The talus is one of the most important bones that makes up the ankle joint, as is helps connect the leg and foot. It’s also a rather unique bone in that over half of it is covered with cartilage that provides the area with cushioning and flexibility. Because of all it provides, a fracture of the talus can have a significant impact on the motion of the foot and ankle joints and your ability to walk. Due to it’s location and shape, a break to the talus is often categorized as a talar neck fracture. Below, we take a closer look at the causes, symptoms and treatment options for talar neck fractures.
Causes and Symptoms
Due to the location of the talus, a rather unique force is required in order for the bone to fracture. Talar neck fractures typically present themselves when a significant upwards force is applied to the sole of the foot or shoe. This actions forces the foot to flex upwards and drives the talar neck up against the front of the ankle joint. Based on the nature of the injury, talar neck fractures are most common in automobile accidents, but can also occur during falls or during athletic activity.
Symptoms of a talar neck fracture include:
Inability to bear weight on the affected foot
Diagnosis and Treatment
The diagnosis of a talar neck fracture begins with an examination by a foot specialist. Signs of an injury will be obvious, but your doctor may look for swelling and range of motion issues in the joint. From there, your doctor will order x-rays or another imaging test, as a talar fracture shows up clearly on an x-ray or on CT scan.
Depending on the nature of the fracture, including whether or not the fracture is displaced, a treatment plan will be developed. It’s rare for a talar neck fracture to break in such a way that they bone remains non-displaced, but in these instances, non-operative treatment may be available. This would involve immobilization and non-weight bearing for 6-8 weeks and confirmation with imaging tests that the bone is healing as hoped.
In the majority of cases, the bone is displaced or unlikely to heal as desired without surgery, so an operation is ordered. There are a couple different procedures that can be used, but the goal of any talar neck fracture correction will be to return the talus to the original position prior to the fracture and to stabilize the injury site. Failing to get the talus back in the correct location can lead to foot misalignment. Correct positioning can typically be achieved with a skilled surgeon and some small hardware, including screws and sometimes a plate.