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Fractured fibula and talus

In the early hours of February 5th I broke my ankle on a night out, it was really icy and I slipped and fell, I got up, tried to carry on walking and fell instantly. Apparently heels and ice don't mix, I don't recommend trying it...
I was brought straight to a+e and was told i was to have an operation. I managed to fracture both my fibula and talus, rip ligaments and tendons and also dislocate the ankle itself.
On Feb 9th I had the operation to relocate the bones and I've had a metal plate and several screws put in. I'm now in a non- weight bearing plaster cast and getting the stitches out on the 25th. So far I've managed to finally reduce the swelling by literally elevating the leg and sitting/lying down all day, everyday (so boring).
Now whenever I put the leg back down, even for as little as 5 minutes; my toes go a deep purple colour and I feel a lot of pressure in my ankle. Has anyone else experienced this? Any idea how to get circulation back to normal?

Also I'm just wondering about the recovery process altogether. I've read quite a few horror stories over the Internet from people who haven't ever fully recovered: getting arthritis, non-union etc...

I'm 19 so I've been told I'm young and healthy so should recover fully. I'm just panicking a bit!
In 2 weeks I'm due another checkup and change of cast - hopefully to a fibreglass as plaster is so heavy! Then finally in 8 weeks I can hopefully start to weight bear and learn to walk once again.
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replied February 20th, 2012
Especially eHealthy
Megan1992,

Any fracture which involves a joint, increased the chances of that joint developing traumatic arthritis later on down the road. There are many things which play into this and no two patients are the same. You are told this, so that you can be a totally "informed" patient. It does not mean that it will actually happen.


However, that said, you have a little more than the "usual" fibular fracture, since the talus is involved. Usually, in ankle fractures, it is the two malleoli (the bones that stick out of the side of the ankle) that get fractured. The lateral malleolus is the distal fibula and the medial malleolus is the distal tibia.

The talus is the third bone that makes up the true ankle joint. It is one of the tarsal bones of the foot. It is extensively covered with articular cartilage, and as such, it does not have a great blood supply.

So, it is the talus fracture that is usually the most troublesome and problematic, depending upon the exact nature of the injury.



As to the toes turning purple, blue, red, deep pink, etc, this is going to happen for quite a while. Wriggling the toes is also very helpful for decreasing swelling in the ankle and foot. By moving the toes it will also help to reduce the chances of the tendons scarring down around the injury site.

You have to remember that the venous and lymphatic systems are low pressure ones. To get the venous blood, lymphatics, and edema back into the body it requires that you contract the muscles of the lower leg and thigh, to help pump those fluids back up. Gravity will help a lot, which is why elevation of the foot above the heart level will help pull the fluids back into the body.

But, since you are immobilized in the cast, you cannot do a lot of muscle action. However, while your leg is up in the air, wriggle the toes and do calf contractions to help pump the fluids back into the body.

Due to being immobilized and having the trauma, which has disrupted a lot of the venous blood vessels, you are going to have a problem with stasis for quite a while. You will notice the toes changing colors for several months.


As to recovery time, that is a little hard to say, since you have the talus injury. Usually, fibular fractures unite in around 6-10 weeks. (If you smoke, quit, at least until the fracture is united.) But, this does not include the time is takes for soft tissue rehabilitation.

When you come out of the cast, you will have very significant ankle stiffness and calf muscle atrophy (muscle wasting). You will have to correct these to be able to walk with a "normal" gait.

To walk without a limp requires at least three basic things. No (or tolerable) pain, full (or near full) range of motion of the joints, and adequate strength in the muscles. This will take a lot of hard work in therapy. It won't just happen, you will have to make it happen.

So, be prepared for some hard work in the future. Also, it can take as much as a year for full recovery from this injury. Not to say you will be laid up for that long, but it make take that long till you know the final outcome.


Good luck. Keep that foot up and wriggle those toes. Wishing you the best.
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replied August 17th, 2012
Talus and Ankle Break
Hi there I broke my ankle, Metatarsals and Talus in April 2012 (fell of my horse at speed) and not walked since. I was in a hard cast for 14 weeks, now I am in a boot for the next 3 months. I go back on November 5th for my next x-ray. It has been non weight bearing for all that time and to be kept elevated when I can. The last time I went to the hospital the foot and ankle were healing fine but my Talus bone was not healing, my last appointment said that the blood is now going to the Talus and this was a good sign. Is this normal to be taking so long and what do you think will happen next? Oh i did have surgery on it when it happened to be pinned but when they opened me up to pin it they said it was stable and didn't want to stress the break further so didn't in the end pint it.
What is the next chapter??
Thank you Caroline (Perthshire Scotland)
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replied August 21st, 2012
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Caroline,

Unfortunately, it sounds like you developed avascular necrosis of the talar dome, but that it is now in the revascularization stage.

Talus fractures are very difficult to treat. The blood supply to them is very tenuous and easily damaged in a fracture. So, the patient has to be kept nonweight bearing, so that the talar dome does not collapse.

If you have managed to get to this stage, and the talar dome has not collapsed, then you have a good chance of it going on to full healing. But, as they say, only time will tell.

And, then you have to start the hard part, rehabilitation. It is going to take a lot of time and effort to regain your range of motion and strength. This is why it is not uncommon for it to take as long as a year to 18 months to fully recover from an injury such as this.


Again, if the talar dome is getting its blood supply back and has not collapsed in the mean time, you have gotten through the bad part, and it should go on to heal fully. But, then you have to do your therapy.

Good luck.
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replied December 10th, 2012
Hello, I am looking for advice and any comments would be welcome and very much appreciated.
I am an active, sporty 32 year old male with a very frustrating injury.
In early August 2012 I went over on my ankle during a match. Very sore at first but no bruising or swelling. Limped on it for few weeks and then started physio. Continued with physio for 6-8 weeks not knowing what was wrong but showed signs of improvement and returned to light running and turning.
However, was still sore and wasnt getting any better. Went for xray in October that didnt show anything wrong. Went for mri shortly after which showed damage to medial tendons with bruising to bone. Went to orthopedic consultant who suggested ct scan. Got CT scan December 2012 and just had meeting with consultant. He said that i fractured the talus bone and that there was also heavy bruising evident. He also said there is some bone spurs (footballers ankle - from repeat injury/over use) but that this was secondary and wasnt causing the pain.
His recommendation is to rest, no cast or support and to return to him in February to check on progress. He thinks that it is healing and an operation would not speed up recovery process. I enquired about a cast or support but again he said they would not speed up recovery process.
Just wondering has anyone else had this type of treatment.
As mentioned earlier I am deeply frustrated and would welcome any input.
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replied December 10th, 2012
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Archie2,

I also answered your same question in the orthopedic section.

Again, sorry that you are having problems.

Hopefully, this will heal up nicely and you will be able to get back to your regular activities soon.

Good luck.
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