A talus fracture is a break in the talus bone. The talus bone lies between the heel bone (calcaneus) and the two bones of the lower leg (fibula and tibia). It plays a vital role in ankle motion and weight transfer between the leg and the foot. Talus fractures are serious injuries that often result from significant trauma and require careful orthopaedic management to avoid long-term complications like arthritis or loss of mobility.
Types of Talus Fractures and Mechanism of Injury
Talus fractures typically fall into several categories depending on their location and severity:
- Neck fractures – the most common type, often from high-energy trauma
- Body fractures – involve the main weight-bearing portion of the bone
- Lateral or posterior process fractures – smaller sections that may be missed on initial X-rays
- Osteochondral fractures – small pieces of cartilage and bone breaking off inside the ankle joint
Fractures can be displaced or non-displaced, and may also involve the ankle or subtalar joints, increasing the treatment complexity.
The Mechanism of Injury for Most Talus Fractures
Talus fractures usually result from:
- High-energy trauma, for example, car or motorcycle accidents
- Falls from height, particularly landing on the feet
- Severe ankle twists or dislocations
- Occasionally, repetitive loading in athletes may lead to a stress fracture of the talus
Due to the talus’s limited blood supply, some fractures are at risk of avascular necrosis (bone death) if not properly treated.
The Symptoms of a Talus Fracture
Symptoms may vary but commonly include:
- Sudden ankle or hindfoot pain after trauma
- Swelling, bruising, and inability to bear weight
- Limited ankle or subtalar motion
- Pain that worsens with movement or walking
- A visible deformity in severe or displaced fractures
In subtle or stress-related cases, pain may develop gradually in the ankle or rearfoot.
Diagnosis of a Talus Fracture
A talus fracture requires thorough clinical assessment and detailed imaging. Diagnosis may include:
- X-rays to assess for fracture and alignment
- CT scans for precise evaluation of joint involvement or complex fractures
- MRI is useful for detecting stress fractures or evaluating the blood supply to the talus
Prompt and correct diagnosis is crucial to prevent complications such as non-union or joint damage.
Access Ortho Fracture Clinics offers urgent care for suspected or known fractures.
Treatment Approaches for a Talus Fracture
Treatment depends on the details of the fracture:
- Non-displaced fractures may be managed with immobilisation in a boot or cast and a period of modified weight-bearing
- Displaced or joint-involving fractures often require surgical fixation with screws or plates
- Stress fractures typically respond to offloading and rest
Recovery usually involves close orthopaedic monitoring and may include physiotherapy during rehabilitation.
Prognosis for a Talus Fracture
The outlook for a talus fracture varies. Many patients recover well with appropriate care, but healing can take several months, especially in more severe injuries. Factors that affect prognosis include:
- Whether the fracture was displaced or involved a joint
- Risk of avascular necrosis, particularly with talar neck or body fractures
- Timeliness of diagnosis and treatment
- Adherence to non-weight-bearing restrictions
Ongoing stiffness or arthritis may develop in some cases.
Role of Access Ortho in Diagnosing and Treating Talus Fractures
At Access Ortho, we specialise in the early identification and treatment of foot and ankle injuries, including talus fractures. Our team of Orthopaedic and Emergency Nurse Practitioners, backed by orthopaedic surgeons, provides:
- Immediate assessment and imaging for foot and ankle trauma
- Same-day moon boot fitting, crutches, and pain management
- Specialist follow-up clinics
- Referral and help with arranging surgery if required
If you’ve had a fall or accident, Access Ortho offers fast, expert care without waiting in a hospital ED.
If you have an open wound or significantly deformed limb you should present immediately to a hospital emergency department.