They can also stem from an avulsion of the Achilles tendon. Both high-energy fractures and avulsion are relatively uncommon in athletes because of the mechanism of injury, but either can result in permanent disability. Following a fracture, patients have severe heel pain and cannot walk. Initial treatment for displaced and nondisplaced intra-articular fractures includes immobilization in a bulky dressing and splint, with ice and elevation to control edema. Most displaced fractures are managed operatively, but these patients typically experience residual stiffness of their subtalar joint that will adversely affect future athletic performance.
Avulsion fractures occur during a violent contraction of the gastrocnemius and soleus.
Most of these fractures, however, are significantly displaced and frequently require immediate surgery to repair the fracture and relieve the pressure on the skin overlying the bony fragment. Talus Fractures Talus fractures typically involve either the talar neck or lateral process, or an osteochondral fracture of the talar dome. A typical mechanism of injury is a motor vehicle accident in which the ankle is hyperdorsiflexed by the brake pedal. The body of the talus may be palpable in the posteromedial ankle area. Displaced talar neck fractures are true surgical emergencies.