Talus fracture and partial displacement, healing advice and support

I'm with you brother and glad to hear you're progressing.  I've got five more weeks no weight and inching to walk again.  This knee scooter, walker, crutches thing sucks.

Blakevan wrote: I'm with you brother and glad to hear you're progressing.  I've got five more weeks no weight and inching to walk again.  This knee scooter, walker, crutches thing sucks.

Ha so I'm basically just a month behind you in our recovery process lol! No one likes eating dust lol! Jk I love having a goal and purpose to live for, and this is my current predicament, so, it'll be nice to be able to look back on this when I'm walking and enjoying my hobbies again! I see you're a pilot...? I'm a skydiver! 

I jumped out of an airplane one time and that was enough for me.  The ride up was a lot of fun though.  :)

Does that iWalk thing hurt you knee?  Wish I would have seen that before I bought the old man scooter.

I'll troll CraigsList for one, thanks!

Whats up everyone!  Figured Id chime in with my story.  Im a little over 4 weeks post op (3/10 and 3/12).  I shattered my talus snowboarding at Copper Mountain and had an external fixation for two days before my ORIF surgery.  6 pins and a plate to repair the brake, and am going to non weight bearing for another 6-8 weeks Id say.  Working PT twice a week with a pro and then an additional 4-5 times a day at home.  Also doing acupuncture once a week.

Been a real pain from a mobility standpoint, but my overall pain is pretty well gone.  Worst discomfort is at night when trying to sleep, which has been somewhat fitful.  Thankfully have been off narcotics for a few weeks now and havent really needed Tylenol.  Healing is going pretty well but still pretty swollen around the incisions and main injury location.

Slowly but surely.  Hoping to salvage some outdoor time this fall but trying to be realistic about the timing for healing and not getting overzealous and reinjuring.

Hope everyone here recovers safely and quickly!!

Once they let you move it, move it!  I'm slowing getting my range of motion back but wish I had worked harder earlier.

Blakevan wrote: Once they let you move it, move it!  I'm slowing getting my range of motion back but wish I had worked harder earlier.

I move mine a little here and there. I'm not cleared for weight-bearing, so I don't wanna stress what little integrity I've worked so hard for, by paying with time and pain. I've tried putting a little pressure on it while standing, with very little confidence. Once you break something, some invisible force tells you that that part is attached to you, but just a fleshy, useless piece of matter. I'm afraid moving my foot could be enough to sever the blood vessels linking to my talus. Sketchy! But, I'm glad I've come this far. My foot wants to, and can move. I feel like I'm very capable, but just in a ball and chain now! I wanna drive so badly! 

I posted earlier in this thread, but I figured I'd recap here and give an update now that I'm a few years out. Hopefully it's a source of inspiration for those of you feeling pretty low with messed up ankles.

I made a series of posts at the time it was occurring, which you should read: Post 1, Post 2, Post 3. Post 3, in particular, has x-rays of the initial break as well as post surgery.

It's been roughly 2.5 years now. I'm currently back to doing whatever I want. My ankle is not 100%, it still gets sore and swollen from time to time with heavy abuse, and it's definitely more temperamental than my other ankle (all ankles are temperamental). It doesn't have the range of flexion, and it's still a little... crunchy sometimes. That said, it's like 98%. Basically, I never think about my right previously injured ankle anymore than my left uninjured ankle before deciding to go do something. Bouldering, climbing, running, jumping, whatever-it-is you want to do. I'm bouldering and sport climbing harder than ever. I was never a runner (I hate running), but it wouldn't stop me if I wanted to.

Some tips: definitely move it as much as possible as soon as possible. The hardest part of rehab was that my ankle had been immobilized for months before I was able to move it. DO YOUR PT. This isn't equivocal. If you want to make as much recovery as possible, then DO YOUR PT. Listen to your physical therapist, trust them with your recovery, and push it as hard and as often as you can. I was ALWAYS moving my ankle and doing stretches and exercises as soon as I was able. Take the time to heal it properly now, so that you don't prolong or further your injury.

I had some pretty low points in my recovery. But I leaned (literally and figuratively) on my friends and family for support and you should too. But if I'm any indication, then you'll be just fine.

Edited to add: this is where I was at day 1 after getting the ex-fix off.

I was seriously paranoid the first few weeks after the splint came off about moving it or being touched.  The MD kept me from PT until the sixth week point and then my PT dude was like MOVE IT.  I was still tentative until I saw how much they moved it while working with me.  I never have put weight on it but that isn't to say I haven't used bands to provide resistance.  PT dude said never put your foot down while standing because you will place far more weight on it then you think. While sitting I have to move this balance board and towels around but I guess that doesn't count.  It's sore as crap right now from moving but it feels better and moves better each week.

Fingers crossed my bone doesn't die but not much I can do about it but keep on swimming.

A talus injury is really hard to talk about because everyone's fracture, surgery, and healing can be so different.  I think climberish made a great point early on about "cartilage between talus and tib/fib and range" [in terms of flexion] as it rellates to outcomes.

My story started in 1999.  There was a flow that wasn't touching down and, for fear of dulling my tools within the first couple of hours of the first ice trip of the season, I scrambled up a boulder to see if I could use a flow on the left to traverse right onto the primary flow.   Satisfied I could, I turned around and started to walk back down like I a was wearing sneakers and walking in a field.  I immediately understood the mistake I'd made.  The top of the boulder was covered in a thin sheet of ice and was angled.  My crampons levered out immediately and I went down on my butt and, instead of sliding off the way I came up, I headed for the 15-20' wall on the other side.  My axes where holstered on the sides of my harness.  I hit the talus quite hard given the speed I picked up sliding.  What came next changed my life forever.  I essentially did a front-flip smashing my heels on the talus with a ton of force with my feet in plastic boots (this was 1999!) and crampons.  At first I thought my left leg was broken.  I had blood running down my face but somehow I avoided taking a core sample out with my ice axes, which landed in the woods.  Too proud or to dumb to accept much help from my climbing partner I worked to crabwalk myself as much as possible back to the car.  I was positive that I didn't ruin the trip, that I just needed time to rest.  As a couple of hours go by the throbbing in my right ankle gets worse and worse and I agree to get it checked out, still positive that we'd be at a bar later that night and climbing the next day.  The xrays come back and the tech said the following words to me: "you should have broken your back because at least that we can fix."  I didn't believe him.  At the time I didn't know what a talus was.  I didn't realize that most people are talking of teh tib/fib when they refer to an ankle break.  They wanted me in surgery the next morning.  Instead I called back home and asked who we knew.  I didn't want to get operated on in the middle of nowhere (although they were going to transport me to Burlington VT, not exactly nowhere).  Within 30 minutes the ortho and sports doc for some of our local profession teams agreed to see me the next day... if I can get home.

We start making our way back to the main highway south and find a state trooper closing the gate at the access ramp because a storm had started and it was going to be bad, and they were closing the road for the night. We come back after the trooper leaves and sneak onto the highway.  We had to make it though about 60 miles of what was almost whiteout at times.  We tried to drive in the center of the road (there were no other cars on the road) and, at times, had to open both doors to look to see where the edge of the road was.  The whole time my leg is on top of the dash.  The pain horrible.  Some 6 hours later I get home.  My girlfriend (now wife) is in the driveway.  I get out and proceed to faceplant on the driveway due to exhaustion.  

I have all these stories of success and controlled risk in the mountains.  All over North America, including Canada and Alaska, South America, and Europe.  Long rock and ice pitches, some big mountains.  Now here I am with an ankle injury sustained basically at the base of a crag, home to some of the stickiest and leisurely 4s, that is unfixable, per the tech.

Fast forward 20 years.  I don't think I am any better or worse through the years.  In terms of healing I am a mystery given the number of fractures, type of fractures and displacement.  Depsite the assumption of total ruin I had no AVN.  The problem is I have no cartilage between my tib/fib and talus, and my foot is permanently a bit north of 90deg (I walk on the ball of my foot without lifts).  I have essentially no range of motion and am highly arthritic.  Some days are great.  Some days the force of gravity has me gasping for breath.  I still go out, but I haven't run in 20 years.  I can ride a bike, though.  Cycling and mountain biking have been great for me.  I try to go backpacking with my family so they can experience the outdoors the way I did when I was a kid.  Doesn't matter whether I do 10 miles or 100 miles, I cripple myself with pain for days.  I wouldn't change it for anything, though.  I climb occasionally and get to the mountains more.  When I was a teen and in my 20's I liked true adventure, like the kind I read about from David Roberts and Messner, and hard climbs.  At the time the adventure thing was getting harder to come by closer to home. On a whim we'd pack up and drive across the country to the Black or RMNP or some wall in the SW if we heard about some route, but I'd have to travel farther and longer to have a wilderness experience.  The crags were getting busy, too.  I'd hike back to my really hard and easily protectable project at the crag with no guidebook only to find a large group of novice climbers toproping it thinking they found booty.  I'd get cranky; no different than how the old-timers got when I showed up and sent their testpieces with dynos when the move could have been made statically - I didn't do it in the right "style" and neither did "they".  But despite my newly rocky relationship with the mountains then, what sucks about the injury is that I didn't even have the choice to do it again in the same way.  Although I'd give it all up in a second if I was able to run the soccer fields and basketball courts with my son or daughter today, and I still enjoy the occasional easy climb that gripped me the first time I did it as a young teenager. 

It's funny how if I look at my whole climbing resume the thing that got me wasn't some crazy unprotected hard pitch in the middle of nowhere when I was laser focused, it was at the base of the climb on a day a leisurely climbing when I wasn't paying attention. 

This thread is so concerning to me because I was told I 'shattered' a good portion of my talus, the surrounding cartlidge and the a hairline of the heel bone it sits on I forget the name. I never got the terms but I had internal bleeding up to my knee and my ankle and shin where the size of a soft ball but first xrays showed nothing except cloudiness from cartlidge everywhere. But I never had surgery my injury was 11 years ago from skateboarding. I was 16 at the time so they assumed I would just heal up I guess even tho i was told I need to come in for PET and MRI scans yearly. My ankle swells, gives out, and even throbs in pain for sometimes days. Reading all these stories makes me realize I may need to go back for surgery. Am I wrong in thinking this? I seen pics of your guys' ankles and mine is always... I wouldn't say swollen (because it gets big and blue) but definitely looks like I got two ankle bones inside out side like I got some extra fat on the out lol. Could really use some feedback on what to do I don't know anyone with the same injury or even close and docs near me are awful (obviously)

Grant Lawrence wrote: This thread is so concerning to me because I was told I 'shattered' a good portion of my talus, the surrounding cartlidge and the a hairline of the heel bone it sits on I forget the name. I never got the terms but I had internal bleeding up to my knee and my ankle and shin where the size of a soft ball but first xrays showed nothing except cloudiness from cartlidge everywhere. But I never had surgery my injury was 11 years ago from skateboarding. I was 16 at the time so they assumed I would just heal up I guess even tho i was told I need to come in for PET and MRI scans yearly. My ankle swells, gives out, and even throbs in pain for sometimes days. Reading all these stories makes me realize I may need to go back for surgery. Am I wrong in thinking this? I seen pics of your guys' ankles and mine is always... I wouldn't say swollen (because it gets big and blue) but definitely looks like I got two ankle bones inside out side like I got some extra fat on the out lol. Could really use some feedback on what to do I don't know anyone with the same injury or even close and docs near me are awful (obviously)

I should add too that after my 8 months in 3 casts and 6 months in a boot w crutches and 3 months w crutches I went back to skateboarding on and off throughout those years. I've never stopped skating longer than 6 months. But recently, the pain the random gives when I'm just walking is more prevalent. Please let me know if anyone else has experienced anything close is surgery worth it or do I need to go through psio again?

2 weeks out from a talar neck fracture with severe displacement of the talar dome. I was on the 4th pitch of a climb outside of San Diego when a hold I was matched on broke, and sent me flying. I fell about 20 feet and landed on a slab. My ankle was visibly crushed. My partner and I tandem rappelled 3 pitches, we slowly descended in about 45 minutes. When I got to the ER I almost immediately was taken to surgery. The surgeon told me before I went under that it was a very serious injury that would have life long effects. I had 2 screws placed to fixate my talus, and After surgery he said he had never seen such a bad displacement (it took him 2 hours to pull my bone out of the soft tissue of my heel). He said my risk for AVN is high.I am not sure why I am posting - I know everyone’s recovery is different. I am just completely horrified at the thought of an ankle fusion. I am an avid climber of 11 years,  but I also love to backpack, surf, and run. Has anyone researched the 3D talus bone replacement? I just want to have options if I do get the dreaded AVN. And even if I don’t get AVN, I’m sure i will have pain and arthritis. Apparently a large portion of my cartilage was ripped off. Thanks.  

If you are young, you will do all you want to for years to come IF you do the PT.  Then, as you get older the weather report will be announced in your ankle prior to the precip.  Then, when around 50 you will push through pain...then, well, up to you.

Grant Lawrence wrote:

I should add too that after my 8 months in 3 casts and 6 months in a boot w crutches and 3 months w crutches I went back to skateboarding on and off throughout those years. I've never stopped skating longer than 6 months. But recently, the pain the random gives when I'm just walking is more prevalent. Please let me know if anyone else has experienced anything close is surgery worth it or do I need to go through psio again?

God failed to prepare his humans for the rigors of this world, for sure. Or, we could just be better at sports lol! My ankle injury is the second injury in which my doctor told me I was very close to amputation. My first injury, a femur shattering, I recovered from, fully. But this is my first joint injury, so I'm experiencing something totally different. I take good care of myself, so I expect to make a decent recovery. Whether I do or not, I'll work hard at life and compromise and be accepting of my consequences. I got metal taken out of my femur (8 years of pain, and during active duty military) after multiple doctors told me it was impossible. It was a military doctor that finally did it for me, so, I deserved every bit of that! Good karma exists! It's awarded by the nature of the universe. You'll never know where life takes you! 

Marisa Shapiro wrote: 2 weeks out from a talar neck fracture with severe displacement of the talar dome. I was on the 4th pitch of a climb outside of San Diego when a hold I was matched on broke, and sent me flying. I fell about 20 feet and landed on a slab. My ankle was visibly crushed. My partner and I tandem rappelled 3 pitches, we slowly descended in about 45 minutes. When I got to the ER I almost immediately was taken to surgery. The surgeon told me before I went under that it was a very serious injury that would have life long effects. I had 2 screws placed to fixate my talus, and After surgery he said he had never seen such a bad displacement (it took him 2 hours to pull my bone out of the soft tissue of my heel). He said my risk for AVN is high.I am not sure why I am posting - I know everyone’s recovery is different. I am just completely horrified at the thought of an ankle fusion. I am an avid climber of 11 years,  but I also love to backpack, surf, and run. Has anyone researched the 3D talus bone replacement? I just want to have options if I do get the dreaded AVN. And even if I don’t get AVN, I’m sure i will have pain and arthritis. Apparently a large portion of my cartilage was ripped off. Thanks.  

Well you only have to stay positive and do everything in your hands to give your talus a second chance. I had a talus displaced fracture (Hawkins type 4) and exposed dislocation which was as per doctors a life changing injury and was given 90% chances of AVN. Well 2 operations later and 2 pins in my talus and here I am on the 2nd anniversary and no AVN, 95% recovery in range of movement, nearly no pain at all when walking, running or doing anything I need to do. I can squat 150kgs again without issues, I can race on my bmx again at high level without issues and I'm just fine. It was a long journey but it's possible to get back. Work through it, stay positive, listen to your body, learn from it, never stop your physio and exercises, be healthy in general specially with food and you should be back. If I bounced back from the situation of the pic below, the you can do it too. Everyone can. Good luck to all and best healing vibes! 

Hang in there and it will get better.  The first few weeks for me were the worst and I fretted constantly about how much damage I had done.  I have a high chance for AVN as well but I'm way old and only need this body for another 30 years or so.  :)  PT has helped me believe I will have an ankle again when this is all over so just be positive and let your body put itself back together again.  

Whew! Damn braj! Seeing my foot crooked at the end of my leg was very weird, but seeing your ankle ejected like that must be HARD!

Dislocated talus with bone fragmentation from an unknown place (lateral malleolus screams quite a bit, which is the direction my foot was shoved from the impact) on March 2nd. One surgery March 3rd. I'm walking in a boot without the aid of crutches. This was nearly impossible just yesterday (had to use one crutch). I'm making noticeable progress a little faster now. This is 2 months in recovery. 

Went to the gym today, climbing with my boot! Solid foot placements with the boot, climbing up to 5.10a! Felt so good to feel a pump while moving up a wall again! 

I thought you weren't supposed to weight the ankle for 3 months.  I've been stuck without driving and going FN crazy because I'm stuck relying on others for transportation.  I see the MD Thursday and then I'm done waiting and will start to do things on my own.  It actually feels pretty normal these days aside from being stiff.