A talus fracture is a break in one of the bones that forms the ankle. This type of fracture often occurs during a high-energy event, such as a car collision or a high-velocity fall.
Because the talus is important for ankle movement, a fracture often results in significant loss of motion and function. In addition, a talus fracture that does not heal properly can lead to serious complications, including chronic pain. For this reason, many talus fractures require surgery.
The talus is the bone that makes up the lower part of the ankle joint (the tibia and fibula bones of the lower leg make up the upper part of the ankle joint). The talus sits above the heel bone (calcaneus). Together, the talus and calcaneus form the subtalar joint, which is important for walking, especially on uneven ground.
The talus is the main connector between the foot and leg, helping to transfer weight and pressure forces across the ankle joint. It is largely covered by articular cartilage, the white slippery material that covers all joint surfaces. This cartilage allows the talus to move smoothly against its neighbor bones.
Most talus fractures are the result of high-energy trauma such as a car collision or a fall from height. Injuries from sports, particularly from snowboarding, are another, less common, cause of talar injuries.
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, 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 and are commonly seen in snowboarders.
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.
Patients with talus fractures usually experience:
After discussing your symptoms and medical history, your doctor will do a careful examination. He or she will:
Information from diagnostic imaging tests will help your doctor decide whether surgery is required and will be critical for surgical planning.