Avascular necrosis of talus

Some people may suffer accidental injuries, especially acrobats and gymnasts, who are prone to leg fractures during practice. Some people have swollen ankles and have difficulty walking. After going to the hospital for an X-ray, the doctor diagnosed it as avascular necrosis of the talus. What kind of disease is this? If it cannot be cured, will it cause disability or even paralysis? Let us learn more about this disease through the following.

1. Concept The talus is the only bone in the whole body without muscle attachments. When the ankle joint suffers severe injury, the blood supply to the talus can be completely destroyed and avascular necrosis may occur, eventually leading to collapse and deformation of the talus body and causing ankle osteoarthritis. 2. Causes: Talus fracture is the main cause of talus necrosis. The rate of ischemic necrosis of the talus body increases with the severity of the injury, which is obviously due to the destruction of blood supply. Other causes of talar necrosis account for only about 10%. Talus necrosis is related to the type of fracture, that is, the extent of the injury:

1. Type I talar neck fracture without dislocation, its ligaments are not damaged, the blood supply is intact, and the necrosis rate of the talar body does not exceed 10%.

2. In type II talar neck fracture combined with dislocation of the superior and inferior talar joints, the interosseous ligament is damaged, the blood supply to the talus body is reduced, and the necrosis rate rises to 20% to 40%.

3. Type III talar neck fracture combined with dislocation of the upper and lower talar joints, that is, both the tibiotalar and talocalcaneal joints are dislocated. This type is rare. After dislocation, there may be only a small amount of soft tissue attached to maintain blood supply. If not promptly repaired, ischemic necrosis is likely to occur, with a necrosis rate of over 70%. 3. The main symptoms are pain and limited movement. Due to the collapse and deformation of the talus body and damage to the articular cartilage surface, osteoarthritis occurs, causing pain during movement. 4. Harm: Patients suffer from limited ankle flexion and extension due to pain and narrowing of the joint space. Its typical X-ray manifestation is an increase in the density of the talus body, which is more than twice the normal bone density. In the late stage, the talus body may collapse and deform, become smaller and flatter, the bone may harden, and the joint space may narrow. 5. In addition to diagnosis based on trauma history and clinical symptoms, taking anteroposterior, lateral and oblique X-rays is extremely important for diagnosis and classification. Avascular necrosis can be diagnosed based on X-rays showing dense bone density. However, it should be noted that on the lateral view, part of the talus is overlapped by the shadows of the medial and lateral malleolus. Because the shadow of the talus is relatively dense, a diagnosis of ischemic necrosis can only be made if there is an increase in density in the non-overlapping position. 6. Treatment 1. Conservative treatment with Chinese medicine to allow the necrotic bone to repair itself.

2. Avoid walking for long periods of time. If pain persists after physical therapy, surgery is recommended.

VII. Prevention

When exercising, pay attention to the range of motion and try not to do dangerous movements to avoid fractures.