The talus is a bone that sits above your heel bone and below the tibia and fibula, and it proves essential in the normal function of your ankle joint. While it is somewhat protected from injury given its location, a fracture of the bone can have long lasting consequences unless the injury is expertly treated. In today’s blog, we take a closer look at talus fractures and how they should be treated.
Talar Neck Injuries
Fractures of the talus typically occur as the result of high energy trauma to the foot. More specifically, this energy is typically applied to the bottom of the foot, forcing it to flex upwards and driving the talus up. When this happens, the talus tends to fracture at its “neck.” The neck is viewed as a middle area of the bone between the head and body of the bone. We put a black line through the talar neck on the image in this blog so you can get a better understanding of where exactly this fracture occurs.
Since it tends to occur during instances of severe trauma, it should come as no surprise that car accidents are the leading cause of talar fractures. This is especially common when a person strikes an object and comes to an abrupt stop, as their feet tend to be braced against the floorboards and a great deal of force is exerted upwards on the bottom of the foot. The can also occur as a result of a fall from a great height in which the person lands on their feet.
You may not know right away that you suffered a talar neck fracture, but you’ll know something is wrong with your foot. Symptoms include moderate to significant pain, swelling and sometimes a visible deformity of the foot. If you’re experiencing these symptoms, head to a specialist or the emergency room. There, they will will conduct a physical exam and take some images of your foot. Most commonly, this is done with an X-ray or CT scan.
Treatment Options
The vast majority of talar neck fractures involve a displacement of the talar bone, meaning it’s highly unlikely it will heal exactly as it should without surgical intervention. In the very rare case that conservative care could be an option, your doctor may recommend 6-8 weeks of non-weight bearing and immobilization.
For the majority of patients with a talar neck fracture, surgical intervention will be recommended. This will ensure the talus is re-positioned in the correct location so that it can continue to provide stability for the foot. It is very important that a skilled foot surgeon perform this procedure, because if things aren’t positioned perfectly, misalignment can occur. And if the bones don’t heal in just the right way, a number of potential complications can arise, including but not limited to:
- Osteonecrosis of the talar body
- Inhibited blood flow to the area
- Subtalar arthritis
- Inward curving or other misalignment of the foot
Aside from the issues that can develop with a poorly performed surgical operation, the surgery itself also carries risks such as infection, bleeding, deep vein thrombosis and nerve damage. This is why it is imperative that a skilled surgeon performs the procedure and gets the hardware in exactly the right position.