The talus, located in the foot between the tibia and calcaneus, has a very small size, but takes on a huge load of the whole body. According to experts, the proportion of fractures in this area is quite small - no more than 1%. But at the same time, a fracture of the talus is considered one of the most difficult, because due to the small blood supply, its healing is extremely slow.
Anatomical details
The structure of the talus of the foot differs in a number of features. First of all, it is important to note that the muscles are not attached to it. In anatomy, the following parts are distinguished:
- body;
- head;
- neck;
- posterior process.
Medical statistics show that most often fractures of this bone occur in athletes and when falling from a height. In this case, as a rule, fractures of the body or head of the talus occur, less often there is a fracture of the posterior process.
The described bone is fundamental in the formation of the ankle joint (its lower part) and is densely covered with cartilage.
Main reasonsinjuries
Despite the fact that the talus of the foot is injured infrequently, it is necessary to know why this happens. Let's list them:
- Active sports.
- Falling from a height.
- Traffic accidents.
- Ballet or dance classes.
- Be hit by some heavy object.
Depending on the cause of the injury, the nature and severity of the fracture will also vary. So, when falling from a height, the talus is clamped between the calcaneus and tibia, which, as a rule, leads to a comminuted fracture.
Unnatural twists and turns of the foot cause injury to various parts of the foot (neck, posterior process).
Fractures of the talus, in terms of the mechanism of injury, are divided into axial load and intense plantar flexion.
Fracture characteristics
Fractures of the main bone of the ankle, like any other, are divided into open and closed. In addition, it is customary to distinguish the following types of injuries:
- Fracture without displacement.
- Fracture with displacement of the talus.
- With dislocation of the joint in the ankle.
- With dislocation in the talonavicular joint.
In severe injuries with complications, symptoms of talus necrosis may occur. The death of part of the bone is due to poor blood supply and the complex structure of the ankle.
Fracture symptoms
A fracture of any joint is accompanied bypainful sensations, but a minor injury to the talus can go unnoticed for a long time, leading to complications.
The main symptoms of a fracture are:
- Severe swelling in the ankle and ankle area.
- Unable to lean on foot.
- Pain when trying to move the ankle or big toe.
In complex injuries, an unnatural displacement of the ankle will also be visually visible, and fragments of the talus can be felt during palpation.
Diagnostic Methods
To establish the diagnosis of an injury to the talus, it is necessary to carry out a number of diagnostic measures. These include:
- Verbal questioning of the patient.
- Visual examination of the ankle.
- Palpation of the damaged area.
- X-ray examination (images should completely cover the ankle area).
- Computed tomography - in cases with displacement, it allows you to determine the severity of the injury.
- Magnetic resonance therapy - allows you to determine the risk of necrosis.
The whole complex of measures allows you to choose a course of further treatment in order to maximize the chances of recovery.
Complications after a fracture
A number of unpleasant and painful complications may develop against the background of a complex fracture in the ankle area:
- Persistent pain.
- Necrosis of the talus.
- Damage in this area of blood vessels, nerve endings,cartilage.
- Arthrosis.
- Impossibility of normal functioning of the ankle.
Much directly depends on the timeliness of going to the doctor, which does not always happen. If there is a suspicion of an injury to the talus, the ankle hurts, then this should not be ignored. It is necessary to seek the advice of a specialist.
In the most extreme cases, an untimely or incorrectly healed fracture leads to disability and loss of ability to work.
How to give first aid?
Knowledge of first aid to a person who has received an ankle injury with a suspected talus fracture will be important. In this case, before falling into the experienced hands of doctors, it is necessary to carry out a number of simple actions:
- Remove unnecessary load on the leg (the person must be put or seated).
- Remove uncomfortable shoes, clothing, anything that can put extra pressure on the ankle.
- Apply dry ice for several hours (with breaks of 15 minutes).
- Offer a pain pill if allergic.
- If you have the skills, apply a splint and get a medical examination as soon as possible.
It is contraindicated to adjust the ankle on your own, this will only worsen the overall clinical picture.
Treatment of a fracture of the talus
The method of treatment is determined by the doctor after a full examination. It could be:
- Immobilization. It implies the imposition of a plaster bandage with a rigid arch support in the sole. The duration of treatment depends on individual he alth characteristics and the complexity of the fracture.
- Reposition. Closed reposition is considered a very painful procedure, which is performed under intraosseous anesthesia. The doctor stretches the ankle in a special way until all bone fragments are in the right places. After that, a plaster cast (boot) is applied.
- Osteosynthesis. In fact, this is an open reposition, that is, a surgical intervention. It is required for severe displacements, open fractures, improper dislocations, and when a risk of necrosis is identified. A cast is also applied after the operation.
Regardless of the method of treatment, the patient needs to take painkillers, especially in the initial stages, and constant monitoring by the attending physician. After the cast is removed, an x-ray is performed to confirm the correct fusion of the bones.
Recovery period
No less important is the period of rehabilitation after treatment of a fracture of the talus. Recovery time depends largely on the age of the patient and the complexity of the injury.
The recovery program is selected individually for each patient and may include the following activities:
- Attendance to physical therapy classes (the practice of doing exercises in water is often used).
- Therapeutic massage treatments and self-massage after doctor's recommendation.
- Physiotherapy treatments thatinclude a complex of various therapeutic actions, selected individually.
After undergoing the main treatment and during the rehabilitation period, it is important to remember that it is contraindicated to give an increased load on the leg. This can lead to collateral injury and prolong recovery time. A patient after a fracture of the talus should be under regular supervision even during the recovery period and take x-rays at least once a month.
