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Talus fracture and partial displacement, healing advice and support


Original Post
Sarah Trudeau · · Unknown Hometown · Joined Oct 2017 · Points: 10

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

FrankPS · · Atascadero, CA · Joined Nov 2009 · Points: 275

What climb did you fall on? What area? 

Good luck with your recovery.

SMarsh · · NY, NY · Joined Sep 2013 · Points: 3

I don't know your injury well enough to comment, but I can tell you that I broke my tibia and fibula (tib/fib fracture) when my binding did not release at a ski area.  This was long ago, and my first thought when I saw my position (foot in one direction, knee in another) was that I was now committed to recovery and rehab.

I got surgery, with a rod and seven screws in place, and spent 3 months recovering to be able to walk.  It took more rehab to be able to run, ski, climb and bicycle again.

It all worked out.  I ski, bicycle and climb.  A lot.  Running, not so much.

If you do what needs to be done, you have better odds than if you don't.  So, don't give up, keep moving forward and don't be too hard on yourself after the fact.

Best wishes for your full recovery.

Sarah Trudeau · · Unknown Hometown · Joined Oct 2017 · Points: 10

Thank you both for the kind words and well wishes! Feeling positive. :) 

I fell on Casey at the Bat at Echo Cliffs in the Santa Monica Mountains. 

Bold Pueblo · · Unknown Hometown · Joined Sep 2017 · Points: 0

Sarah, I fractured my talus in June, it was not as displaced as yours. A similar circumstance, took a lead fall and hit a ledge. It is a nasty injury and I still have limitations in my range of motion. 2 screws and bone chips removed from the sub-talar joint. That said, I've gotten back to running up to 15mi, mainly on the road, trail is still a bit of a challenge, and am back to some intense hiking. From what the doctor tells me my recovery has been fast. While still in the cast and boot I went to a trainer and we did lots of upper body and core workouts, I actually got super strong, minus my whithered left leg. I'm also back to climbing again. It's been quite a process but getting better every week. Wishing you a speedy and smooth recovery!

JSH · · Unknown Hometown · Joined Apr 2007 · Points: 969

Sarah, there's a few threads here on talus fractures, and a super-long one on calcaneus fractures, which are related.  Lots of reading and support.  Best wishes healing!

Alexander Stathis · · Athens, GA · Joined Jan 2016 · Points: 111

Hi Sarah, 

The post that JSH is referring to is this one: https://www.mountainproject.com/forum/topic/107305448/shattered-talus-report-analysis

When I broke my talus it was nice to read other's experiences there. You'll find my experience there also. Allow me to warn you: people in there had widely varied results, and I think the thread suffers a bit from the "people only post here when it's really bad" issue, in that it seems like most of the posts had pretty negative prognoses.

I had a much bigger displacement than you, although mine was a talar body fracture and not a talar neck fracture, so my risk of AVN was much lower. Just over a year out from surgery and I'm back to doing all the things I want to do such as boulder and lead climb. My ankle is still swollen and painful and I need to be careful with it, but the only time it really keeps me from doing what I'd like to do is when doing something that requires a lot of agility from it or when (heavily) landing on it. Things like basketball (where you stop and turn quickly) or jumping one legged are the types of things I can't do, but otherwise it's still improving and not limiting me much.

The road to recovery will be long and difficult, but you'll make it. Good luck. Do your PT, and the sooner you can start weighting it the better. PM me (or just reply here) if you have questions or are interested in chatting with me further. 

El Duderino · · SoCal · Joined Apr 2015 · Points: 1,360

Hi Sarah, Alexander has been a great support for me, we both F-ed our ankles up around the same time last year. You WILL be able to climb again, and better at it yet. It’s hard to believe in the moment, but after some recovery time you’ll surprise yourself. Perhaps some permanent loss in range of motion, perhaps not, but you pull through no matter what. From what you have said, your injury could be a lot worse, many climbers manage to send as hard/harder than ever before. Yet in the moment (bedside, casted, self loathing) it seems next to impossible. Hang in there in the meantime. After a very near death experience, I’m happier now and climbing harder than ever! I wish you the best in your recovery.

Amanda C · · Unknown Hometown · Joined Jan 2018 · Points: 0

I fell off a runaway horse and broke my Talar neck and displaced it sept 27, 2017 and got 2 screw put in 2 days after. It’s been rough bc I’m an active person. I’m just 4mo out and still walking with a decent limp. My dorsiflexion (toes up) is only slightly pass 90 degree but i can point my toes pretty good. I can tip toe on both feet but can’t do it on that foot alone yet. Also walking on uneven surfaces is still rough 

Anyone have a roundabout timeline of when they fully walked “normal” or was able to run. My dr keeps telling me to relax bc of how severe and bad of an injury i had. I get it, i truly do but just curious. I just started back at the gym but still limited on what Im able to do. 

TIA :)

climberish · · Unknown Hometown · Joined Jul 2013 · Points: 10

Hi Sarah,

To echo David and Alexander's posts every injury is unique and none of us can predict your recovery, and what kind of activities you'll be able to get back to. From what I've gathered from my injury - severe pilon fracture and collapse of the ankle joint capsule after a 30ish foot ground fall, is that as long as your fracture's heal the level of activity/types of activity that you can get back to will depend a lot on your ankle joint range of motion. If your range of motion is unaffected or minimally affect than typically barring any other pain issues you will be fine. 

As far as climbing goes - you can maintain or build a lot of strength as a climber when you have a lower extremity injury. I was hangboarding, doing mellow gymnastic rings exercises, and core work a week out of my first surgery. I had a fib fracture, and an external fixator installed to hold my ankle together, but as long as I wasn't banging that around I could do a lot of exercises. 

I was doing leg lifts and hanging core with the external rods in with no ill effects.

Once I was casted/booted up after my second surgery I was back in the gym climbing with one leg, hangboarding, and campusing. It's all about what you comfortable with. 

My ankle now currently looks like this.

I have virtually no range of motion in my ankle, which sadly right now affects how much I can hike, and I cannot run. In the x-rays you can see that I no longer have a joint. But within 11 months of the accident I redpointed my hardest sport route outside (5.12+, a project from the season before my accident), which involved multiple bad smeary foot placements on my bad ankle. I also since the accident, before and after sending that project, sent multiple mid-5.12s. I can boulder in the gym pretty safely, but need to be conscientious of how I come off of problems and land. I will eventually get back into trad climbing and hopefully be able to jam my foot into cracks again. But during the recovery process I spent a lot of time learning how to train, and got much much stronger than before my accident.

So, use the recovery process to come back stronger than before, and don't let an injury get in the way. Feel free to message me if you have any questions you don't want to ask in the public forum.


Alexander Stathis · · Athens, GA · Joined Jan 2016 · Points: 111

Amanda C wrote:

I fell off a runaway horse and broke my Talar neck and displaced it sept 27, 2017 and got 2 screw put in 2 days after. It’s been rough bc I’m an active person. I’m just 4mo out and still walking with a decent limp. My dorsiflexion (toes up) is only slightly pass 90 degree but i can point my toes pretty good. I can tip toe on both feet but can’t do it on that foot alone yet. Also walking on uneven surfaces is still rough 

Anyone have a roundabout timeline of when they fully walked “normal” or was able to run. My dr keeps telling me to relax bc of how severe and bad of an injury i had. I get it, i truly do but just curious. I just started back at the gym but still limited on what Im able to do. 

TIA :)

My accident occurred November 27th, 2016, and I had surgery December 16th, 2016. I still have some swelling in my ankle and I don't have my full range of motion back yet (but it's close -- I particularly have trouble doing a deep squat on my injured ankle). I can run, hike, walk, boulder, climb, and basically do anything other than play basketball without difficulty. 

Ben Martinez · · Unknown Hometown · Joined 21 days ago · Points: 0

Hi all, 

Finally I'm able to find a forum which discusses real cases of Talus fractures. It is so helpful to read.

So my story is as follows:

Professional racing bmx athlete. Had a crash in June 2017 at one of the British nationals and fractured and dislocated my talus. The diagnosis was a non displaced fracture of the talar neck with exposed dislocation of the talus and complete rupture of surrounding soft tissue. The force of the impact was so strong that my talus popped out my skin to say hello breaking ligaments, tendons and nerves on its way. 

I was operated 3hrs after the accident for a realignment of the talus and two days later a 2nd op to put 2 pins in there and stitch all soft tissue together.

I was given 90% chances of AVN and was put in a boot (no cast)  to keep movement of the joint as much as possible to try and keep blood supply. 10 weeks non weight bearing with crutches and 7 weeks of blood thinners via a self injection in my stomach. 

9 months after the accident and still don't feel the sole of my foot because the nerves are taking forever to come back. My ankle still has a bit of a swollen appearance and the pain is not gone when doing inward or outward movements. However, I can walk 100% normal with very very mild pain (there are some good days and bad days) and can walk up or down the stairs with some effort but improving day by day. The ct scans and further xrays (last one was las month) have shown no sign at all of AVN so far which is making my consultant feel very positive about it. He keeps saying that we need to wait at least 2 years to be able to rule out AVN from happening but the likelihood is getting smaller as the time goes by. 

I've been doing physio from week 12 onwards and I'm now back on my bike and at the gym (very easy sessions) but with quite limited range of movement. I really struggle with deep squats and I feel the weakness on the bmx bike when dealing with jumps. I think at the moment, the worst of all is the pain that follows the sessions I do at the gym or on the bmx track. Usually one session is followed by 2 days of quite intense pain although the swelling is nearly not present anymore other than the constant ballooned appearance.

I feel the strenght of the joint is at 50% of what it used to be, my range of movement is at 60% which makes me feel like a normal person in terms of completing the day to day requirements of life but probably nowhere near what I need to be in order to feel like I can train for racing again. The chances of AVN are still a threat but I'm confident that I can be part of the 10% of cases where a Hawkins type IV injury doesn't develop necrosis of the bone.

How has your range recovered in general guys? Which direction took the longest or never came back? Did you get back to 100%? Did anyone of you also dealt with recovery of broken nerves? Do you also wake up in the mornings so stiff that it takes you 5 mins of easy steps to get the ankle to function normally?

Thanks a lot for reading and for all the information shared. Some pics attached. Hope it's not too gory for you.

BEN

JohnnyG · · Unknown Hometown · Joined Nov 2009 · Points: 10

I broke my talus in 1999. This mornning, I skied 20k on my skate skis, and I didn't think twice about my ankle.  First the bad news: it hurts most mornings; it took a decade before I wanted to run again. Now the good news: I didn't get surgery right away, so I probably screwed it up when I hiked a bunch before it healed--and you will likely fare better than I did. It is still getting better. I went on to climb way better than I did in in '99. It got me interested in other things that became my career.

Good luck healing!!! You got this! it's just going to take a while.

Ben Martinez · · Unknown Hometown · Joined 21 days ago · Points: 0

JohnnyG wrote:

I broke my talus in 1999. This mornning, I skied 20k on my skate skis, and I didn't think twice about my ankle.  First the bad news: it hurts most mornings; it took a decade before I wanted to run again. Now the good news: I didn't get surgery right away, so I probably screwed it up when I hiked a bunch before it healed--and you will likely fare better than I did. It is still getting better. I went on to climb way better than I did in in '99. It got me interested in other things that became my career.

Good luck healing!!! You got this! it's just going to take a while.

Thanks a lot JohnnyG. I will keep updating in here with anything new. 

Norm Larson · · Wilson, Wy. · Joined Jan 2008 · Points: 55

Another survivor here. I broke my calcaneous in to what the doctor said was 40 pieces 41 years ago April fools day. 30 foot ground fall.

It’s been forty years and I’m still climbing, hiking, and carrying packs that are much to heavy. 

 It took a few years to get back on my feet so to speak. There was a lot less information about those fractures then and a lot less treatment and PT. You will recover, it will be painful, and you might have a slight limp, but don’t give up and keep focused.

Amanda C · · Unknown Hometown · Joined Jan 2018 · Points: 0

Update : i wrote in here 2 months ago and now 6mo into recovery. Still having major problems with flexing my foot past 90 degree so I still can’t run or squat.  It’s like something is blocking it bc i can’t even force it past that. Still have a pretty good limp. My ankle to me doesn’t feel straight and I have brought it up to my dr and he’s stumped bc on X-ray “technically” everything looks aligned. When i walk my ankle rolls out. I feel like if that weren’t the case I’d be walking with less of a limp. Walking barefoot is worse and that’s a bummer bc with summer coming I usually am in flip flops non stop and we go to the shore a lot and uneven surfaces still bother me.  I’m just so frustrated. 

Pics of my my flexion and straight on (looks crooked to me)

Warrior · · Rock City, GA · Joined Sep 2015 · Points: 310

I understand your frustration.  Just remember these things take time, usually way more than you want.  I broke a bone in my foot 10+ years ago.  Was religious about PT/recovery, etc. You are doing lots of thera-band(?) etc and have a good PT, correct?  My program was 600 reps of bands every day iirc. What a gas...

LSS I climbed my hardest routes since.  But my foot kind of always hurts, so there is that, and some things I just can't do, like virtually all bouldering.


My ortho said he could "re-break" it if it was giving me "pain" but I'm thinking that would really set me back, with no guarantee of "perfection".  Good luck and if you don't have a superb PT you might look there first

climberish · · Unknown Hometown · Joined Jul 2013 · Points: 10

Amanda C wrote:

Update : i wrote in here 2 months ago and now 6mo into recovery. Still having major problems with flexing my foot past 90 degree so I still can’t run or squat.  It’s like something is blocking it bc i can’t even force it past that. Still have a pretty good limp. My ankle to me doesn’t feel straight and I have brought it up to my dr and he’s stumped bc on X-ray “technically” everything looks aligned. When i walk my ankle rolls out. I feel like if that weren’t the case I’d be walking with less of a limp. Walking barefoot is worse and that’s a bummer bc with summer coming I usually am in flip flops non stop and we go to the shore a lot and uneven surfaces still bother me.  I’m just so frustrated. 

Pics of my my flexion and straight on (looks crooked to me)

If you have any images of your x-rays you should post them up here. Also feel free to DM me, I have a bit of experience with lack of ROM.

Tristan Mayfield · · SLC, UT · Joined Feb 2013 · Points: 45

Hey there! I have a similar injury. The biggest advice I'd give is to not do too much too fast.

I did a 60+ mile backpacking trip in RMNP a week after I was cleared to walk without a medical boot on. I'm pretty sure I've jacked my ankle up for the rest of my life because of this. However, I'm confident that this trip was a turning point in my relationship with my now amazing wife, so was the steep price worth it? Yeah. Would it be worth it to everyone in every situation? Probably not...

Good news is that only crack climbing and some slab climbing (more ROM is better) is hard on ankles, and cycling is a somewhat decent replacement for running if you want cardio.

Amanda C · · Unknown Hometown · Joined Jan 2018 · Points: 0

This was at 6wk but I’m now 6mo. I don’t have my recent X-rays. I was seeing my PT for about 2 months and then after it became redundant i started doing the routine at home. I do CrossFit so that works my ankle pretty good too. Just having trouble mainly with the extension part big time

JSH · · Unknown Hometown · Joined Apr 2007 · Points: 969

Are they sure those screws aren't impeding motion?  Have you asked about having them out?

Beautiful tat, by the way.

Guideline #1: Don't be a jerk.

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