Fractures of the talus or calcaneus (hindfoot bones beneath the ankle) can cause significant long-term problems. Some of these specifically include pain and stiffness. In some circumstances, conservative treatment with bracing or steroid injections may be of benefit, but long-term solutions are often surgical. For some patients with arthritis in the subtalar joint (joint below the ankle joint), significant improvement in pain relief and function can be achieved with a subtalar arthrodesis (fusion, or gluing together of this specific joint of the foot). In other patients, if arthritis of the subtalar joint has not already developed, other procedures may be applicable that preserve the normal joints of the foot and ankle.
After talus fractures or calcaneus fractures, the bone may have failed to heal together or healed incorrectly. In these scenarios, called nonunions or malunions, if the subtalar joint is still without significant abnormality, the bones may be rebroken and realigned, made possible through the use of bone graft and new screws or plates to realign the foot.
After talus fractures in particular, a condition called avascular necrosis may develop. This is a problem with the blood supply to the talus bone, causing the bone to die and possibly collapse. In some scenarios, patients may benefit from a procedure to stimulate the bone to develop a new blood supply by making small drill holes in the bone or to transfer bone and tissue with a viable blood supply to stimulate healing.
These bones have complex, intricate relationships, and as such should be treated by an orthopaedic foot and ankle specialist experienced in treating such disorders. Dr. Vora has published and lectured locally and nationally on the reconstructive options following such conditions.