Talus Fractures

A talus fracture is a break in one of the key bones of the ankle joint. The talus connects the foot to the leg, sitting between the tibia and fibula above and the heel bone (calcaneus) below. Because of its central role in ankle movement and weight transfer, a fracture of the talus can cause significant pain, loss of mobility, and long-term complications if not properly treated.

Understanding the Talus

  • The talus is largely covered in cartilage, allowing smooth motion between the bones of the ankle and foot.

  • It helps the ankle move up and down, and also contributes to side-to-side motion through the subtalar joint.

  • Damage to this bone can disrupt both mobility and stability, making recovery more complex than with many other fractures.

Causes

Talus fractures usually occur due to high-energy trauma, such as:

  • Motor vehicle accidents

  • Falls from significant heights

  • Sports injuries, especially snowboarding (lateral process fractures are sometimes called “snowboarder’s fractures”)

Less commonly, twisting injuries or repetitive stress can cause smaller fractures.

Symptoms

Typical signs of a talus fracture include:

  • Severe ankle pain and swelling

  • Inability to bear weight on the foot

  • Bruising and tenderness

  • In some cases, fracture blisters or visible deformity

Because the talus has limited blood supply, complications such as avascular necrosis (bone tissue death) can occur if the fracture is not treated promptly.

Diagnosis

Evaluation often includes:

  • Physical examination to check stability, circulation, and nerve function

  • X-rays to identify the fracture and alignment

  • CT scans for detailed imaging of complex or displaced fractures

Treatment Options

Management depends on the type and severity of the fracture:

  • Non-surgical care: casting and immobilization for stable, minimally displaced fractures

  • Surgical treatment: open reduction and internal fixation (ORIF) using screws or plates for displaced fractures, or external fixation if swelling prevents immediate surgery

  • Rehabilitation: physical therapy to restore strength, motion, and stability once the bone has healed

Recovery and Outlook

Healing time varies but often requires 6–12 weeks or more of limited weight-bearing. Even after the bone heals, patients may experience stiffness, swelling, or arthritis. Early diagnosis and proper treatment improve the chances of regaining normal function.