A talus fracture is a broken bone in your ankle. Your talus is the main connection between your foot and your leg. A talus fracture can cause significant loss of function in your ankle. Talus fractures usually occur due to high-impact injuries such as car accidents. Treatment usually requires surgery, and the recovery process can take months.
Your talus is a bone in your foot that connects your ankle to your leg. A talus fracture is a break in this bone. Your talus joins with your tibia and fibula (lower leg bones) to form your ankle joint. This joint allows for the up and down movement of your foot. Your talus sits above your heel bone (calcaneus), forming your subtalar joint. This joint allows for the side-to-side movement of your foot.
Your talus helps transfer weight across your ankle joint. It’s mostly covered in cartilage. Cartilage is a slippery material that allows your bones to move smoothly against each other. A talus fracture can cause a significant loss of motion and function because of how important it is for ankle movement.
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Your talus bone can break in different places and different ways. Talus bone fractures include:
Talus fractures are classified by how much the talus or pieces of bone have moved out of their normal position. These classifications include:
The most common symptoms of a talus fracture include severe ankle pain and swelling. Other symptoms may include:
Talus fractures most commonly occur due to high-energy injuries. These injuries include car and motorcycle accidents and falls from significant heights. Talus fractures occur due to sports injuries, too. Many snowboarders break their talus bones. Sometimes, talus fractures occur due to twisting your ankle, which can result in small chips breaking off the edges of your talus.
Your healthcare provider will examine your ankle and foot, looking for swelling, bruises and cuts. They may:
Your healthcare provider may also request the following imaging tests:
Treatment for a talus fracture depends on the type of fracture and the severity of your injury. First, you’ll be placed in a splint to keep your foot and ankle from moving. If your fracture is stable and your joints are well-aligned, surgery may not be necessary. Your healthcare provider may recommend:
For most talus fractures, ankle surgery will be recommended because of the high-energy force that caused the injury. If your bones are out of place, a foot and ankle surgeon will perform surgery to reset them.
If your bone is broken into several pieces, your surgeon may perform an open reduction and internal fixation (ORIF). With an ORIF, your bone fragments are put back in place and held together with a metal plate and/or screws until your bone heals.
If there’s too much swelling, your surgeon may place you in an external fixator. With an external fixator, your surgeon will place large pins in your bones to hold them in place. The pins are visible from the outside of your skin and are held together with special bars. After the swelling goes down, your surgeon may try an ORIF again.
A talus fracture can cause difficult complications if left untreated or if it doesn’t heal correctly. These complications include:
After surgery, you’ll experience some pain. Your healthcare provider can prescribe a medication to help with the pain. These medications may include opioids, nonsteroidal anti-inflammatory drugs (NSAIDs) or local anesthetics.
Once your talus bone is healed, your healthcare provider may recommend rehabilitation or physical therapy to help improve the function of your ankle. Exercises can help with your range of motion, stability and strength in your foot and ankle.
When you start walking again, you may have to wear a special boot or use a cane. You won’t be able to put full weight on your foot for a few months.
Your healthcare provider will want to take X-rays to make sure the bone has healed properly, too.
With or without surgery, your foot will be in a cast or splint. You won’t be able to put any weight on it or walk on it. Depending on the complexity of your injury, you may have to wear the cast for eight to 12 weeks or more.
The more severe your injury, the longer your foot will be in a cast. You may have persistent pain, stiffness and swelling even after the bone heals. After treatment, many people may return to normal activities after your healthcare provider gives you clearance to do so.
Depending on the severity of your injury and the type of job you have, you may not be able to return to work right away. Most people don’t return to work for at least two weeks. If you’re on your feet all day, you may not be able to return to work for up to a year.
It depends on the type of talus fracture you have. A talus fracture can be a severe injury. A talus fracture can result in a significant loss of motion and function of your ankle and foot joints. This can affect your ability to walk and bear weight on your foot.
Depending on the complexity of your injury, you may have to wear a cast for three months or more. You may have pain, swelling and stiffness even after the cast is removed.
A talus fracture is a high-impact injury. People describe talus fractures as extremely painful.
Some talus fractures can be corrected by casting and rehabilitation. However, most talus fractures require surgery to correct the alignment of your bones.
A note from Cleveland Clinic
A talus fracture is a painful injury usually caused by a high-impact accident such as a car accident or fall. If you have a talus fracture, you’ll want to be seen by your healthcare provider right away. Talus fractures usually require surgery to repair. You’ll be in a cast for a minimum of two weeks (for a simple fracture) and up to 12 weeks or more depending on the severity of your injury. While a talus fracture can cause pain, treatment will help with the healing process, and you’ll be back to normal activity as soon as possible.
Last reviewed by a Cleveland Clinic medical professional on 10/19/2021.
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