Gypsum after resection of the talus. Treatment of a fracture of the talus

Talus fractures account for less than one hundredth of the total fracture statistics and less than a fifth of the number of foot fractures.

However, this is one of the most severe injuries, difficult to diagnose and treat. A separate injury to the talus is extremely rare, as a rule, in 65% of cases it is combined with fractures: calcaneus (10%), medial malleolus (20-29%), other bones of the thigh and foot, as well as ruptures of the tibiofibular syndesmosis.

The talus is not one of those bones that can be removed from the skeleton, used to create, for example, Eve and continue a completely comfortable life.

The value of this small bone, 70% covered with cartilage and not attached to any muscle of the bone, cannot be overestimated.

Located between the tibia and ankle, it practically takes on the entire static and dynamic load from the body, redistributing it to the feet.

In the talus, such functional zones are distinguished as:

Body;
Head;
Neck;
Rear branch.

More often than others, a fracture of the neck or body is diagnosed, and a fracture of the posterior process of the talus occurs much less frequently.

The head of the talus comes into contact with the navicular bone, its lower part is connected to calcaneus, and the body is clasped on both sides by the tibia and fibula. On the posterior process, two tubercles protrude - lateral and medial, separated by a tendon.

Contrary to the opinion of some experts, the talus is quite well supplied with blood, thanks to three arteries: the tibialis posterior, the tibialis anterior, and the fibula.

Mechanisms and causes of fractures

The cause of such a serious injury is excessive sudden loads in the ankle area, which are provoked by:

Awkward movement during sports, ballet and similar exercises.
Falling from a height;
The impact of a heavy object on the lower leg.

A strong arch of the foot in the ascent (as in a ballet position on toes) can lead to a fracture of the neck, and reverse flexion, exceeding the margin of safety, can lead to a posterior process. If such an inflection is accompanied by a fold, then a fracture of the outer process is possible.

With a vertical impact, the bone is pinched between the tibia and calcaneus, and a compression fracture of the talus occurs with the formation of fragments.

In addition, sudden dorsiflexion plus axial loading or strong plantar flexion often results in dislocation or displacement of the talus body.

Forms and classification

Regardless of the location of the fracture (neck, body, head), there are four main types:

Like other fractures, a talus fracture can be either open or closed.

Symptoms and other diagnostic methods

Symptoms of talus fractures are often similar to other injuries in this area, such as sprains:

If a external examination did not give a reliable picture of the violations of the internal structures of the bone, it is necessary to conduct x-rays in the direct, lateral, oblique Broden and Canale projections, make a CT or MRI of the affected area to make an accurate diagnosis.

The consequences of a fracture of the talus of the foot

An already complex injury to the talus is often complicated by fractures in the bones of the ankle, calcaneus, or rupture of the tibiofibular syndesmosis, which entails:

cartilage damage, nerve fibers and blood vessels;
osteomyelitis;
Aseptic necrosis of the bone;
Deforming arthrosis;
Functional disorders of the ankle;
Persistent pain syndrome.

Subsequently, such injuries can lead to disability and complete disability.

First aid

Emergency care for a suspected fracture of the talus is no different from the same measures for any other fracture:

Give the victim anesthesia: Analgin, Ibuprofen, Ketorol, Nimesil (tablets or injections).
Lay or seat so that the injured limb is not subjected to further stress.
Call an ambulance.
If the nature of the injury allows, remove shoes, socks and apply a fixing bandage.
If open wounds are found, before applying a bandage, treat them with an antiseptic.
Apply cold to the injured area, controlling the time (if it is ice crushed in a plastic bag, remove it for 2-3 minutes every 10 minutes) to avoid frostbite.
If necessary, independently, as quickly and carefully as possible, deliver the patient to the nearest medical facility.

You should be aware that in case of a belated visit to a doctor in case of a fracture of the talus, the consequences can be the most undesirable from prolonged treatment and rehabilitation, to amputation of part of the leg.

Treatment Methods

If you suspect a fracture of the talus, you should immediately contact an orthopedist or surgeon.

He will conduct an examination, make a diagnosis and prescribe the appropriate treatment. Depending on the nature of the fracture, the following treatments may be used:

Immobilization

When the talus of the foot has received a mild fracture, without displacement, a polymer or plaster bandage with an arch support in the sole of the "boot" is used as a treatment, which remains on the patient's leg for at least 6 weeks, without axial load, followed by exercise therapy.

In this case, it is necessary to take painkillers and provide an elevated position to the injured leg, in order to avoid the development of edema. Efficiency conservative treatment is 45-50%. Upon completion of the rehabilitation program, the full functionality of the joint is restored, starting from the third month, depending on age and other factors. individual features organism.

Closed reduction

This is a medical manipulation of matching parts of a broken bone without disturbing the soft tissues surrounding the joint. The procedure is very painful and is performed only after intraosseous anesthesia.

The victim is laid on his stomach. The orthopedist flexes the patient's leg in knee joint, stretching the heel with one hand, bend the foot with the other so as to close the displacement, after which he applies an immobilizing bandage. After seven weeks, the plaster cast is changed to a new one when the foot is already bent at an angle of 90º.

The patient wears a bandage for up to four months from the date of application. After this period, the plaster is removed, and with satisfactory control images, a rehabilitation program is prescribed.

Open reduction and osteosynthesis

Surgical intervention to detect and eliminate traumatic changes in bones and soft tissues.

Open reposition is carried out in the following cases:

Surgery to treat a fracture of the talus must be performed no later than six hours after the injury.

When applying such a radical intervention (incisions in access zones of at least 7 cm), one should pay attention to Special attention maintaining the integrity of the tendons, blood vessels and nerve fibers surrounding the joint.

Simultaneous use of two approaches - posteromedial and anteromedial - can be a good solution to avoid osteotomy of the medial malleolus and visualize up to 80% of the talus dome.

AT modern medicine Ankle arthroscopy is widely used. Arthroscopic approaches are minimally traumatic. Thanks to a diameter of 2.7 mm, they allow you to work on the entire dome of the talus, without leaving large scars and greatly facilitating rehabilitation.

Open reduction techniques

At the end of the operation, the limb is fixed either with an immobilizing bandage or with a rod apparatus in the desired position.

AT postoperative period The patient is taking antibiotics and pain medications. After 1-2 months, an MRI is performed to exclude avascular necrosis.

After a week of immobility of the limb, the patient is shown small, calculated movements in the joint. It is allowed to fully load the operated leg after three months of rehabilitation.

Recovery period

The postoperative period can be aggravated by various complications that have developed due to:

big therapeutic effect provide:

Exercise therapy complexes;
Aquatherapy;
Massotherapy;
Various physiotherapy procedures.

However, an individual set of procedures for each individual case is compiled by the attending physician, taking into account the anamnesis, age, gender characteristics and other nuances.

AT rehabilitation period you should not force an increase in loads, increasing them gradually in a safe mode. Also, do not forget about dispensary registration and control x-rays at least once a month.

conclusions

Fracture of the talus is a very dangerous, albeit infrequent, type of injury. Even at the slightest suspicion of this damage, you should immediately go to the nearest emergency room and carry out necessary examination to confirm or rule out a fracture.

Depending on the severity of the injury, undergo the prescribed treatment and complete rehabilitation program to ensure maximum restoration of joint mobility.

A fracture of the talus is a serious injury that, despite the small size of this bone, can lead to very serious injuries. Let's take a closer look at why this injury occurs and how it can be treated.

In what cases can you get a fracture?

The structure of the talus of the foot is as follows: the head of the talus, its neck and the posterior process. The latter, in turn, has a medial tubercle and a lateral tubercle of the posterior process of the talus. The medial tubercle is larger than the lateral one.

Based this building bones, there are such types of injury:

Fracture of the posterior process of the talus.
Fracture of the neck of the bone.
Fracture of the body of the bone.

The most common is a split (avulsion) fracture of the bone. Common Causes, which can cause a fracture of any of the structural parts of the bone, are considered: getting a fracture when falling or jumping from a great height, resting your feet on a support; the possibility of a fracture as a result of excessively intense dorsiflexion of the foot; obtaining a fracture during dorsiflexion and tucking of the foot at the same time; injury can also occur during sports or in an accident.

How can a fracture be recognized?

Symptoms of a hip fracture may include:

acute pain syndrome in the affected area, but if there is only a bone fracture, the pain will be very weak;
limitation of joint mobility;
hematoma and swelling in the area of injury;
the presence of deformity of the ankle joint;
there is an impression of the bones in the swollen soft tissues ankle joint;
a fracture with a displacement (breaking off of a bone fragment) is accompanied by a bent position of 1 finger, which is not observed with a fracture of the talus without displacement;
if a fracture of the neck is combined with a subluxation or dislocation of the bone, an asymmetric deformity of the joint can be observed.

Injury diagnosis

Diagnosis, which will help confirm or refute a fracture of the talus, includes the following activities: a visual examination of the leg by a doctor; palpation of a limb; instrumental research.

With visual inspection and palpation, it is impossible to get an accurate picture of the injury, because appearance and the nature of the pain, one can speak not only about a fracture, but also about injuries similar to it, such as a fracture of parts of the foot adjacent to the bone and bruising of the soft tissues of the ankle.

Only X-ray examination, which is carried out in two projections, will help determine the final diagnosis and the necessary treatment. Also, the doctor may prescribe a tomography - computer or magnetic resonance. Thanks to such diagnostic methods, it is possible to detect the presence of even the slightest damage that may not be noticed during an X-ray examination.

It is difficult to make a diagnosis in the case of an isolated fracture of the posterior process of the talus. In other words, a Shepherd's fracture, which is due to the presence of an additional triangular bone, which is present only on one side. A predisposing factor in obtaining this type of injury is the presence of a tooth-like and hook-shaped form of the posterior edge of the talus.

Bone fracture treatment

First aid after receiving a fracture is as follows:

The imposition of a plaster cast, starting from the toes and ending with the upper third of the lower leg (if the fracture is not accompanied by displacement).
Applying a cold compress.
Giving the foot an elevated position.

In the presence of displacement, the doctor compares bone fragments. If a fracture dislocation occurs, blood circulation in the limbs may be disturbed, the soft tissues that surround the bone can be severely squeezed and damaged by fragments. In this situation, an urgent operation is performed to restore the anatomical localization of the fragments.

In the event that during several attempts it was not possible to match the bone fragments, an open reposition and fixation with Kirschner wires are prescribed. The process is controlled by X-ray. When the articular surface of the talus block is destroyed, arthrodesis of the joint is also performed. The most severe cases require bone removal.

Recovery after surgery

Rehabilitation after a fracture is of no small importance for the full recovery and recovery of the body after an injury. As a rule, such recovery after a fracture of the talus is standard: massotherapy; performance physiotherapy exercises; carrying out physiotherapy procedures.

There are also such fractures that require an individual course of rehabilitation developed by the attending physician. The recovery process is monitored by a doctor every month.

For a speedy recovery, it is recommended to limit any load on the injured limb until the time determined by the attending physician. As a rule, in case of a fracture of the neck of the bone, the limb should not be loaded for 6 months, and in case of a fracture of the bone block, within 9 months.

Fracture dislocation of the bone

Fracture dislocation is very rare. Determining the severity of the injury occurs by clarifying such data as: how complex and difficult to reduce fracture dislocation; how pronounced are the violations of the blood supply to the soft tissues of the foot; is there any aseptic necrosis bones.

The main reason for such an injury is excessive, forced dorsiflexion of the foot. The impact of the anterior edge of the tibia on the talus leads to the fact that the integrity of its neck and body is violated, and its proximal fragment is dislocated.

If a dislocation of a bone fragment has occurred, its protrusion can be observed on the posterior surface of the ankle joint. Quite often, along with a fracture-dislocation of the talus, a fracture of the medial or lateral malleolus occurs.

It is possible to eliminate the fracture-dislocation of the bone only operatively. But even this method of treatment will be extremely difficult. As soon as the dislocation is reduced and the exact reposition of the fragments is carried out, the fracture zone is fixed with special needles. Reposition may be difficult if the angle of rotation of the bone body is more than 90°. One month later, the spokes are removed, the external plaster is replaced, which is now applied up to the knee. Gypsum at the same time contains a built-in metal instep support.

The plaster can be removed after about 3 months. To avoid the development of aseptic bone necrosis, dosed load on the leg is allowed no earlier than 9 weeks after the operation, and full load - no earlier than 5 months.

Sometimes there is also a subluxation of the talus. With subluxation, the angle of rotation of the bone body will be less than with dislocation.

What are the possible complications after an injury?

These include the following consequences:

Disturbed blood supply to the bone, which is a consequence of a malfunction in the functioning of the vessels of the foot.
As a result of the above complication - necrosis. This pathological phenomenon is accompanied by extensive edema, pain syndrome, limitation of foot mobility.
Wound infection.
Limitation of mobility of the entire ankle joint.

All of these complications, of course, can be avoided if you start treatment in a timely manner and follow all the doctor's recommendations.

Fractures of the foot are rare, but even among them, a fracture of the talus is a very rare injury. Only 6% of all patients' visits to emergency centers for injuries of the bones of the foot are associated in any way with damage to the talus.

Despite its small size, the talus plays a very important role in the human body. It is she who is responsible for the stability of the ankle joint and takes on the load of the whole body when walking. In addition, the normal formation of the arch of the foot depends on it.

The talus is made up of 3 parts:

block;
heads;
back process.

AT human body not a single muscle is attached to this bone, but it is thanks to it that a person is able to walk. Almost the entire surface of the talus is cartilaginous tissue. This bone is a structural element of the tarsus and is connected to the fibula and tibia with the help of joints.

Based on in which part of the bone the fracture occurred, doctors distinguish fractures of the lateral and posterior process, as well as the neck and body of the talus. Moreover, each type of injury has its own causes of occurrence:

A sharp blow (usually happens when falling on your feet from a height). As a rule, in this case, crushing of the entire talus occurs.
Dorsiflexion of the foot can cause a fracture of the talus neck.
Dorsiflexion of the foot in combination with its dislocation provokes damage to the lateral process.
Excessive flexion of the foot is the cause of a fracture of the posterior process.

The most common injury to the talus occurs in road traffic accidents. Fractures of the feet in this case are often combined with injuries to the ribs, arms, spine and other parts of the body. Sometimes athletes (especially skiers and snowboarders) experience this injury.

signs

After a fracture of the talus in the victim near the ankle joint and foot, hemorrhage occurs and swelling occurs. This phenomenon is especially noticeable with inside ankles. In this case, the patient develops clubfoot.

If the bone fragments have shifted, the victim may experience leg deformity. During palpation of the foot, severe pain occurs. And pain are most severe if a fracture of the process of the talus has occurred.

The pain intensifies when trying to move the ankle joint and stepping on the foot. With a fracture of the talus, which is combined with a dislocation of the foot, the patient may also complain of discomfort in the area of the Achilles tendon. The mobility of the lower limb is severely limited.

The symptoms of a fracture can also include a pathognomonic sign, in which the victim has pain during passive flexion. thumb legs. This phenomenon is due to the special location of the long tendon (on which the talus is suspended) - the main flexor of the finger.

Diagnostics

Symptoms alone are not enough to make a diagnosis of a talus fracture. To accurately verify the presence of this pathology, it is necessary to carry out diagnostic measures, which include instrumental methods research.

That is why, if a fracture is suspected, specialists prescribe radiography in two projections, as well as computed and magnetic resonance imaging (if necessary).

After carrying out these procedures, the doctor will know exactly what type of injury the patient has, assess the condition of the surrounding tissues and choose a treatment method.

First aid

To help a person with an injury to the talus, you must:

To seat the patient in such a way that the load on the legs is reduced or completely gone (for this, a chair can be placed under the lower leg).
Take off your socks and shoes.
Call a doctor.
Apply ice or something cold to the injured area. In this case, it is not desirable that the skin be in contact with ice. It must be wrapped in a clean cloth.
Give the victim an anesthetic.

While waiting for a doctor, the patient should not be left alone. At this time, you need to talk to him and try to calm him down.

The patient should never step on the damaged part. This can provoke a displacement of bone fragments, damage to surrounding tissues or blood vessels. The victim can be picked up and put on his shoulder, moved to a quiet place. In extreme cases, you can just put it on the ground. In this case, the patient must lean on something, thus removing the load from the damaged area.

Treatment

After the victim is taken to the hospital, he is given an anesthetic injection. After that, if the bone fracture is not combined with displacement (even if the bone is crushed, but the fragments are not displaced), a plaster is applied to the leg (from the fingers to the upper part of the lower leg) for a period of 2 to 3 months. During this period, the patient should not stand on the affected leg.

If the fragments have shifted or the victim has a dislocation of the bone, then he first undergoes a closed reposition of the fragments. If it was not possible to eliminate the displacement with the help of a closed reposition, then the patient is given an open reposition and the fragments are fixed using Kirschner wires.

If the patient has both a dislocation and a fracture at the same time, then this can cause serious consequences for him, because in this case blood circulation is disturbed and muscle and adipose tissue is squeezed. In this situation, an urgent operation is necessary, during which the correct position of the bone will be restored. In severe cases, compression-distraction osteosynthesis can be performed.

With the help of x-rays, doctors control whether the treatment is going well. If the patient has a complete or partial destruction of the surface of the joint, then it will be artificially recreated for him. With a very strong destruction of the bone, its complete removal is prescribed. If the skin near the fracture is injured and infected, the treatment is performed with percutaneous fixation devices.

In case of a fracture of the posterior process of the bone, the foot is fixed with a plaster cast for a period of 1 month. If bone fragments do not heal well, patients may be prescribed compression osteosynthesis. In this case, the victim is subjected to resection of non-fused parts in the talocalcaneal joint and calcaneocuboid zone. After that, the fragments are placed as tightly as possible. Finally, the bones are fixed with Kirschner wires and plaster is applied.

Rehabilitation

The recovery time of a patient with fractures depends on the individual characteristics of the patient's body. The date of removal of the plaster in any case is appointed by the doctor, based on the results of the X-ray examination.

After full consolidation, patients should undergo a course of rehabilitation. At this time, a set of measures is carried out that prevent undesirable consequences, help develop the fingers and joints of the legs.

Ideally, during rehabilitation, the patient should:

perform therapeutic massage on your own or go to professionals for this;
engage in physical therapy;
go to physical therapy.

It is worth saying that for the first time after removing the cast, excessive loads on the legs are highly undesirable. If the victim had a broken neck of the talus, it will be possible to return to a normal lifestyle only after 6 months, and if the block is fractured, after 9.

In order to identify the consequences of an injury in time, it is strongly recommended that all patients register for a dispensary. To monitor their condition, they must undergo an X-ray examination once a month. If any discomfort occurs in the area of the talus, patients should immediately consult a doctor.

Complications

The most frequent and at the same time the most dangerous complication fracture is aseptic necrosis of the bone. When this occurs, bone tissue dies. Often in this case, an infection joins. In this case, arthrodesis (immobilization) of the ankle and sometimes subtalar joints is performed.

Another common complication is the dysfunction of the ankle joint. In this case, when timely diagnosis and treatment, the prognosis remains favorable.

Sources

Traumatology and orthopedics. Textbook for students medical institutes edited by Yumashev G.S. Publishing house "Medicina" Moscow. ISBN 5-225-00825-9.
Kaplan A.V. Closed injuries of bones and joints. Publishing house "Medicine". Moscow.

A fracture of the talus is a serious injury, which is often accompanied by complications and severe consequences. It is considered one of the rarest types of foot fractures, which accounts for only about 6%. Since the talus is the largest in the foot, after the calcaneus, any damage to it is especially difficult and often leads to disability.

The talus includes the head, block and posterior process. She constantly experiences great efforts, because thanks to her, the load is distributed from the lower leg to the metatarsal bones. In this regard, elementary sharp increase voltage. According to the frequency of cases of damage to the talus, the largest number of them occurs on the neck, the smallest - on the posterior process.

A distinctive feature of the talus is a weak blood supply, for this reason, the consolidation of the fragments is extremely slow. Even her simple fracture without displacement can cause a large number of serious complications such as necrosis.

Another feature of the talus is that more than half of its area is covered by cartilage. In this regard, the consequences of injuries lead to limited mobility of the joint and deterioration of the motor function of the limb. Even if there is proper treatment almost a third of all cases lead to disability.

Possible causes of fracture

Common causes of a talus fracture are:

jumping from a height;
the fall;
traffic accidents;
reckless sports.

Snowboarders and skiers often suffer from such injuries.

Each of the causes causes the most characteristic damage for it:

A fracture of the posterior process of the talus is noted in case of excessive flexion of the foot.
Fracture of the neck often occurs with its intense dorsiflexion, when there is a leverage effect.
An unusually high load, or a strong blow, usually leads to crushing of the talus.
Sharp outward turning of the foot causes fractures of its lateral process.

Main features

With a fracture of the talus, the following symptoms are noted:

intense pain;
pronounced deformation;
puffiness;
mobility disorder.

The main symptom of this injury is sharp pain, which a person feels in the ankle and foot as a whole. In 80% of the victims, the appearance of bruising and swelling that has spread to the lower leg is observed. Palpation causes intense pain not only in the foot - usually the whole leg hurts up to the knee. The pathognomonic sign is painful passive flexion of the thumb.

A displaced fracture of the talus leads to a transformation of the configuration of the ankle joint and a decrease in the height of the ankles. This is accompanied by a color change skin that look overstretched.

The marginal fracture of the talus makes you feel slight pain and a slight violation of the range of motion. For this reason, it is often mistaken for a simple bruise, which is the result of late presentations and subsequent complications.

Types of diagnostics

Diagnostic procedures that help to detect a fracture of the talus in a patient consist of a visual examination and the use of instrumental studies.

Since similar symptoms can also be observed with fractures of other bones of the foot or bruises of nearby tissues, it can be difficult even for experienced doctors to make a similar diagnosis based on external examination and palpation. In order to confirm the diagnosis, the patient is prescribed x-ray in two projections.

In cases where intra-articular fracture is suspected, it is also recommended CT scan. This study will help to detect those microscopic lesions that could not be seen on x-rays.

Conservative treatment

Treatment for a talar fracture depends on its location. In most cases, conservative therapy is carried out, which consists in immobilizing the diseased foot with a cast until its integrity is restored.

In the case of a simple fracture without displacement, which is localized in the body of the talus, therapy is carried out in accordance with the standard scheme - from the fingertips to the height of one third of the lower leg, plaster is applied to the leg for a period of up to 10 weeks. In this case, it is necessary to observe the required angle between the foot and the lower leg, which should be 95 degrees. For fractures of the neck of the talus, as additional method conservative therapy perform foot traction.

In the case of a comminuted fracture of the talus, with dislocation or subluxation, treatment begins with a manual closed reposition of the fragments, which is carried out with the obligatory use of anesthesia. After that, an immobilization bandage is applied, which will have to be worn for up to 4 months. For the period of wearing it, you should carefully protect the limb from overload, you need to move at this time only on crutches.

Surgery

If there is a displacement of fragments of the talus, then it is definitely required surgical intervention. Surgery may also be required for open or dislocated fractures.

The type of surgery depends on the nature of the damage. Most often, abdominal reposition is performed, which consists in dissecting soft tissues and manually comparing the fragments, followed by their fixation with screws or plates.

Often surgery fracture of the talus proceeds with the use of compression-distraction osteosynthesis. The procedure involves passing through the fragments, fastening spokes and installing special structures to hold the fragments in a position that will better preserve the consolidated area. The use of compression osteosynthesis makes it possible to achieve healing of an injury even with non-united fragments.

If the patient has necrosis or complete destruction of the bone, then arthrodesis is used. When it is carried out, an artificial connection of adjacent parts forming the joint occurs, after which any movements in it are impossible. In the case of extensive destruction of the talus, it is necessary to resort to its removal.

For all types of operations, an immobilizing bandage is applied to the injured foot.

Possible Complications

Due to the poor blood supply to the talus, the fusion of its fragments is slow, which can cause necrosis of the fragments. Necrosis is usually observed in cases where damage to other tissues occurred simultaneously with the fracture and it became possible for infection to enter the wound cavity. With this complication, there is a strong swelling of the soft tissues and intense pain. To prevent necrosis to some extent, orthopedic shoes are recommended in some cases.

Another typical complication is dysfunction of the ankle joint. If this problem can be found in early stage development, then the chances of a complete restoration of the ankle function are much higher. Frequent adverse complications are damage to the vessels, ligaments or nerve endings of the foot, as well as the development of osteomyelitis.

The appearance of these consequences requires surgical intervention and a long recovery period.

Rehabilitation

A fracture of the talus requires special rehabilitation, which is explained by the peculiarities of the blood supply to this area and the specifics of its location. The essence of restorative measures is to restore the mobility of the ankle joint and return the lost functions of the limb.

Rehabilitation after a fracture of the talus includes the following measures:

physiotherapy treatment;
Exercise therapy with gradual addition of loads;
massotherapy;
paraffin therapy.

To avoid complications, the affected leg should not be overloaded. In case of a fracture of the neck of the talus, loads are allowed only after 6-9 months, depending on the complexity. Patients during this period should be attentive to the pain that occurs in the foot. In order to better control the recovery process, all patients who have had a fracture of the talus are put on a dispensary record.

The talus is one of the bones involved in the formation of the foot. The peculiarity of the location of this bone makes it prone to injury and complicates treatment. More than half of its surface is covered with hyaline cartilage, which is very important for the functioning of the lower limb. If the ankle joint bears the flexion-extensor load during movement, then the talus is responsible for supination.

Trauma to the talus often affects other bones and joints. Any damage to this small bone requires immediate restoration of its integrity. Surgical intervention should be professional and accurate. Happy development modern traumatology, which gives more opportunities to solve problems with fractures of the talus.

Possible fractures and their causes

The talus, due to the specifics of its structure, is subject to constant loads. Enough sharp tension to damage it. Complicates all the poor blood supply to this place of the foot. In that main reason her poor healing after the fracture. Fracture can be caused by:

sports loads and injuries;
falling from height;
severe foot injury
Occupational foot injury in dancers and ballerinas.

Let's look at what fractures are:

compression fracture;
fracture of the neck of the bone;
with dislocation in the joint and displacement of fragments;
posterior fracture.
fracture of the external process.

Symptoms and specifics of treatment

Such fractures are characterized by a sharp manifestation of symptoms. There is hemorrhage and swelling in the ankle area, most of all on the inside of the ankle. Strong pain sensations are observed. The localization of pain depends on the place where the fracture of the talus occurred. Even slight movement of the toes leads to increased pain. Such an injury disrupts the functioning of the entire foot and limits movement.

The main symptoms of a displaced fracture are swelling and deformity of the joint. But a fracture at the edge of the talus is manifested by pain of lesser intensity, and at the same time, the motor function is almost not disturbed. If a person complains of pain near the Achilles tendon, then he has a dislocation of the body of the bone. In this case, any action increases the pain.

Let's summarize. There are four main symptoms:

Strong pain.
Swelling of the soft tissues of the foot.
Noticeable deformation.
Violation of motor function.

Diagnosis is not limited to a doctor's examination, because at first glance, all bone fractures lower extremities similar. For an accurate diagnosis, most likely, the following will be carried out:

foot x-ray. He will bring clarity;
if there is a suspicion of an intra-articular fracture, then an additional examination will be required - computed tomography;
in severe cases, when the specialist suggests necrosis or damage to the dome of the bone, magnetic resonance imaging is necessary.

Depending on the location of the injury, the treatment will be different. If there is no displacement of the bone, then gypsum is needed. During the first week after the plaster is applied, the patient cannot walk at all. And the bandage will be removed only after a month or a half. Further rehabilitation is required. It consists of physiotherapy. The terms of disability in this case range from one and a half to two months.

If an isolated posterior process fracture is diagnosed, a plaster cast is recommended for two or four weeks. It will be possible to restore working capacity faster, in one month. Displaced neck fracture? So, there is a need for surgery. When the fragments are compared, the foot will also be fixed with a plaster splint for a month.

There is a risk of necrosis of the talus if it is rotated or dislocated from behind. This is where surgery can help. After the bone is set and the operation is completed, a plaster cast will be applied. You can only take it off after a month.

But if the fracture is closed, then traumatologists often do without surgery. But it is a completely different matter when a patient has an open fracture of the talus. Then no options: emergency surgery. In addition, these patients are at an increased risk of developing infections.

The main types of rehabilitation are:

physiotherapy;
physiotherapy;
massage;
wearing a special orthosis.

Possible complications and consequences

Even after treatment and strict adherence to all prescriptions, such complications are possible:

aseptic necrosis of the bone;
damage to the nerves and ligaments of the foot;
osteomyelitis;
deforming arthrosis;
decrease in joint mobility;
regular pain.

Any of the complications cannot be ignored. You may need surgery or lengthy rehabilitation. The main goal is to restore the mobility of the foot and defeat pain and osteomyelitis. You need to be aware that the consequences can be dire. Understand that even if you suspect a fracture, you should not hesitate and you should immediately consult a doctor. Otherwise, there is a risk of long-term disability and disability. No self-treatment!