The talus is a small bone located between the heel bone (calcaneus) and the two bones of the lower leg (tibia and fibula). Where the talus meets the bones of the foot, it forms the subtalar joint, which is important for walking on uneven ground. The talus “connects” the foot and the leg and body, helping to transfer weight and pressure forces across the ankle joint.
Most talus injuries result from motor vehicle accidents or falls from heights. Often they occur together with injuries to the lower back and other foot injuries, such as heel fractures. An increasing number of talar fractures are seen among snowboarders, because the soft boot that is used is not supportive enough to prevent ankle injuries.
- Acute pain
- An inability to bear weight
- Significant swelling and tenderness around the ankle
Talar fractures that result from snowboarding injuries may be mistaken for ankle sprains because of the tenderness on the outer side of the ankle and severe bruising. It is imperative to see a physician for evaluation.
Untreated talar fracture may create serious problems such as impaired foot function, possible development of arthritis and chronic pain, or even bone collapse. If you suspect this fracture, you should see a physician immediately.
Immediate first aid treatment for a talar fracture is RICE: apply a padded splint around the back of the foot and leg from the toe to the upper calf. Elevate foot above the level of the heart and apply ice for 20 minutes every 1-2 hours until you can see a doctor. Don’t put any weight on the foot.
Occasionally, a talar fracture can be treated without surgery if the bones have not moved out of alignment. A cast for at least 6-8 weeks will be necessary and no weight can be put on the foot during that time. Exercises will help to restore the range of motion and strength to your foot and ankle after the cast is taken off.
Most talar fractures require surgery to avoid complications. The surgeon will realign the bones and use metal screws and bone grafts to hold the pieces in place. Small fragments of bone may be removed.
A cast is applied after surgery for 6-8 weeks. The foot should not bear weight for at least 3 months. The healing of the bones is monitored with X-rays or a magnetic resonance image (MRI) to see whether blood supply to the bone is returning. If the blood supply is disrupted, the bone tissue could die, a condition called avascular necrosis, which could cause bone collapse.
One of the complications is a possible development of arthritis in later years. If the cartilage covering the talus is damaged, the bones will rub against each other, resulting in pain and stiffness.