking/approaching for at least another year, maybe 2. Never had surgery. And whatever fragment of bone never unionized. It’s probably still floating in there and worn down a lot. Very rarely I feel something icky in there - like something has moved, and then the feeling goes away.

Luckily I've recovered to still be able to do what I love. I'm climbing, running distance, and have done plenty of 20+ mile days in the mountains. Sometimes I will be really stiff after these activities, sometimes not. I rarely do long slab climbs anymore, and don't multi-pitch anymore. Partly because of my ankle but mostly other foot issues. I have never had good dorsiflexion and that hasn’t changed, and my foot makes all kinds of crazy sounds, but I couldn’t even remember which ankle I had hurt when I was thinking about it a few weeks ago. At the time though it was hard not to imagine the worst. Depending on the day I still limp out of my chair after sitting for awhile or in the mornings getting out bed, I have wooden ankles. I don't know why sometimes I have pretty intense stiffness and other times, none. 

Really empathize with anyone dealing with this injury or any others. It is a really difficult process. I remember reading this thread back when I was dealing with my talus and it was comforting, so thought I would share my story.

I didn’t use it in my healing process, but I urge you to look into BPC-157, a peptide that we naturally produce very small amounts of, that helps us heal. You can buy it online. I’ve taken it orally and injected. I first heard of it when my biohacker sorta bro-sciencey former boss told me about it. My biochem PhD partner looked into it and decided to try it when he ruptured his A2 a few years ago and still swears by it today (took it again for another pulley rupture).

Blakevan wrote:

I would listen to the medical professionals and not rush the healing.  I was non-weight bearing for four months and then in PT for a total of ten months.  It's a serious injury and rushing it will only cause further problems.  Your body will determine when you can walk again so please give it time to heal.

Thank you. It is so important to listen to your body. I am so grateful that I was resting for the first three months, and now I am already walking with a boot. Soon, I will be able to walk with shoes again.

Pain is still here, and I have to live day by day. There has been a lot of distress. If I can offer you one piece of advice: rest a lot and don't feel like you have to do too much. It's a process that you have to go through, and you will probably encounter many fears, but you will come out of it so much stronger.