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Talus/talar fracture??

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  • Talus/talar fracture??

    Need your collective COTH wisdom for a friend.

    Talar fracture in ankle, they are now worried about avasclar necrosis. Anybody deal with this and have some encouraging stories to share?


  • #2
    Sorry not an encouraging story as I have this and Talar fractures are real trouble. The talus is the keystone of your ankle and has a limited blood supply. I had a non-displaced Talus hairline fracture and excellent care and have AVN and 3 large OCD in the Talus.
    I know a great deal about this and you really need an expert foot and ankle surgeon. If you are the east coast I strongly recommend Dr Lou Schon in Baltimore.There are several great ankle orthopods in Baltimore. Be very careful who you let treat your ankle and if this is a recent break I hope you are in a cast and remember you should be non-weight bearing for 3 to 5 months. My arms looked great after that long on crutches'.
    My AVN didn't show for a few yrs. its a very common complication of talar fracture. Do not do a fusion or ankle replacement.
    PM for more info.
    Also Dr. Myerson has a web site with some good video and info on the talus but he does some extreme treatments so be careful.
    Bad news is no more sking,jogging or serious hiking but you can ride!


    • #3
      Hi Mouse&Bay,
      I'm so sorry to read that you have a talar fracture, I had a fall a few years ago and had a similar injury. I have had two surgeries, and I am going in for a third in the next few months. As walkers said, it is very important to find a good ortho that you can trust. I'm not sure where you are located, but I have had a fantastic experience with Brigham Orthopedics.

      In addition to a good ortho, be sure to take your time with your rehab. This particular injury takes a long time to heal so it's ok to baby your ankle a little until it is feeling back to normal. I would suggest dismounting onto a mounting block for a while (if possible) once you have started riding again. Best of luck, and feel free to PM me if you have any questions.


      • Original Poster

        Well, its 6 months post fracture (not my talus at risk here) and I wanted to take the time to post an update for anyone that may be dealing with this and searching the archives.

        The talus is good!

        To recap, one of the top ortho surgeons in Ontario (who specializes in ankles) pieced the parts together after 2 sets. We were very fortunate that ankle was pinned/fixed within 12 hours of break (thank you OHIP). Within 2 weeks ankle was enclosed in removable cast and owner of said ankle was trotted (ok, hobbled) off to a naturopathic doctor. *LOTS* of supplements for the next 6 weeks (calcium, vit D, ginko for blood flow - the works).

        Back on track human socks were purchased and worn 24/7 under cast.

        At the 6 week check up doctor reported that fracture had healed very well, could not explain why you could barely see it. Cleared to 50% weight bearing and instructed to go to physio.

        Being in the field, I tapped the best physio in town on the shoulder and asked her to fix it. Pretty please. After observing some medieval looking shoving/pulling and prodding of said talus (not for the feint of heart), mobility started to be restored to the ankle. Only thing ortho didn't tell us was that the scar should have been mobilized as soon as sutures were out - according to physio you need to zig zag across the scar to prevent it from binding down the tissues all the way to the bone. Some more ugly but gentle-ish ripping freed the connective tissues so the talus could mobilize properly.

        At the 3 month check up doctor (same ortho specialist), after a MRI to check blood flow, reported that all looks good and blood flow has returned. This was the best news we could hope for!! With a type 3 talar fracture (dislocated and ugly) the studies say that the chances of blood flow returning (no avascular necrosis) was about 18%. We were thrilled.

        At the 6 month check up everything looks fabulous and no more doctor's appointments until the 1 year mark. Disaster averted, big fingers crossed that everything stays happy and healthy.

        So - if anyone out there is dealing with this all hope is not lost. Ankle was back to riding at the 6 week mark (cautiously - with cast on - much to the amusement and chagrin of physio who officially deemed horse people to be crazy).

        While we will never know what the magic bullet was with respect to the blood flow returning, I credit the supplements and back on track socks with helping expedite a fabulous recovery. Totally worth the $500 investment and I wouldn't have done any less for an injured horse.


        • #5
          So glad that the ankle is doing well! I just found out today that I have an OCD lesion on my talus (per the radiologist) and am going to see my orthopedic surgeon on Monday. I have had it for a few months now and only found out about it because I went in to my doctor because of pain in my lower leg/ankle for the past few months that has recently become unbearable by the end of the day. Everything I've read online (which I try to take lightly) is saying anywhere from 8 weeks to 6 months recovery depending what stage/level injury it is. I alreadyhaave a bad knee on the same side and am not looking forward to my appt on Monday. I suspect it will be do more tests and wait for the results but at this point I feel like cutting my leg off by the end of the day the pain is so bad.


          • #6
            Need help with Talus fracture

            Hi - we live in NJ and my daughter 2 years ago fractured her talus in 2 places when she fell off of her TB gelding. Fractured her talus in 2 places. Needed surgery and screws...about 8 months later needed another surgery b/c the bone was dying off...went in cleaned it out removed a few screws...8 months from then had to go back in and have a 3rd surgery and do a bone graph which we just went for a second opnion and was told that she has AVN, the bone is collapsing and is arthritic. Options are fusion, leave it alone and monitor, or a brace...Our doctor said he wouldn't recommend an ankle replacement but didn't say why...Anyone have any other info or exeperince they can offer - I am thinking about going for the 3rd opnion but would have to be somewhere reasonably close to the tri-state area....My daughter is only 19 years old I just don't feel that something as permanent as ant fusion and no being able to move your ankle more than 90 degress is something she should have to endure for the rest of her long life. Wondering if anyone has any other suggestions, doctors or info to share. Please DO NOT send me replies saying how wonderful you are doing and it wasn't a big deal, and stop the complaining... I am happy to hear those stories with happy endings but obviously if my daughter has needed several surgeries compared to someone's one surgery...it wasn't as severe as hers. I was on one forum and that is was I heard. Not that I am dismissing anyone elses injury I just don't want to hear "it was no big deal, I am fine, clearly my daughter is not and that is why I am asking for help -Thanks.


            • Original Poster


              When I was doing research (and I am not a doctor), there were studies that showed that AVN can be prevented with the use of hyperbaric chambers:

              Unfortunately it was not an option for us as we don't have one within a 3 hour drive. Due to lack of other options, we went with naturopathic medicine instead (lots of vitamins/minerals/supplements to encourage blood circulation and healing). It worked for us. The doctors said it was a 'fluke'. I'm fine with flukes especially when the end result is good.

              I don't know if your doctors will be on board or not - but I would suggest discussing the options of hyperbaric and whether that is still a possibility for your daughter or not. I also think that it would be worth a consult with a qualified/board registered naturopathic doctor to see if there is anything they can recommend to help your daughters ankle heal.

              Best of luck to you and your daughter. <hug>