Broken Talus

Hello. I am not a climber at all, but I broke my talus last year and this website was one of the only places I could find good information and personal accounts of similar injuries. I found reading others experiences very helpful and figured I would share my story in the hopes it can help others.

My story started with a fall off a ladder, no more then three feet. I went to the hospital and it was initially diagnosed as a sprained ankle.  First Xray was inconclusive, 2nd showed possible hair line fracture. Finally a CT scan showed the extent of the damage, a talar neck fracture in the right foot with the talar head displaced 8mm and broken up into several pieces.  I was in an air cast with crutches (no weight bearing) for two weeks from the day of the injury until the CT scan, after which I received a back cast and was sent to Thunderbay for surgery. After a few days on the wait list I had surgery 18 days after the injury occurred.  I was concerned with the time lapse between injury and surgery, especially after hearing from the doctor and reading about the nature of Talus injuries and some of the bleak outcomes,  but my surgeon said that although the wait time wasn’t ideal, it also wasn’t a deal breaker in terms of full recovery.  The surgery itself consisted of him cleaning up and removing bone fragments and then screwing the two largest remaining pieces of the talar head together, and then using two screws to attach the talar head to the talar body.

I was discharged about 16 hours after the surgery. Pain was not bad, just kind of achy and uncomfortable. I was pretty restless for the first couple days, couldn’t get comfortable. The first two weeks were spent in bed with the foot elevated, lots of Netflix.  At this point I was terrified at the prospect of avascular necrosis. I’m not a smoker, I quit drinking alcohol for a while, I started eating a lot healthier, I read up on certain food and spices that are supposed to improve blood flow and repair blood vessels, such as tumeric, cayenne, salmon oil, blueberries etc., I was taking vitamins and slamming smoothies like crazy. After the first week I went back to work on modified duty with foot up all day. Two weeks post op I went for X-rays and got the staples removed and a full cast put on from toes to just below the knee. (The first cast was cut to allow the incisions to breath). First Xray looked good, (screws were fine, alignment of bone was good). 

Four weeks post op the cast came off in place of a walking boot/air cast.  Had to wear it all the time day/night. The surgeon said I could remove the cast to work on pointing my toes and moving the foot up/down. He said I could apply 25% body weight to the ankle and then an additional 25% each week thereafter or longer if I wasn’t comfortable moving that quick. At this point my foot was still very swollen.  The scars itched a lot and I remember getting tingling sensations in my toes.

At eight weeks post op I was at about 75% weight bearing with crutches and another Xray was looking good. Able to start all range of motion exercises. The bone was filling in nicely but still no feedback about the dreaded necrosis yet. Started doing alphabet with foot, toe curls, etc. I was massaging my foot and the scars a couple times a day at this point as well.  I started sleeping with out the boot around this point and removing it in the day as well to, I was very paranoid of my wife, kids or the dogs bumping or jamming it accidentally, I was very protective of it.

By 12 weeks post op I was off crutches and walking boot and onto a cane and normal shoes with virtually 100% weight bearing.  At work I strapped on an old pair of basketball shoes and burned laps constantly with the cane for a week or two until I ditched it for good. Started physio around this point. Did the towel exercises, resistance band exercises, calf raises. Another Xray came back good, no sign of necrosis yet. Surgeon had no limitations on the bone/joint. He said to keep with the physio and work on flexibility to help prevent future injury to the foot/ankle.

Five months post op I returned to regular duty in a very physical job as an industrial mechanic. Lots of walking, standing, lifting. Some restrictions initially on excessive lifting, climbing. 

Six months post op I had a CT scan. No sign of necrosis but there was arthritis on the joint where the talar head broke apart.  I had issues with my peroneal tendons at this point.  Lots of tightness, it could cause a bad limp.  My plantar fascia proved a bit troublesome, very tight as well.

One year post op Xray showed no necrosis. He said I should be out of the woods with that. The bone looked good.  Surgeon said how fast or slow the arthritis progresses will determine any future treatment, if any at all.

Now been a year and nearly one month since surgery.  I am very happy with where I am at considering some of the stories I read at the beginning about these types of injuries.  The talus is just a terrible bone to break.  These days I walk with a very slight limp.  I don’t even feel it or notice it. People who know about my injury see it because they are looking for it but I’ve asked people at work who are new and they say they don’t notice me limping.  I do limp more when I get up in the night, first thing in the morning before I do all my stretches, and at the end of an exhausting day.  I can’t really run now but I was never a big runner anyhow so that doesn’t bother me.  I think I could run more smooth if I worked at it.  I go out and shoot hoops but nothing really rigorous.  I can jump and pivot and change direction without discomfort but I don’t think I’ll play in a group for a long while.  I still favour that foot and protect it, just instinct now, but it is getting better.  I’ve taken a couple spills and jammed and twisted it a couple times so once you get the first couple out of the way you start to trust it a little more.  

I can walk easily on all surfaces although it is still prone to rolling and I can feel some good pulling in the soft tissue if the ground gets to crazy.  I never got back all range of motion.  Plantar flexion is good,  dorsiflexion is lacking a bit but even now it is still improving.  Eversion is good, inversion is not nearly what it used to be.  Pronation inwards and out didn’t come back fully either but I have enough ROM to do what I need to.  I can crouch and kneel with very little discomfort.  There is no pain at all but the ankle just seems to get tired sooner then the other one. Could be due to a lack of strength in that leg as I lost all my calf and quad muscles in from not using them, still trying to get that muscle back.  Most issues arise from soft tissue elsewhere in the foot.  Kind of moved around from peroneals, to Achilles to plantar to calf to weird pressure in the balls of my smaller toes.  I got fitted for orthotics and they seem to have smoothed some of that out.

 But when the surgeon said it’d never be the same again, he meant it.  It doesn’t hurt per say, but I kind of always feel it.  Always conscious of it, maybe that’s a mental thing that will pass with time or maybe the day will come when it does start to actually hurt.  Just enjoying doing the things that I like doing again now.  I read one post on here and the guy said it always gradually improves so I hope that proves true to. 

Anyhow it’s a bad injury to get, I feel fortunate with my recovery thus far.  It had lots of ups and downs, can be mentally draining but stick with it.  Celebrate the little improvements, stick with the physio for sure,  try stay positive.  Hope this helps.