It can be difficult to advise parents or caretakers of children with traumatic fractures of the talus because this type of fracture is rare. We know how these fractures develop (the mechanism of injury). But other information on talus fractures in children is limited.
A recent study from Children’s Hospital in Boston might help shed some light on the subject. Although they only had 29 cases to review, it was the largest group of patients with this type of injury to learn from. Here’s what they found.
There were no cases of infection or problems with wound healing and only one fracture that failed to heal. A couple of children/teens needed another surgery to help stabilize the joint. A closer look at those who developed joint problems later showed that these patients had high-energy injuries and a displaced fracture. Likewise the one nonunion and all cases requiring additional surgery were displaced fractures.
Post-traumatic arthritis was the most common complication affecting 17 per cent of the group. Second to arthritis were nerve injuries and avascular necrosis (loss of blood to the bone causing death of bone tissue). Most of the nerve injuries were temporary and healed. Only one patient had residual loss of sensation.
Surgeons think that perhaps younger children have fewer complications and better recovery rates because they have thicker periosteum (outer layer of bone). This feature may offer some protection. And, of course, supportive cartilage in and around the joint in children is more flexible allowing for more give and bend during trauma.
If your grandson has a nondisplaced fracture (two fracture ends of the bone have not separated or shifted apart), then treatment will likely be with a cast. Holding the bone in place for four to six weeks may be all that’s needed. If all goes well, there is every reason to believe he will be back in action within eight or nine weeks.
Displaced (separated) fractures that require surgery take longer to heal. Expect about a 12-week recovery period.