The talus contributes to motion not only at the ankle joint but also below the ankle at the subtalar joint and in the midfoot at the talonavicular joint.
Injuries to the talus can have a significant effect on the motion of your ankle and foot joints and limit your ability to walk and bear weight.
Talus fractures are most often seen in car and motorcycle crashes, snowboarding accidents, and severe falls.
Symptoms
Talus fracture causes significant ankle pain, difficulty bearing weight on the ankle, and swelling around the ankle joint. These symptoms warrant going to the healthcare provider right away.
Expect to have an X-ray and ankle exam to determine whether it’s a fracture or other type of injury.
The most common symptoms of talus fractures include:
Swelling around the ankle jointPain with movement of the ankleFracture blistersBruising of the skinInability to place weight on the joint
Treatment Options
Treatment of a talus fracture depends on the extent of the injury.
If the fracture is not out of position, a cast may be sufficient for treatment.
If the fracture is out of position, then surgery may be recommended to realign the broken bones and stabilize them with screws or pins.
Complications
Three major complications commonly occur with talus fractures:
Ankle arthritisMalunionOsteonecrosis
Other potential problems include infection, nonunion, foot deformity, and chronic pain.
Ankle Arthritis
Arthritis is common after a talus fracture because when the cartilage is injured, the normally smooth joint surface becomes uneven. These irregularities can lead to accelerated wear in the joint, and ultimately to arthritis.
Because so much of the bone is covered with cartilage, arthritis may occur above the talus at the ankle joint, or below the talus at the subtalar joint.
Even with surgical treatment of a talus fracture, the development of arthritis is common.
Malunion
Malunion means that the break has healed, but the position where the bone healed is not anatomically correct.
This can lead to a number of different problems, especially with foot fractures where altered alignment can lead to long-term problems and difficulty walking.
Osteonecrosis
Osteonecrosis, or avascular necrosis, is a problem that is found commonly in the talus.
Because of the pattern of blood supply to the talus bone, it can be disrupted when the bone is injured in a fracture. Without a blood supply, the bone cells can die (osteonecrosis) and lead to a collapse of the bone.
Even with surgery to realign the bone and hold the fragments in position, damaged blood supply may lead to this problematic complication.
Recovery
The recovery from a talus fracture can be lengthy because until the bone is healed, you cannot place weight on your foot.
Therefore, most talus fractures require a minimum of six to 12 weeks of protection from weight-bearing. In more significant injuries, the time may be longer.
Studies have shown that the ultimate outcome of patients correlates with the extent of the initial injury. (So the worse the injury, the more on-going issues you’re likely to have.)
During or after the healing process, your healthcare provider may start you on a rehab program of physical therapy to regain:
Range of motionStabilityStrength
You may have to use a cane or wear a special boot and may not be able to put your full weight on your foot for two to three months.
