Fracture of the Talus
The talus is a bone that is an important part of the ankle joint. It helps to transfer weight and pressure forces across the ankle point. It is located between the tibia and fibula of the lower leg and the calcaneus or heel bone. The tibia and fibula are situated on top and around the sides of the talus and thus form the ankle joint. At the point where the talus meets the calcaneus, it forms the subtalar joint. This joint is essential for individuals walking on uneven ground.
Most injuries to the talus are the result of trauma, such as automobile accidents and falls. These injuries are most often associated with injuries to the lower back. Snowboarding accidents also account for an increasing number of talus fractures, especially when a soft boot is used.
Treatment
An untreated talus fracture or one that doesn’t heal properly can affect foot and ankle function later in life. This includes the development of chronic pain, arthritis, or even bone collapse.
Treatment for a talus fracture must begin immediately. A well-padded splint should be applied around the back of the foot and leg from the toe to the upper calf. The foot should then be elevated above the heart level and ice should be applied for at least 20 minutes every hour or two until the patient is seen by a doctor. Weight should never be placed on a talus fracture.
In cases where the broken talus is aligned well, the fracture can be treated without surgery. The patient will be fitted with a cast to be worn for approximately six to eight weeks and will not be allowed to place any weight on the foot during that time. After the cast has been removed, the physician will suggest exercises that will help restore the strength and range of motion to the foot and ankle.
However, most fractures of the talus do require surgery to reset the bone and help minimize later complications. The orthopaedic surgeon realigns the broken bone with metal screws placed inside the bone. Any small fragments of bone discovered during this procedure will be removed and bone grafts will be used to help restore the shape of the joint.
After surgery, the patient will then be placed in a cast for approximately eight to twelve weeks. The patient will not be allowed to put any weight on the foot for at least two to three months. During healing, the physician may request X-rays or an MRI to be done. This will reveal if the talus bone has a good blood supply.
If it is discovered that the blood supply is injured, the bone could collapse. This condition is called osteonecrosis.
Even if the bones heal well, arthritis may still develop. Since most of the talus is covered with cartilage, bones are allowed to move smoothly against each other. If the cartilage is damaged, the bones will be forced to rub against each other without that protection. This results in stiffness and pain. Treatment of arthritis includes activity modifications, ankle braces, and either ankle joint fusion or replacement. |
