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What's the worst thing that can happen after a fracture of the ankle involving the talus? We have a young family member (16-years-old) with this type of injury from a car accident. No one at our local hospital seems to know much about this type of problem in kids or teens. All we have to go on is what they tell us happens to adults.
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The talus is located just above the calcaneus (heel bone). The talus has a bit of an odd shape with a main square-shaped body and a small extension of bone coming off the body called the talar neck. It is sandwiched between the calcaneus and the bones you feel on the top of your foot where the end of the tibia (lower leg) meets the foot. The talus is an important bone in ankle motion because it helps create the rocking motion needed for front-to-back and side-to-side movement of the ankle/foot complex. It is the link between the other major joints in the ankle.
Fractures of the talus are more common in adults but rare in children. However, children and teens of all ages (from one up to 18) can fracture this area as well. Talar fractures in patients under the age of 18 are more common in teens who are involved in sports or driving cars. Younger children are less likely to fracture this bone.
The most common place for a talar fracture is the talar neck. There can be fractures of the talus body as well. Fractures in more than one area of the talus (neck and body) are also possible. High-energy injuries are more likely to result in damage to other areas of the foot and ankle.
Most motor vehicle accidents resulting in talus fractures are high-energy injuries. Displacement (separation) of the fracture is the key here. More severe injuries are displaced fractures with accompanying damage of the surrounding soft tissues (e.g., ligament, cartilage, tendons).
The biggest concern following displaced talus fractures is avascular necrosis. This is a loss of blood to the area because the blood vessels have been cut or damaged. Nerve injuries can also occur but most of the time, the nerve repairs itself so any sensory disturbances are temporary.
When younger children experience a talus fracture, it is often less severe and less involved than in older children and teens. A recent study from Boston Children's Hospital on talus fractures in children did not find that avascular necrosis is a likely complication following treatment in this age group.
There were no cases of infection or problems with wound healing and only one fracture that failed to heal. A couple of children/teens needed another surgery to help stabilize the joint. A closer look at those who developed joint problems later showed that these patients had high-energy injuries and a displaced fracture. Likewise the one nonunion and all cases requiring additional surgery were displaced fractures.
Most of the children healed well and were able to return to full weight-bearing and activities on average of nine weeks.
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*Disclaimer:*The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. |
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