What causes talus pain?

There are many reasons for talus pain. It may be caused by trauma, rheumatism or cold. It is best to go to the hospital for a detailed examination. You can take some Panax notoginseng to promote local blood circulation, which is a good auxiliary effect on the recovery of the disease. In fact, no matter what causes the talus pain, everyone needs to pay attention to it. Timely treatment is the key. Don't treat it blindly.

The talus, distal end of the tibia and lower end of the fibula together form the ankle joint, which is the largest weight-bearing joint in the human body. The talus is one of the proximal bones of the tarsus in higher vertebrates, considered to be the fusion of the tibia and the intermedius of many lower vertebrates, the bone that bears the weight of the human body and articulates with the tibia at the ankle. It is a short bone located between the tibia, fibula and calcaneus, and is divided into three parts: head, neck and body.

Talus fracture is a fracture of the talus with local swelling, pain, subcutaneous ecchymosis, and inability to stand and walk as the main symptoms. Talus fractures are rare and are usually caused by direct violent compression or indirect compression from falling from a height, the latter of which is often accompanied by calcaneal fractures. The prognosis of talus fracture is not very ideal, and it is easy to cause nonunion or ischemic necrosis, so it should be diagnosed and treated early.

Talus body fractures are mostly caused by falling from a height or violent direct impact. The talus body can fracture in the transverse plane or form a longitudinal split fracture. Fractures may be linear, stellate, or comminuted. Talar body fractures often affect the ankle joint and subtalar joint. Although the displacement is very slight, it can lead to a stepped deformity of the above-mentioned joints and eventually produce traumatic arthritis. Therefore, the prognosis of talar body fractures is worse than that of talar neck fractures.

1. Fracture of the neck and body of the talus

Most of them are caused by falling from a height, with the heel landing on the ground, and the force pushing down along the tibia. The reaction force pushes upward from the heel, and the front part of the foot is strongly dorsiflexed, causing the front edge of the lower end of the tibia to insert between the neck and body of the talus, causing fractures of the talar body or talar neck, the latter being more common. If the foot is forcefully inverted or everted, the talus may fracture or dislocate. After a talar neck fracture, the talar body may suffer from ischemic necrosis due to circulatory disorders.

2. Posterior process fracture of talus

It is caused by forceful plantar flexion of the foot being impacted by the posterior edge of the tibia or the superior edge of the calcaneal tuberosity.

3. Blood supply to the talus

(1) The posterior tibial artery is divided into three branches. One of the calcaneal branches of the posterior tibial artery supplies the posterior tubercle of the talus. The tarsal artery supplies the middle and lateral thirds of the body of the talus and anastomoses with the tarsal sinus artery, a branch of the anterior tibial artery. A triangular branch arises approximately 5 mm from the tarsal artery and supplies the medial 1/3 of the talus.

(2) The anterior tibial artery can be divided into three branches, two of which branch inward and anastomose with the triangular branch below the medial malleolus. The tarsal sinus artery originates outward and supplies the lower half of the talar head and part of the talar body. The dorsal artery of the dorsalis pedis directly supplies the upper and inner parts of the neck and head of the talus.

(3) The peroneal artery has two branches, one of which anastomoses with the calcaneal branch of the posterior tibial artery and the other anastomoses with the tarsal sinus artery.

Based on the above images of talar fractures, it can be seen that the medial and superior half of the talar head is supplied by the dorsal artery of the dorsalis pedis artery, the lateral and inferior half is supplied by the tarsal sinus artery, the middle and lateral 1/3 of the talar body is supplied by the tarsal canal artery, and the medial 1/3 is supplied by the triangular branch. The tarsal sinus artery also supplies a small part of the lateral and inferior part, and the posterior tubercle of the talus is supplied by the calcaneal branch of the posterior tibial artery.

Although the talus has a relatively rich blood supply, most of the surface of the talus is covered by articular cartilage and has no muscle attachment; the blood vessels are relatively concentrated at the site where they enter the talus and are easily damaged; the talus is a cancellous bone and will be compressed and damage the blood vessels during trauma, so ischemic necrosis is likely to occur in fractures or dislocations.