Mid-Term Results of Rare Foot Fracture
Stress fractures of the talus bone in the foot and ankle are rare. Studies reporting the long-term results of treatment for this problem are equally rare. Most published articles are case reports of one or two patients.
In this study, patients were identified at a military hospital who had a stress fracture in the talus. Stress fracture was defined as bone marrow edema and low-signal fracture line seen on MRI.
Over a period of eight years, only nine cases were found. Only eight of the cases were reviewed. All were treated with reduced exercise and non-weightbearing status.
Patients were interviewed and examined by an orthopedic surgeon 14 to 74 months later. Joint motion and ligament stability were measured. X-rays and MRIs were taken of each ankle/foot. Imaging studies were compared to tests done at the time of the initial injury.
MRIs for half the patients showed at least minor bone changes. There was bone marrow edema in the joint close to where the fracture had been. Half the patients had completely normal findings. No one had an unstable ankle from ligament damage. No one had any tenderness when the foot/ankle was examined.
About one-third of the group reported minor ankle pain or swelling after exercise. None of these patients noticed any ankle problems during everyday activities. The results of this study show that stress fractures of the talus in military recruits do not result in permanent disability. Minor symptoms are still observed a few years after injury.
The results of this study confirm earlier reports that stress fractures of the talus are low-risk injuries. Over a short to mid-term period of three to four years, degenerative findings are present. Long-term follow-up may show more severe symptoms later.
Markus J. Sormaala, MD, et al. Outcomes of Stress Fractures of the Talus. In The American Journal of Sports Medicine. November 2006. Vol. 34. No. 11. Pp. 1809-1814.