January 23, 2019

What is a fractured talus (broken ankle)?

Foot and Ankle | Trauma

THIS POST IS PART OF THE ULTIMATE GUIDE TO FOOT AND ANKLE INJURIES

A break in one of the bones that form the ankle is considered a talus fracture.

The talus is the bone that makes up the lower part of the ankle joint. Together the talus and the heel bone form the subtalar joint, which is important for walking. Because the talus is the connector of the foot and leg, it helps transfer weight and pressure across the ankle joint.

The talus provides ankle movement, therefore when the talus is fractured you will experience a significant loss of motion and function.  A fracture can occur in any part of the talus bone, it most commonly breaks in its mid-portion.

The talus can also fracture along the outside of the bone (the part in your ankle where it sticks out slightly). This is referred to as a lateral process fracture.

Classification of talus fractures

  • Minimally displaced or stable fractures: The fracture is barely out of place and the bones still line up almost accurately; surgery to fix the bones is not typically required
  • Displaced fracture: The bone breaks and the pieces are out of the correct position; surgery is almost always required to restore alignment and correct movement of the foot and ankle
  • Open fracture: The bone breaks through the skin; surgery is necessary to fix the surrounding muscles, tendons and ligaments

Cause

  • A high impact event such as a fall or car accident
  • Injuries from sports such as snowboarding

Symptoms of a broken ankle

  • Acute pain
  • Swelling
  • Bruising
  • Tenderness
  • Inability to walk
  • Inability to bear weight

Physician examination

Most times the pain of a fractured talus will cause you to go to an urgent care or emergency room. To determine whether you have a talus fracture, your physician will ask you for a complete medical history, have you describe your symptoms and how the injury occurred, and conduct a physical examination. An X-ray or CT scan is necessary to confirm the diagnosis and determine the complexity of the injury.

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Broken ankle treatment

Nonsurgical treatment

Only fractures that are well aligned can be treated without surgery and include:

  • Immediate splinting around the back of the foot and leg
  • Elevating the foot above the level of the heart to minimize swelling and pain
  • Casting to hold the bones in your foot while it heals; it usually takes six to eight weeks before the cast is removed
  • Physical therapy to restore range of motion and strengthen the foot and ankle

Broken ankle surgery

Because of the high-energy force that causes talus fractures, surgery is almost always necessary and depends on the severity and type of fracture. During surgery, the bones that have shifted out of place are stabilized with special screws or metal plates. Your surgeon will determine the best surgical option based on your fracture.

Broken ankle recovery

The more severe your fracture, the longer the recovery may be. After surgery, your foot will be in a splint or cast from two to eight weeks. Periodic X-rays are usually necessary to confirm that the ankle is healing accurately.

Physical therapy exercises are essential to restore range of motion and strengthen the supporting muscles in your foot and ankle.

Sometimes, a patient will experience post-traumatic arthritis in their ankle. This is due to the damaged cartilage, which leads to pain and stiffness over time. Sometimes additional surgery is needed to relieve pain, but usually pain is managed with nonsurgical options.
The Ultimate Guide to Foot and Ankle Injuries

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