A talus fracture is a break in the small bone at the base of the ankle. The talus connects the top of the foot to the ankle and provides much of the joint's stability, range of motion, and weight-bearing ability. Fractures are often very painful and cause major swelling and tenderness. People can suffer talus fractures if they experience sudden, severe impacts from falls, car accidents, or sports injuries. Treatment often consists of surgery, casting, rest, and guided physical rehabilitation that can take up to six months.
The talus bone is small but strong, and relatively well protected. Intense force is required to fracture the bone. High-impact car crashes are a leading cause of talus fractures, as are falls from height and industrial accidents. Sports in which high-velocity falls are common, such as snowboarding and skateboarding, also leave athletes susceptible to major foot injuries. Elderly individuals and people with degenerative bone and cartilage disorders may be at an increased risk of talus fractures as well.
A talus fracture is immediately noticeable, as it causes intense, throbbing pain. A person may become nauseous and lightheaded because of the overwhelming pain and be unable to bear any weight on the injured foot. Swelling and stiffness occur very quickly. Whenever a person suffers a serious ankle injury, it is essential to provide first aid in the form of a protective wrap or splint and seek emergency medical care as soon as possible.
At an emergency room or doctor's office, a physician can inspect the foot to gauge the severity of damage. A physical exam and x-rays are performed to look for signs of a talus fracture and any concurrent damage to nearby ligaments and tendons. Patients are usually given high-strength painkillers and anti-inflammatory drugs while treatment decisions are made.
If the fracture is small and bones are not displaced, the patient is typically fitted with a hard plaster cast and allowed to go home. He or she may need to wear the cast for up to six weeks while being careful not to bear any weight on the foot. After the bone has had time to heal, the cast is removed and the ankle is re-evaluated. The patient may need to continue resting the foot and wear a protective brace while gradually returning to normal activity.
A talus fracture that results in significant bone displacement or shattering usually requires surgery. An orthopedic surgeon can realign the bone with the aid of metal screws, remove damaged tissue, and graft new bone material into the ankle if necessary. After surgery, patients generally need to wear casts for several months. Follow-up physical therapy sessions are important to safely regain strength and flexibility in the healing foot. Most people are able to recover from talus fractures, though they are encouraged to be very careful in future activities to avoid additional injuries.