What are the symptoms of talar necrosis?

Talus necrosis is a common disease, mainly caused by fractures of the talar neck and body, fractures of the posterior process of the talus, etc. The most common clinical symptoms are pain in the affected area and restricted movement. At the same time, the surface cartilage of the joint will also be damaged. If not effectively treated, the condition will further worsen, and finally the talar body will collapse, deform, and harden.

1. Causes of talus fracture:

(1) Fractures of the neck and body of the talus: Most cases occur when the patient falls from a height, with the heel touching the ground, causing the force to move downward along the tibia. The reaction force moves upward from the heel, causing the front part of the foot to dorsiflex, causing the front edge of the lower end of the tibia to insert between the neck and body of the talus, resulting in fractures of the talus body or talus neck, with the latter being more common. If the foot is forcefully inverted or everted, the talus may fracture or dislocate. After a talar neck fracture, ischemic necrosis of the talus may occur due to circulatory disorders in the talar body.

(2) Fracture of the posterior process of the talus: caused by strong plantar flexion of the foot and the impact of the posterior edge of the tibia or the upper edge of the calcaneal tuberosity.

2. Clinical manifestations

The main symptoms are pain and limited movement. Due to the collapse and deformation of the talus body and damage to the articular cartilage surface, osteoarthritis occurs, causing pain during movement. The patient's ankle flexion and extension movements are limited due to pain and narrowing of the joint space. Its typical X-ray manifestation is an increase in the density of the talus body, which is more than twice the normal bone density. In the late stage, the talus body may collapse and deform, become smaller and flatter, the bone may harden, and the joint space may narrow.

3. Prevention

On the one hand, as a doctor, you must correctly analyze the patient's condition, choose the appropriate period, and treat the disease accurately; you must also clearly explain the precautions to the patient. Make them understand the effects of prescriptions and medicines, methods of decocting medicines, etc., establish long-term mental preparation for patients, and have confidence in the treatment. Secondly, patients should follow the doctor's instructions, cooperate closely with treatment, and not conceal their condition or make false statements. If the doctor prescribes the use of crutches, the patient may not have enough understanding of this and may not insist on using them or may refuse to use them for fear of being "embarrassed", resulting in rapid necrosis and collapse of the femoral head. For example, if patients are advised to abstain from alcohol, their condition may become unstable because they cannot control themselves and abstain from alcohol due to social activities. If you need to exercise according to your doctor's instructions for your condition, you must also persist in doing muscle and joint exercises step by step to improve the therapeutic effect.