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Talus Bone "dead" "osteochondral defect" UGH
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gbogh


May 13, 2012, 1:19 PM
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Talus Bone "dead" "osteochondral defect" UGH
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In Jan (12th to be exact) I was bouldering in a gym, dynoed on a 30 degree wall, caught and peeled from a hold and had an awkward landing. at first the people in the gym ran to my head thinking i landed horribly on my face etc. but in my mind all i could think was "wow that is a weird feeling in my ankle"... i tried to walk and it was very painful. looked like a bad sprain to me but there was a sharp pain when i flexed up and down that was very different than a normal sprain. turns out that an MRI a month later showed that there was definitely fracturing in the talus and one of the lower leg bones. not a clean break but "deep bone bruising" they called it and to watch for osteochondral defects (when the bone dies). i was in and out of a boot for a while and PT from then on. three months later (now four months from injury) and second MRI does indeed show a dead spot in the Talus :( so now i am scheduled for surgery where they will be drilling holes through the dead part to the live bone in hopes of having better blood flow and repair etc.

I am curious if anyone out there has had something like this done and what they would recommend for helping with repair etc? i read somewhere that other people will actually inject bone marrow stem cells from the hip or something into the drilled holes as well to help in repair. im told that after surgery i will be 6-8 weeks on crutches NO WEIGHT and then slow recovery after that. this has to be the most frustrating injury i have ever had... no cardio or climbing etc... on top of that i apparently tore (not fully) nearly every ligament and tendon in my ankle as well. PT guys said he had never seen this much damage in an ankle without reconstructive surgery... guess im headed that way now....

any words of encouragement would be greatly appreciated...

any advice on supplements or other forms of healing like ultrasound etc would be greatly appreciated ...


onceahardman


May 13, 2012, 4:21 PM
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Re: [gbogh] Talus Bone "dead" "osteochondral defect" UGH [In reply to]
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Terrible injury.

I was diagnosed with osteochondritis dessicans when I was a freshman in high school, but it bothered me for several years even before that.

You are decribing a "microfracture" type of surgery, if you are looking to do some research.

The only real bright side is that surgical techniques are better now than they used to be. OBEY THE WEIGHTBEARING LIMITATIONS AT ALL COSTS! This is your best chance at a functional ankle. The alternative is fusion, and you might end up with that someday anyway.

I'll tell you what the first surgeon said to me, when I was a freshman. "Go to school, and work hard, learn to make a living with your brain instead of your back."

I had my first surgery in 1978. I started climbing shortly after, got pretty good for a while, traveled a lot. Also started skiing. Did lots of long approaches with heavy packs to remote areas. It hurt, but I managed. I pretty much have pain on most days, sometimes with every step. I had a second surgery in 2010. I will be a candidate for a total knee replacement someday. I still ski a lot, but don't get air anymore. I climb only sporadically these days.

But, I have a very satisfying career (partly got interested in PT because of my orthopedic problems.). I have a great family, and a great life. I probably have a deeper satisfaction with life overall than I had back then. But I do miss climbing harder stuff.

I hope your surgery goes well. Stay in touch.


oldiebutnoob


May 13, 2012, 5:41 PM
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Re: [gbogh] Talus Bone "dead" "osteochondral defect" UGH [In reply to]
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I had a different condition (chondromalacia under the knee-cap). But it sounds like I may have had a similar procedure. The Chondromalacia was under the kneecap and they drilled several holes into the end of the femur until blood started to flow out of the holes. Seven weeks of no weight bearing and three years at about 70%-80%, the knee has been 100% for the last thirteen years.

I wish you a speedy and full recovery.

Ron


gbogh


Jun 17, 2012, 9:01 AM
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Re: [gbogh] Talus Bone "dead" "osteochondral defect" UGH [In reply to]
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well i had surgery 3 weeks ago and have 3 weeks more on crutches. according to the doc the surgery was a good as could be and now only time will tell. the bone was definitely dead and the cartilage around the dead bone had died as well. he removed the cartilage and then carved out some of the dead bone. 4 drill holes were then drilled through the dead bone to fresh bone and blood flowed nicely and pooled in the area of bone he cut out. so now the hope is this blood will clot and form new bone and new cartilage will attach etc. then on the outside of the ankle the two major ligaments were so stretched out they were useless so he cut them and restitched the ligaments together . that part still has a some soreness and pain but all in all this surgery was nothing compared to my shoulder injury as far as pain. however we will not know if the bone took or not until i begin rehab in 3 weeks. so for now i have a very new found appreciation for those on crutches. it is a pain in the arse! however i am building up endurance to do hopefully 2.5 mile walk in crutches before i am off... i have done as long as 1.4 miles straight so far... heres to surgery and rehab :)


RomeoNovember


Jun 23, 2012, 7:26 AM
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Re: [gbogh] Talus Bone "dead" "osteochondral defect" UGH [In reply to]
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Wow! Rough! I just did this about 10 days ago--fractured my talus that is. I was also bouldering at the climbing gym and tried to stick the landing and my left ankle just crumpled like an accordian. I went to the ER right away. Glad I did. Like you, I felt it wasn't very significant. There was a pretty severe deformity so I thought it might just be dislocated and the pain was very minimal...but they found a fracture in that bone and sent me for surgery the next day. Two screws and a small plate. No weight bearing for at least 8 weeks. I have a follow up this coming Wed. It's splinted now but I think they might put a plaster cast on it? That's what someone mentioned while I was still in the hospital. I was also warned about the avascular necrosis because the talus has poor circulation compared to other bones. It seems to me that your putting weight on it for a month before they found the problem could have had a lot to do with the necrosis. I'm surprised they didn't get you surgery sooner, though! My surgeon explained to me that they do early surgical intervention as a means to prevent that...but it's not always fail proof. She also warned of osteoarthritis developing later.

I asked about supplements as well--trying to stack the deck to cut down on healing time if possible. I was told they weren't necessary unless I'm suffering from a deficiency, but I don't like the idea of sitting around doing nothing. I did some online research for alternative/natural medicine (I'm a nurse and try to be open-minded about all modes of healing). I am going to try some homeopathic remedies that are supposed to help heal bones/tendons/etc. I know that a lot of people see homeopathy as sketchy pseudoscience, but the way I see it, the remedies are cheap and they're not harmful at all so I'm giving it a shot. If there's even a glimmer of hope that I can get back to climbing faster/better, I'll take it!

Hope your recovery goes well!


whiskas


Aug 17, 2012, 7:44 AM
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Re: [gbogh] Talus Bone "dead" "osteochondral defect" UGH [In reply to]
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Sorry to hear this. Hope you're recovered by now or at least recovering at a steady rate. I had a similar thing happen to me when I was younger. Blocked a soccerball with one hand fully extended, I was the keeper, and thought I sprained my wrist. Got it checked out after and had it wrapped. It healed but apparently not the right way. Turns out, finding this out 14 years later, I had a minor fracture in there that the doctor didn't catch, so there was inadequate blood flow to the area and the bone died. So I've had osteonecrosis of the wrist for almost a decade and a half now. I carry on pretty much as normal although I have a little more limited range of motion with it and am told it will eventually end in arthritis sometime when I'm older. They told me they could carve out the dead bone and put in some "filler," whatever that means, but the process would be painful and take awhile to heal. So I said no. Still crushing it on the walls with only a little soreness. I actually think working it out helps with the strength and mobility of the area. Rolling stone type of thing. Anyway, round about way of saying it but these injuries don't necessarily have to translate into surgery and you'll be a step ahead of me since you've had it and are recovering properly. Have a good one!


maldaly


Aug 17, 2012, 10:13 AM
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Re: [gbogh] Talus Bone "dead" "osteochondral defect" UGH [In reply to]
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I shattered my talus in an accident 12 years ago and spent 2 years trying to het it healed. One interesting factoid I learned is that caffeine has 2 deleterious effects on bone growth. First, it inhibits calcium absorption and second, it's a vaso-constrictor and will shut down the micro-capillaries that are trying to get blood to what is already the least blood saturated bone in your body. Go cold turkey for the healing process.

Mal


(This post was edited by maldaly on Aug 17, 2012, 10:14 AM)


gbogh


Oct 29, 2012, 2:43 PM
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Re: [gbogh] Talus Bone "dead" "osteochondral defect" UGH [In reply to]
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just a quick update: i have now been given the go ahead to begin exercising again. I was able to get nearly all range of motion back in the ankle through rehab. however i will say that i still have a bit of pain that lingers both at the OD area and the ligaments that were repaired. also if i dont keep up on the stretching the range of motion on forward flexing becomes very stiff. running is going ok and after about two weeks i have been able to do about 3.5mile trail run but i definitely feel it from a soreness standpoint. the hardest part at 40y/o and with this injury is getting my knees back to handling the shock of running as well as getting form right again. in general it appears that i will have nearly all use of my ankle back but i dont think it will ever feel the same. i still have pain at times that may very well be placebo affect of my being worried that the bone will die again or may actually just be soreness from scar tissue etc. i am very nervous though about bouldering again and wonder if i will actually ever really do that again without the fear of landing wrong. either way i feel pretty fortunate to be able to even walk normally let alone run or bike or climb again. its funny b/c what was probably a fall that would not even approach what i thought was "dangerous" or "hard" turned out to be my worst injury... i would never wish this injury on anyone and wish all safe landings in climbing / bouldering....

John


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