Talus Fracture of the Ankle

A Talus Fracture of the Ankle is a Serious Injury

Testing mobility of foot.
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What Is the Talus Bone?

The talus bone is one of the most important bones that make up the ankle joint. The talus is a compact bone that sits between the calcaneus (heel bone) and the tibia and fibula (bones of the lower leg). Much of the talus is covered with cartilage, a smooth, slippery substance that provides cushion and allows these bones to move more freely against each other. Because the talus is a primary connection between the bones of the ankle, a fractured talus can severely limit the ability to walk and bear weight.

Symptoms of a Talus Fracture

A fractured talus causes intense pain, swelling, bruising and the inability to put any weight on the ankle. Because these symptoms are similar to those of a severe ankle sprain, it's important to get immediate medical attention and an x-ray to determine if there is a bone fracture. To limit swelling immediately after any ankle injury, wrap the injured ankle in ice and get medical attention quickly.

Causes of a Talus Fracture

Talus fractures most often result from a fall from a height, or a severe impact to the foot, such as those caused by a car or motorcycle accident. Some experts believe an increase in talus fractures among snowboarders might be related to the use of a soft boot that, unlike ski boots, aren't stiff enough to adequately protect the ankle from injury during crashes.

Typical Treatment of a Talus Fracture

The specific treatment of a talus fracture depends upon the severity of the fracture.

Small fractures that are in proper alignment may heal on their own if immobilized for several weeks with a cast or boot. More severe fractures that result in the talus bone breaking into pieces that move out of alignment require surgery to re-align the bones and hold them together with screws or pins as they heal.

Bone chips or fragments also may need to be removed to allow the joint to heal properly.

Complications of a Talus Fracture

Because talus fractures often irritate the smooth cartilage covering the talus bone, many people develop arthritis in the ankle joint after a fracture. Another more serious outcome of a talus fracture is something called osteonecrosis or avascular necrosis. Due to its location, the talus bone has a very limited blood supply. If the fracture disrupts this blood supply, the bone may fail to heal properly and may die. Specific imaging exams, such as an MRI, may be performed to monitor the blood supply to the talus as your fracture heals.

When Can I Return to Sports After a Talus Fracture?

Simple talus fractures may heal after six to eight weeks in a cast or a boot. During this time, you will not be able to put any weight on the ankle. Once the bone has fused properly, you will follow a length rehab program of physical therapy to regain range of motion, stability and strength in the ankle joint.

If your talus fracture required surgery, you might need to avoid any weight on the joint for up to 12 weeks, followed by the same lengthy rehabilitation program. If complications occur, the recovery from a talus fracture may take longer or may result in long-term ankle joint dysfunction or activity restrictions. It's important to work with your surgeon and your physical therapist throughout your recovery to have the best possible outcome.

References

Fortin, PT and Balazsy, JE. Talus Fractures: Evaluation and Treatment J. Am. Acad. Ortho. Surg., March/April 2001; 9: 114 - 127.

Vallier HA, Nork SE, Benirschke SK, Sangeorzan BJ. Surgical treatment of talar body fractures. J Bone Joint Surg Am. 2004 Sep;86-A Suppl 1(Pt 2):180-92.

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