Talus fracture and partial displacement, healing advice and support

Hi Inga! Did you have any sort of surgery? At 2mm of displacement I believe surgery is generally indicated. My displacement was <1mm so they didn’t do the ORIF but I did get a surgical OCD repair of the talar dome.

How do you know how much displacement you have?  After four months I was pushed off by the trauma surgeon onto an orthopedic and stopped seeing him after a year.  I was supposed to schedule a follow-up but honestly, I didn't see a need since I was doing better.  I doubt I would let them take out the hardware and other than limited movement and daily pain I have a pretty normal life.

Hi Inga,

I update my story a bit... Last time when I see my doctor (2021-02-25), He said that the signal intensity of the AVN is the same as the signal intensity of the sorrunding area. (but I do not know how the TR and TE value affect the colors on MRI, I need to mention the settings of these value on MRI was different, so I am still worried about the pain i going to feel if i can start walking on it. My ROM is improved as well. I have PT almost every day and I use a stationary bike (3km / day; 20-23 km/h speed). See the pics below. Sometimes I feel indefinite small "feelings" (i say it because it is not really pain. mostly I may find a tendon which was neglegted) in my foot, and sometimes it became red, but these pains goes away in a few days and others comes. Though I am non-weight-bearing since 2020-08-26 (so now more than 7 months), I feel all in all my foot looks better and moves better. My doctor says we try to close this non-weight-bearing section at the end of may (at the 9 months line) if the MRI / X-ray do not shows new problem. 

ROM video:

https://drive.google.com/file/d/1jdT4Ogd9pCkuGTxrizZRKr2Wt77V1lBi/view?usp=sharing

ROM - 2021 januar 9: (90-76 deg = 14 deg)

ROM - 2021 marcius 26: (90-62 deg = 28 deg)

There are some pictures of my talus AVN in my last MRI: /if the pics are too small you can check them on the inserted link too/

Axial - 2021-02-25 - drive.google.com/file/d/1XK…

Coronal - 2021-02-25 - drive.google.com/file/d/1ww…

Saggital - 2021-02-25 - drive.google.com/file/d/1ym…

I would be happy to hear about your improves. Maybe at you 6th or 8th line! :)

Hi Blakevan,

You can check the alignment on your first CT scan. In the CT software usually have a ruler like these

Everybody

I read an article which says there is a chance that 9+ months non weight bearing can bring good outcomes with AVN talus injury: AVN conservative management outcomes according to some studies: (do anybody have experience? how does it feel walking with a talus AVN?)

source: Management Options in Avascular Necrosis of Talus (nih.gov)  

If anybody can send pictures (CT, MRI, X-ray) about his/her talus AVN progress it would be a good chance to compare each others pictures.

If anybody has any question, would like to share story, or just talk about his/her injury, feel free to PM me. 

Marcell

Inga Hjaltadottir wrote:

Hi

I’m 4,5 months into a very similar talar fracture (signs of AVN in talar dome and a 1-2 mm misalignment - fissures crisscrossing the talus and a more prominent fissure line going up through the middle). MRI showed signs of AVN after 8 weeks - blood thinners from then on - weight bearing after 14 weeks and free of crutches now (16,5 weeks from fall). Range of motion is pretty good and I am using the rowing machine and my trainer again - I’ve been told to be patient - no skiing or long hiking days or climbing until at least 6 months post fracture - and to pace myself based on how tired the ankle gets and how much pain I feel. And that I will have to see how this develops - for the next 6-8 months at least. Trying to keep a level head under the circumstances to varying degrees of success... 

PT helps a lot I feel but am very worried as to how much accumulated weight I can but on the ankle per day - how much to rest / use the crutches.

So happy to have found this thread - finally.

I broken my talus and gave myself a high ankle sprain almost 4 weeks ago. Walking down steps I turned around to say something to the person behind me and missed the last step instead of my foot twisting sideways it went inwards.  I know its only 4 weeks in but I dont feel like its healing at all.  My ankle is still tender but my foot seems to be as bad as day 1. I currently wear a air cast. Im glad I didnt need surgery but im afraid when I go back to ortho in 2 weeks he may suggest it

+1 for broken talus experience; mine was a lateral process fracture re-attached with 2 screws. 6 months post surgery, my ankle still has limited dorsiflexion and plantar flexion. Due to this limited mobility I still cannot run, but I can hike on difficult terrain and for long distances. In the gym, I can do lunges, squats (with a heel lift to improve squat depth) and deadlifts. I just went back to physical therapy for a second round to improve my ankle and increase strength and mobility for athletics. It will likely take a least a year for the ankle to remodel itself and feel normal again (TBD).

I broke the talus on a lead fall where I pulled a hold off the wall and got turned sideways, then hit the wall at a sideways angle. This has been a huge scare in regards to long term mobility, so returning to climbing is not worth it to me.

Hi I fractured my talus Aug 2019. It's June 2021 and I still have significant swelling after doing more than 10,000 steps a day. However I did all my therapy and all my stretching but I feel that I will have life long complications. I'm doing my best not to let this injury define my life. I hike on my good days..I can't run any more but I bike and swim for cardio... im just now getting to a point where fitness can resume.  I put on 70 lbs agree l after the injury simply cause I couldn't do what I used to... im icing it as I type because I feel I have arthritis as well. I will be making a Dr appt to make sure everything is good. I do have more good days than bad. But those bad days can be 2-4 days long at a time. This picture is after surgery and stitches out. 

One year post-op check in…

Figured I’d give an update now that I’m a year out! Talar dome fracture, <1mm displacement, OCD repair (not ORIF) at five months post-injury (misdiagnosed as a sprain initially).

I still have mild swelling, my strength is at maybe 95%, my ankle feels “tight” (Achilles and hamstring too), and some positions are painful (squatting in particular). My Morton’s neuroma has also flared up in that foot, I’m guessing due to some change in my gait.

Functionally, I can do most stuff - walk and hike but not run, and I could probably climb but haven’t tried yet. My insurance only paid for 4 months of PT and I wasn’t great about doing it on my own, so I think some of my slow progress is my own fault.

All in all I’m optimistic this will continue to improve, but I think I’ll be stuck with some degree of tightness forever. My goal is to participate in a 5k by November (Turkey Trot).

In talar solidarity,

Samantha

ok, an annual check-up revealed that a screw is broken and backing out and I can actually feel it through the skin.   Doc says it needs to come out so has anyone had their hardware removed?  If so quick and easy with a short recovery or stall and delay as long as possible?

Quick and easy. I was weight bearing the next day and climbing immediately after the staples were removed.

@blakevan - I had my hardware out two years post injury, and it improved the pain quite substantially. It did not improve my ROM. While they are in there they can always clean out scar tissue too. My recovery was a month or so because they took out 10 screws and two plates. It was worth it. 

Thanks, guys, they're only taking out one side so sounds like it will be easy than my wisdom teeth.

Hey, 

I went through a similar accident as you. Mine wasn’t on lead but actually in the climbing gym :( my accident lead to me fracturing my talus bone, and complete tears in my ATFL and CFL in my right ankle. I was back climbing 5ish months after surgery. I was very careful with doing PT everyday and not overdoing it. I feel as if my ankle that has 6 screws in it is actually stronger then the non injured ankle now! Best of luck and keep the positive mindset that only lets the body hea lfaster!

Cheers,

Greg

Hi all! 

Im so glad reading all of your stories. Eh, not glad like that but glad to hear how well i Talus fracture  eventually can heal. 

One week ago I fell like two steps from our staircase. It was early morning, I didnt want to wake the kids so kept.the light of. I didnt see when the staircase ended so I let my foot down and twisted it. First thing I thought it was only a twist (have done it before on the same foot). It was painful but not THAT painful. I walked (limped) on it for two days until I got to the ER (because it was more swollen and on both sides I got recommended going there). After a long wait and 2 X-rays, the doctor told me it was an fracture on the Talus and I should come back the next morning to get plaster. I can not bare weight on the foot and I think that hurts me the most. We have stairs and my left leg is to weak to jump them.up, so I need to like bump on my ass up to the second floor. But maybe I will get strong arms from it

Three days post-surgery from the removal of hardware and so far so good.  I can put full weight on it but still tender so hoping for a full recovery after they remove the stitches. 

first of all what a great platform this is. :) Glad I found it. thank you to all to share your experiences concerning a talus fracture. 

I am a Belgian guy who moved to lisbon and on jan 16 2022 I went for a hike off the beaten track in beautiful Sintra, Portugal. At some point I realized I lost  my wallet (stupid me)  and I panicked. I went looking for it for over 4 hours going up and down up the hill. The sun was going down and at some point i took peace with it and decided to go back direction the main track. I had fallen few times during my search but kept in looking. my mind was tired my body was tired. And then 20 m from the main track  I went over a little rocky wall and I landed very badly and I literally heard the ‘crack’ and I fell down. 

There was no one around so I walked in pain for over a km to then find a police man to help me out. I got surgery on January 21 5 days after the accident. I don’t have pictures of the screws in my foot but I am happy to share the pics of my fracture. The doctor said big bits of my cartilage are gone. I am positive always and looking to understand what bit has been broken, how long the recovery time will take since I don’t understand everything my portugese doctor tells me. right now I am 2 weeks past my surgery. I have a cast on and have been waking since the accident with crutches. week 3 out of maybe 10 weeks with crutches or longer... Thanks for your thoughts and sharing your experiences. This platform feels like coming home to me.

Greetings and i am looking forward to hear from you.  Harry

What’s up everyone! I fractured my right talus dome 3 months back. I have two screws now and have just been released to PT.

The foot feels a little wobbly, and I do feel pain on the top right side of my foot when I step, which is weird because that area wasn’t broken.

Any recommendations on things I should or shouldn’t be doing? I am going through physical therapy, but I would like to see what some of you say. Also, what are some reasonable expectations for recovery times - I’ve been non-weight nearing for 12 weeks. 

Alec, go slow and be patient.  I'm three years post-accident and still know it was damaged.  Removal of the hardware has made a much larger change than I expected and very happy I had it pulled out.  Listen to the PT person because they really know what they're doing.  Work hard and accept the pain but don't go too fast to damage it.  It takes at least a year to even come close to being about where you'll end up.

Blakevan wrote:

Alec, go slow and be patient.  I'm three years post-accident and still know it was damaged.  Removal of the hardware has made a much larger change than I expected and very happy I had it pulled out.  Listen to the PT person because they really know what they're doing.  Work hard and accept the pain but don't go too fast to damage it.  It takes at least a year to even come close to being about where you'll end up.

Thank you for the response! I completed my first week of PT. I feel like I am seeing minor improvement, but I still have swelling and pain on the top right side of my foot (ankle side) it’s frustrating because it feels almost like a sprain. After being non-weight beating for 12 weeks, the last thing I want is a sprain. Lol

How long did it take you from going full non-weight bearing to full? I know everyone is different, but I’d like to have a gauge. 

Alec, I'm sorry but I don't remember.  The brain has a wonderful way of losing those types of memories so from just before the accident until the year after it's hard to remember specifics.  The thing I remember the most was trying to stand on one foot a few months after starting PT and not being able to.  The PT dude said the nerves lose center so to speak so it takes a bit to relearn how to stand on that one foot.  It's been over three years and my calf on that leg is still slightly smaller than the other side.

I'm sure you will have ups and downs for the first year and a bit so just keep the faith and know it will eventually be as good as it gets.  It will never be the same so just accept what you can get to because you don't get a choice.  Work hard my man and be patient and the rest will come.

If it makes you feel better, a year to the day I was back outside bouldering.

Sarah - by this time you most likely don't need advice, but I trust you may appreciate support, which I will attempt to provide by telling my story.  In June of 2009 I was swept off a belay by a lightning triggered avalanche, and pinballed down a couloir for over 1000'.  One of the many injuries I sustained was a fractured right talus / dislocated right ankle.  In the emergency room the  consulting orthopedic surgeon told me he would have to amputate that foot.  As luck would have it, the ER physician on duty was a climbing partner of thirty-some years who'd been best man at my wedding.  Tom convinced the ortho to wait on the amputation, and I still have that foot.   Believe it or not, I was rock-climbing again before I could walk without canes.  Before the injury, I would walk into the weight room  and squat a "century" (single set 100reps) with more than my bodyweight on the bar.  It was seven years of therapy and work before I could perform an "air squat" in form that I could dare load.   Today, 13 years after the injury, I can barely squat a bodyweight bar.  My right ankle  is significantly less mobile than my left, and I am no longer capable of running (I can sort of hobble/jog).  But I can walk off trail on talus again, and I have sufficient ankle mobility for ice-climbing as hard as I ever climbed before the injury.  What I most notice is that my balance seems to have changed.   Part of this may be age - I was 57 when I got hurt, and will turn 70 this fall.   Whether because of age or injury, my rock-climbing lead standard has dropped about one number grade.  This has made almost no difference for me as an alpinist.  I'm much slower than I used to be, and I need trekking poles when carrying a pack of any weight, or traveling off trail.  But I can have fun on long alpine snow-rock-ice mixed routes, and I still love backcountry skiing.  I tell you all this, because at a few years along, you may be where I was before I could perform a clean squat to progress to a loaded squat.  So I'll repeat -- SEVEN YEARS to a clean air-squat.  At ten years out, I was still improving.  At thirteen years out I am plateaued - due to age, covid sedentariness, or just "as good as it gets". -- but I'm the poster boy for "just keep at it".   The gains may be coming more slowly, but trust me, they're still coming.

-Haireball