The talus is a small bone that sits between the heel bone (calcaneus) and the two bones of the lower leg (the tibia and fibula). It has an irregular, humped shape like a turtle's shell. The bones of the lower leg ride on top and around the sides to form the ankle joint.
Where the talus meets the foot bones, it forms the subtler joint. This joint is important for walking on uneven ground. Besides connecting the foot to the leg and body, the talus helps transfer weight and pressure across the ankle joint.
A fractured talus usually causes:
Most talus injuries are due to car accidents. Fewer are due to falls from high places. These injuries often also involve lower back injuries. More and more talar fractures are due to snowboarding, which uses a soft boot that isn't rigid enough to prevent ankle injuries.
During a physical examination, your doctor will look at your foot and ask how the injury happened. He or she will generally check to see that the nerves of your foot are working properly. Your doctor will also check to see that the blood flow to your toes hasn't been cut off and that you have normal muscle tension in your foot.
Your doctor may probably order foot and ankle X-rays. If these don't show a fracture, a computed tomography (CT) scan may be ordered. These tests help pinpoint where the fracture is. They also may show whether the bones are still aligned (non-displaced fracture) or have shifted out of place (displaced fracture). Any loose bits of bone that may need to be removed also can be seen.
A talar fracture that doesn't heal properly will create problems for you later. These may include not being able to use your foot normally, arthritis, chronic pain or collapse of the bone. Immediate first aid for a talar fracture is to apply a well-padded splint around the back of the foot and leg from the toe to the upper calf. Raise the foot above the level of the heart and apply ice for 20 minutes every hour or two until you can see a doctor. Don't put any weight on the foot.
In rare cases, if the bones haven't moved out of place, a talar fracture can be treated without surgery. You will have to wear a cast and avoid putting weight on your foot for six to eight weeks. After the cast has been removed, your doctor may give you exercises to restore the strength and range of motion of your foot and ankle.
Most talus fractures need surgery to avoid complications.
After surgery, your foot will be put in a cast for six to eight weeks. You will not be able to put any weight on the foot for at least three months.
