A ‘talus avulsion fracture’ is a small break (fracture) to the ankle bone (talus).
It is caused by a fragment of bone breaking off (avulsion) from the ankle bone where it attaches to tendons or ligaments. It is treated like a sprain.
Healing
Healing usually takes around 6 weeks.
Pain and swelling
Your ankle may be swollen and painful. This is normal for 3 to 6 months after your injury. Swelling is often worse at the end of the day. Resting with your foot up, and using ice or cold packs, will help (see Caring for your injury, below). You can also take pain killers.
Speak to your GP or pharmacist for advice on what medicines to take for the pain.
Walking and your boot
The boot protects your ankle and will make you more comfortable. Wear the boot when you are standing and walking for the first 2 weeks. You can put weight through your foot. You may find it easier to use crutches in the early stages. You can take the boot off at night or when resting.
Tell us if you have diabetes. You may need a special boot.
Exercises
Start exercise as soon as possible. See Exercises (below) for details.
Stop smoking
Reducing or stopping smoking will help recovery.
For help, talk to your GP or pharmacist, or go to www.smokefree.nhs.uk for more information.
Follow-up
We do not usually book to see patients again. With this injury, most people recover well by following the instructions we give here.
Contact the Trauma Triage Clinic team (details at the bottom of this leaflet):
if you are still using the boot after 6 weeks
if you still have significant pain or swelling after 12 weeks
if you are concerned about your symptoms
if you are unable to follow the instructions given below
if you have pain other than in your ankle.
Caring for your injury: week 1 to 2
Rest your ankle, especially in the first 3 days. Raise your ankle on a stool or cushions so that it is above the level of your hip. This will help reduce the swelling.
Wear your boot whenever standing and walking for the first 2 weeks. You can take it off when resting and at night. Wear a long sock in your boot.
Use a cold pack to help with pain and swelling. You can use an ice pack or bag of frozen peas wrapped in a damp towel. Put this on your ankle for up to 15 minutes every few hours. Make sure the ice is not in direct contact with your skin.
Exercises
Early movement of the ankle and foot is important to promote blood flow and reduce the risk of a blood clot. You can find out more, including symptoms of a clot, at www.nhs.uk/conditions/deep-vein-thrombosis-dvt.
Do these exercises 3 to 4 times a day.
Start straight away.
Take your boot off first.
Move gently and within comfort. You do not need to push into pain.
1.
Point your foot up and down.
Repeat this 10 times.
2.
With your heels together, move your toes apart to turn the foot outwards.
Repeat this 10 times.
3.
Make gentle circles with your foot in one direction and then the other direction.
Repeat this 10 times.
Caring for your injury: week 3 to 6
You can stop using the boot 2 weeks after your injury.
Start by walking without the boot at home. Build up to walking without it outside and for longer walks. You should not be using your boot 6 weeks after the injury.
It is normal to still have mild discomfort and swelling. This may continue for 3 to 6 months.
Activity and exercise
Gradually increase your activity.
Avoid anything that involves impact for 3 months. This includes running, jumping and dancing.
Contact the Trauma Triage Clinic if you are struggling to recover your movement or return to activity (contact details below).
Frequently asked questions
I am struggling with my boot. What do I do?
The boot has a thicker sole which can make you feel uneven. Make sure you wear a supportive shoe or trainer on your uninjured foot. This will reduce stress on other joints.
If you need more advice, contact the Trauma Triage Clinic.
I am diabetic, does this change things?
If you have diabetes, contact us to discuss your boot. This is particularly important if you have problems with your skin or sensation. We may provide you with a specialist diabetic boot.
When can I start driving?
You can return to driving when:
you are no longer using your boot
and you can walk comfortably
and you can perform an emergency stop without pain.
Before you start driving again, it is recommended that you speak to your insurance company and test your ability to drive in a safe environment.
How can I get a certificate for work?
You can get a fitness for work statement from your GP.
What do I do with my boot and crutches when I no longer need them?
Both the boot and crutches can be returned to the Physiotherapy Department.
Please speak to a member of staff before or during your visit to the hospital if you require translation.
Accessibility
Please contact the Patient Experience Team on 020 8934 3850 if you need this information in a different format.
For information accessibility please visit Kingston Hospital AccessAble www.accessable.co.uk/kingston-hospital-nhs-foundation-trust
Support services
Visit the hospital website, ask a member of staff, or ring us for details.
www.kingstonhospital.nhs.uk
Switchboard 020 8546 7711
‘Find Us’ page for maps, transport, registering a blue badge, disabled access
Information, advice and support for patients and relatives (PALS) 020 8934 3993
Please speak to a member of staff before or during your visit to the hospital if you require translation support to access Patient Information. Please ring the phone number on your appointment letter, if you have one.
Request More Information
Accessibility
Please contact the Patient Experience Team on 020 893 3850 if you need this information in a different format.
For detailed information on accessibility at Kingston Hospital visit Kingston Hospital AccessAble (https://www.accessable.co.uk/kingston-hospital-nhs-foundation-trust).
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