Could I have a Talus Fracture?

A talus fracture is a break in one of the bones that forms the ankle. This type of ankle fracture often occurs from high-impact, such as a car accident or fall.

Because the talus is important for ankle movement, a fracture often results in significant loss of motion and function. A talus fracture that does not heal properly can lead to serious complications, including chronic pain. For this reason, many talus fractures require surgery but a foot surgeon.

Fractures occur in all parts of the talus bone. Most commonly, the talus breaks in its mid-portion, called the neck. The neck is between the body of the talus bone, located under the tibia, and the head, located further down the foot.

Another common site for talus fractures is along the outside of the bone where it juts out slightly. This area of the bone is called the lateral process.  Fractures of the lateral process often occur when the ankle is forced out to the side.

Fractures are often classified according to the severity of the displacement — how much the pieces of bone have moved out of their normal position.

Minimally displaced or stable fractures: This type of fracture is barely out of place. The broken ends of the bones line up almost correctly. In a minimally displaced fracture, the bones usually stay in place during healing, and surgery to fix the bones into position is not usually required.

Displaced fracture. When a bone breaks and the pieces move out of their anatomic position, it is called a displaced fracture. The amount of displacement relates to the amount of energy that caused the fracture. Fractures that are highly displaced are more likely to be unstable. Unstable displaced fractures of the talus often require surgery to restore correct alignment and to give the best chance for the return to normal movement of the foot and ankle.

Open fracture: When broken bones break through the skin, they are called open or compound fractures. Open fractures often involve much more damage to the surrounding muscles, tendons and ligaments. In addition, open fractures expose the fracture site to the environment. They have a higher risk for complications and infection and take a longer time to heal.

What causes a Talus Fracture?

  • High-impact trauma such as a car collision or a fall from height.

  • Sports injuries are another, less common, cause of talar injuries.

When to see a foot and ankle specialist about a Talus Fracture:

  • If you have acute pain

  • Inability to walk or bear weight on the foot

  • Experiencing considerable swelling, bruising, and tenderness

If I have a Talus Fracture, what are my treatment options?

Non-Surgical:  

Only fractures that are well-aligned (stable) can be treated without surgery. This is very rare in a talus fracture because of the high-energy force that causes the injury.

  • Immediate first aid treatment by applying a well-padded splint around the back of the foot and leg from the toe to the upper calf to immobilize the limb and protect it.

  • Elevate the foot above the level of the heart helps to minimize swelling and pain.

  • Specific treatment depends upon the severity and the type of fracture, so it is important to seek immediate medical attention from a foot and ankle specialist.

  • Casting of foot and ankle to hold the bones in your foot in place while they heal. You will have to wear a cast for 6 to 8 weeks. During this time, you will be asked to limit the amount of pressure you put on your foot. The goal is for the bone to heal enough for you to bear weight on it without the risk that it will move out of position.

  • Physical therapy or home exercises to help restore the range of motion and strengthen your foot and ankle.

Surgical:  

In cases where the bones have shifted out of place (displaced), surgery to internally set and stabilize the broken pieces of bone results in the best outcome and reduces the risk of future complications in your foot and ankle.

  • Open reduction and internal fixation: During this procedure, the foot surgeon will reposition the bone fragments into their normal alignment. They are then held together with special screws or metal plates and screws.