Fractured talus1/17/2024 Immobilizing the joint using an ankle brace or walking cast for about six to ten weeks.However, it is recommended to initiate the treatment with a conservative approach, which includes: The treatment of a talar dome fracture is often delayed due to late diagnosis. These diagnostic tools are especially helpful in diagnosing Stage I osteochondral defects and in assessing the extent of the damage to the bone. If initial X-rays do not show any evidence of fracture despite the signs and symptoms, a bone scan, CT scan or MRI may be advised. However, if there is tenderness behind the inner bump of the ankle with the foot bent upwards, the inner side of the talar dome is involved. Moreover, in the case of fracture of the outer side of the talar dome there is tenderness in front of the outer bump of the ankle with the foot bent downwards. The result is a persistent deep pain in the ankle and recurrent swelling with activity.įollow-up X-rays, about 4 to 6 weeks after injury, should be taken to rule out any fractures of the talar dome. The treatment given for the sprain or injury usually fails to treat the unidentified fracture. Talar dome fractures are often missed at the initial examination following an ankle sprain or injury. There may be weakness and instability of the joint. There may be stiffness of the joint (a locking sensation during movement) and crepitance (a grating or crackling sound on movement). Return to activity leads to recurrent pain and swelling. Symptoms:Ī great number of talar dome fractures usually occur with an ankle sprain, a result of an accidental inward twist of the foot.Īlong with the pain of damaged ligaments, there is a deep-set pain in the ankle, which persists for longer, even after the initial intense pain has subsided. The overlying cartilage derives its nutrition from the fluid in the joint space and therefore does not suffer from a lack of blood flow.Īseptic necrosis is a major factor impeding the healing of talar dome fractures. Moreover, injury to the bone may damage its blood supply, leading to aseptic necrosis of the bone (death of bone cells in the absence of an infection). Fractures of the inner talar dome may occur even in the absence of trauma for reasons which are still unclear.Īs a result of the damaged joint surface and/or the fractured fragments present in the joint space, there is pain and inflammation and the movement at the joint becomes painful and restricted. A direct injury to the ankle (such as an object hitting where the talus joins the leg bones)Ī fracture usually involves the shoulder of the talar dome on either the inner side or the outer side however, both sides are only rarely involved simultaneously.An inversion ankle injury (the foot rolls inwards accidentally), about 2%-6% of acute ankle sprains are associated with a talar dome fracture. ![]() Nonetheless, men are twice as likely to acquire an ankle fracture. Talus fractures are not a common occurrence, however, their incidence is greater in active young adults such as athletes or in postmenopausal women. ![]() Trans (through) chondral (cartilage) fractures: As the injurious force causing the fracture is transmitted through the cartilage to the underlying bone. Osteo (bone) chondral (cartilage) fractures: that is fractures involving both bone and cartilage, or, ![]() For this reason, fractures of talar dome are also called: Like the joint surfaces of all the bones forming a moveable joint, the upper surface of the talar dome is also covered with a smooth glossy cartilage that reduces the friction between the two bone surfaces during movement at the joint.
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