The talus located in the foot between the tibia and heel is very small, 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, the fracture of the talus is considered one of the most difficult, since due to the small blood supply its healing is extremely slow.
Anatomical details
The structure of the talus of the foot is distinguished by a number of features. First of all, it is important to note that the muscles do not attach to it. The following parts are distinguished in anatomy:
- body;
- head;
- neck;
- posterior process.
Medical statistics indicate that most often fractures of this bone are found in athletes and when falling from a height. In this case, as a rule, fractures of the body or the 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 tissue.
The main causes of injury
Despite the fact that the talus of the foot is injured infrequently, it is necessary to know the reasons for this. We list them:
- Active sports.
- Falling from height.
- Traffic accidents.
- Classes in ballet or dancing.
- Blow with any 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 kinks and turns of the foot entail injuries of its various parts (neck, back process).
Fractures of the talus, from the point of view of the mechanism of injury, are divided into axial load and intensive plantar flexion.
Fracture characteristic
Fractures of the main bone of the ankle, like any others, 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 scaphoid-navicular joint.
In severe injuries with complications, symptoms of talus necrosis may occur. The death of a 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 by painful sensations, but a minor injury to the talus can go unnoticed for a long time, which leads to complications.
The main symptoms of a fracture are:
- Severe edema in the ankle and ankle.
- Inability to lean on the foot.
- Pain when trying to move the ankle or big toe.
With complex injuries, an unnatural displacement of the ankle will also be visually visible, and fragments of the talus can be palpated during palpation.
Diagnostic Methods
To establish a diagnosis of talus injury, a number of diagnostic measures are necessary. These include:
- Verbal interview of the patient.
- Visual inspection of the ankle.
- Palpation of the damaged area.
- X-ray examination (the images should fully cover the ankle area).
- Computed tomography - it in cases with an offset allows you to determine the severity of the injury.
- Magnetic resonance therapy - allows you to determine the risk of necrosis.
The whole range of measures allows you to choose a course of further treatment in order to maximize the chances of recovery.
Complications after a fracture
Against the background of a complex fracture, a number of unpleasant and painful complications can develop in the ankle region:
- Constant pain.
- Talus necrosis.
- Damage to this area of blood vessels, nerve endings, and cartilage.
- Arthrosis
- The impossibility of the normal functioning of the ankle.
Much 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, an ankle hurts, then this can not be ignored. It is necessary to consult a specialist.
In the most extreme cases, an untimely or improperly healed fracture leads to disability and disability.
How to provide first aid?
Important will be the knowledge of first aid to a person who received an ankle injury with suspected fracture of the talus. In this case, before falling into the experienced hands of doctors, it is necessary to carry out a number of simple actions:
- Eliminate unnecessary strain on the leg (a person needs to be put or sit down).
- Eliminate uncomfortable shoes, clothing, anything that can put extra pressure on the ankle.
- Apply dry ice for several hours (intermittently for 15 minutes).
- Offer an anesthetic pill if there is no allergy.
- If you have the skills, apply a splint and provide a medical examination as soon as possible.
It is contraindicated to adjust the ankle on their own, this will only worsen the overall clinical picture.
Talus Fracture Treatment
The method of treatment is determined by the doctor after a full examination. It could be:
- Immobilization. It implies the application of a plaster cast with a rigid arch support in the sole. The duration of treatment depends on the individual characteristics of health and the complexity of the fracture.
- Reposition. Closed reduction is considered a very painful procedure that is performed under intraosseous anesthesia. The doctor pulls the ankle in a special way until all bone fragments have fallen into place. After this, a plaster cast (boot) is applied.
- Osteosynthesis In fact, this is an open reposition, that is, surgical intervention. It is required for severe displacements, open fractures, abnormal dislocations, and if there is a risk of developing necrosis. After the operation, gypsum is also applied.
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 removal of the gypsum, an X-ray examination is performed, which should confirm the correct bone fusion.
Recovery period
Equally important is the rehabilitation period after the treatment of the talus fracture. The timing of recovery 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 at physiotherapy exercises (practice of performing exercises in water is often used).
- Procedures for therapeutic massage and self-massage after the recommendation of a doctor.
- Physiotherapy procedures, which include a complex of various therapeutic actions, individually selected.
After undergoing the main treatment and during the rehabilitation period, it is important to remember that giving an increased load on the leg is contraindicated. This can lead to concomitant injuries and increase the period of recovery. The patient after a fracture of the talus should be under regular monitoring even during the recovery period and take an x-ray at least once a month.