Talus fracture
Background
Bones of the foot.
- Almost always associated with other injuries, often misdiagnosed as ankle sprains
- Talar neck fracture most common (~50%)
- Dorsiflexion with axial loading, snowboarders
- Talar body fracture (~20%)
- Hindfoot in either supination or pronation, high energy trauma
- Lateral process fracture (~10%)
- Dorsiflexion with axial loading
- Posterior process, medial or lateral tubercle very commonly misdiagnosed as ankle sprains
- Talar head fracture least common
Clinical Features
- Mid ankle pain/injury
Differential Diagnosis
Evaluation
Talus and subtalar joint
Talus fracture
- CT often required for accurate diagnosis
- AP, lateral, possibly Canale view
Management & Disposition
General Fracture Management
- Acute pain management
- Open fractures require immediate IV antibiotics and urgent surgical washout
- Neurovascular compromise from fracture requires emergent reduction and/or orthopedic intervention
- Consider risk for compartment syndrome
Specific
- Major fracture (talar neck and head)
- Immediate ortho consultation required (high rate of avascular necrosis)
- Minor fracture
- Posterior Ankle Splint
- Non-weight bearing, short leg cast if minimally displaced fracture
- Ortho referral
See Also
References
- Weatherford B. Talar neck fractures. Orthobullets, last updated 12/19/14. http://www.orthobullets.com/trauma/1048/talar-neck-fractures.
- Aiyer A, Moore D. Talus Fracture (other than neck), last updated 1secondary to7/14. http://www.orthobullets.com/trauma/1049/talus-fracture-other-than-neck.
- Judd DB, Kim DH. Foot Fractures Frequently Misdiagnosed as Ankle Sprains. Am Fam Physician. 2002 Sep 1;66(5):785-795.
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