1 July 2022 at 21:57:15
Flake-avulsion fracture --> Walking boot, crutches if needed. Refer all others
Refer to VFC for flake-avulsion fractures All other talus fracture - Refer to Ortho on-call.
Small flake avulsion fracture of the talus
Small (<5mm) flake avulsion fractures of the talus can be managed non-operatively. These can take 6 weeks to heal but pain and swelling can last for 3-6 months.
Acute A&E management include:
weight bear as tolerated in walking boot
offer crutches if required
elevate foot when not mobilsiing
Online referral to VFC
Other talus fractures
The talus has a complex bony structure and can fracture at various locations. these can include:
talar head fracture
talar neck fracture
talar body fracture
lateral process fracture
posterior process fracture
Decisions on definitive treatment depends on location size and displacement of the fragment. A CT scan as outpatient may be required to evaluate these factors for decision making. Displaced talar neck and body fractures, and dislocations are all associated with avascular necrosis and may require surgical treatment.
Acute A&E management include:
below knee backslab
non-weight bearing
VTE prophylaxis
refer to ortho oncall
