Talus fracture: Difference between revisions
No edit summary |
|||
| (18 intermediate revisions by 5 users not shown) | |||
| Line 1: | Line 1: | ||
==Background== | ==Background== | ||
*Almost always associated with other injuries | [[File:Foot_Bones.jpg|thumb|Bones of the foot.]] | ||
*Almost always associated with other injuries, often misdiagnosed as ankle sprains | |||
*Talar neck fracture most common (~50%) | |||
**Dorsiflexion with axial loading, snowboarders | |||
*Talar body fracture (~20%) | |||
**Hindfoot in either supination or pronation, high energy trauma | |||
*Lateral process fracture (~10%) | |||
**Dorsiflexion with axial loading | |||
*Posterior process, medial or lateral tubercle very commonly misdiagnosed as ankle sprains | |||
*Talar head fracture least common | |||
==Diagnosis== | ==Clinical Features== | ||
*Mid ankle pain/injury | |||
==Differential Diagnosis== | |||
{{Foot and toe fractures DDX}} | |||
==Evaluation== | |||
[[File:Subtalar Joint.png|thumb|Talus and subtalar joint]] | |||
[[File:Talus Fx.png|thumb|Talus fracture]] | |||
*CT often required for accurate diagnosis | *CT often required for accurate diagnosis | ||
*AP, lateral, possibly Canale view | |||
==Management & Disposition== | |||
{{General Fracture Management}} | |||
== | ===Specific=== | ||
*Major fracture (talar neck and head) | *Major fracture (talar neck and head) | ||
**Immediate ortho consultation required (high rate of avascular necrosis) | **Immediate ortho consultation required (high rate of avascular necrosis) | ||
*Minor fracture | *Minor fracture | ||
**[[Posterior | **[[Posterior Ankle Splint]] | ||
**Non-weight bearing, short leg cast if minimally displaced fracture | |||
**Ortho referral | |||
==See Also== | ==See Also== | ||
| Line 15: | Line 38: | ||
*[[Foot Diagnoses (Main)]] | *[[Foot Diagnoses (Main)]] | ||
== | ==References== | ||
* | *Weatherford B. Talar neck fractures. Orthobullets, last updated 12/19/14. http://www.orthobullets.com/trauma/1048/talar-neck-fractures. | ||
* | *Aiyer A, Moore D. Talus Fracture (other than neck), last updated 1secondary to7/14. http://www.orthobullets.com/trauma/1049/talus-fracture-other-than-neck. | ||
*Judd DB, Kim DH. Foot Fractures Frequently Misdiagnosed as Ankle Sprains. Am Fam Physician. 2002 Sep 1;66(5):785-795. | |||
[[Category: | [[Category:Orthopedics]] | ||
Latest revision as of 05:14, 18 September 2019
Background
- Almost always associated with other injuries, often misdiagnosed as ankle sprains
- Talar neck fracture most common (~50%)
- Dorsiflexion with axial loading, snowboarders
- Talar body fracture (~20%)
- Hindfoot in either supination or pronation, high energy trauma
- Lateral process fracture (~10%)
- Dorsiflexion with axial loading
- Posterior process, medial or lateral tubercle very commonly misdiagnosed as ankle sprains
- Talar head fracture least common
Clinical Features
- Mid ankle pain/injury
Differential Diagnosis
Foot and Toe Fracture Types
Hindfoot
Midfoot
Forefoot
Evaluation
- CT often required for accurate diagnosis
- AP, lateral, possibly Canale view
Management & Disposition
General Fracture Management
- Acute pain management
- Open fractures require immediate IV antibiotics and urgent surgical washout
- Neurovascular compromise from fracture requires emergent reduction and/or orthopedic intervention
- Consider risk for compartment syndrome
Specific
- Major fracture (talar neck and head)
- Immediate ortho consultation required (high rate of avascular necrosis)
- Minor fracture
- Posterior Ankle Splint
- Non-weight bearing, short leg cast if minimally displaced fracture
- Ortho referral
See Also
References
- Weatherford B. Talar neck fractures. Orthobullets, last updated 12/19/14. http://www.orthobullets.com/trauma/1048/talar-neck-fractures.
- Aiyer A, Moore D. Talus Fracture (other than neck), last updated 1secondary to7/14. http://www.orthobullets.com/trauma/1049/talus-fracture-other-than-neck.
- Judd DB, Kim DH. Foot Fractures Frequently Misdiagnosed as Ankle Sprains. Am Fam Physician. 2002 Sep 1;66(5):785-795.