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The talus bone makes up part of the ankle joint and the subtalar joint. The ankle joint gives up-and-down motion and the subtalar joint gives side-to-side motion. A fracture of the talar body is a break in the talus bone that often involves both of these important joints.
What is the goal of surgery for a talar body fracture?
The ankle and foot must be well aligned for proper function. The goal of surgery for talar body fractures is to restore the normal bone shape. The function of the ankle and subtalar joints must also be restored. It is important to reach these goals while the fracture heals without complications. The overall goal is to restore function without pain.
What signs indicate surgery may be needed?
Normal joint movement requires smooth gliding of cartilage that covers the bones. An uneven cartilage surface can cause pain and arthritis. The indication for surgery for a talar body fracture is disruption of this smooth surface in either the ankle joint or the subtalar joint. Other indications may include damage to nerves or blood vessels or fractures where a piece of the bone pokes through the skin.
When should I avoid surgery?
There are situations when it is best to treat a talar body fracture without surgery. These include when the bone pieces are not displaced. Poor overall patient health could also make surgery inappropriate. Surgery is delayed when there is swelling that could affect healing. Blisters or other skin wounds can also prohibit a safe operation.
General Details of the Procedure
Talar body fracture surgery puts the talus bone back together as best as possible. It typically requires general or regional anesthesia. An overnight hospital stay may be required. Incisions are required and may be somewhat large.
Incisions are customized for each patient and fracture pattern. Incisions are usually on the front of the foot or ankle. At times they are on the back of the foot or ankle. Sometimes a cut must be created in the tibia bone to gain access to the talus. A combination of screws and plates are then used to hold the bone fragments together while they heal.
What happens after surgery?
After surgery, either a temporary cast or a boot is applied to the lower leg. The surgeon monitors the incisions and bone healing for the first several weeks after surgery. No weight is to be put on the leg until approved by your surgeon. This is can be six to 12 weeks, or longer after the operation. A cast or removable brace is typically required.
Talar body fractures are severe and often life-changing injuries. You can expect to have some degree of pain and stiffness even after appropriate treatment.
There are several important complications to be aware of when undergoing surgery for talar body fractures. The first set of complications relates to surgery in general. These include the risks associated with anesthesia, infection, damage to nerves and blood vessels, and bleeding or blood clots.
The second set of risks applies specifically to talar body fractures. These include a risk that the bone does not heal or dies, or that the bone cannot be put back to its original state (malunion). There is a risk of developing arthritis in the joints over time. Severe complications, including amputation, can occur. The frequency of these complications varies with each injury.
Frequently Asked Questions
Will I walk again?
The goal of treating talar body fractures is to get the patient as close to normal as possible. Every patient’s fracture is different but a majority of patients walk again. Most patients are left with some degree of pain, stiffness or weakness after a talar body fracture.
Does smoking affect my outcome?
Yes. Smoking affects your body’s ability to heal the broken bone as well as the surrounding tissues. Smoking also increases the risk of infection. You should quit smoking immediately in order to minimize these risks.
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