Fracture of a tarsus bone

introduction

The tarsal bones include a total of seven bones. These include the talus (Talus), the calcaneus (Calcaneus), the navicular bone (Os naviculare, see: Scaphoid fruit in the foot), the cuboid bone (Os cuboideum) and three cuneiform bones (Ossa cuneiformia). A fracture of the ankle bone or the calcaneus bone is particularly common. Both are important for the stability of the foot and for the rolling process when running and are part of the rear foot. The remaining tarsal bones form the transition between the ankle bone, Ferrsen bone and the metatarsus. These tarsal bones are significantly smaller than the ankle bone and the calcaneus and are connected to one another by many ligaments, so that a fracture often leads to ligament injuries. Since they also form the arch of the foot like the heel bone, they must be restored correctly.

Read more on the subject at: Scaphoid fracture in the foot

Symptoms

Safe character a fracture are a present deformity, one Misalignment of the bone or a abnormal mobility of the foot. Sometimes you can do a so-called Crepitation noise Listen. You can hear a crackling sound when several bones rub against each other. Go further, of course Pain associated with the fracture. The pain mainly occurs when moving. Usually it comes to one swelling of the affected area and sometimes a bruise occurs. There is also often one Loss of function of the foot. Symptoms such as pain, swelling, loss of function, however, are not sure signs of fractures; they can also speak for a sprain of the foot or the like.

causes

A fracture of a tarsal bone is usually caused by a direct force, for example in the course of a Accident or by being hit on the foot with an object. In most cases, a fracture in the tarsal area is caused by one Fall. Especially if the bone structure has already changed in the context of Underlying diseases like osteoporosis or tumors, the development of a fracture is favored. Also through a permanent one Inflammation of the bone continuous stress on the bone can lead to a fracture. Fractures of the smaller tarsal bones usually occur as a result of the foot being represented or also due to a fall.

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Athletes (joggers, soccer players, etc.) are particularly often affected by diseases of the foot. In some cases, the cause of the foot discomfort cannot be identified at first.
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Diagnosis

At the beginning of the diagnosis there is always a medical discussion with the patient. By describing the Cause of the accident and the Symptoms the doctor can already make the first suspicious diagnoses. This is followed by a physical examination. However, a clear diagnosis can only be made through the X-ray examination. The X-ray examination must always be carried out in two planes, since a break can also be overlooked in one plane. In rare cases, computed tomography (CT) or magnetic resonance imaging (MRI) can be used. Damage to the tissue in the area of ​​the tarsal bones can be ruled out particularly by means of magnetic resonance tomography. Furthermore, it must be examined whether the rupture has injured blood vessels or nerves.

classification

The fractures of the tarsal bones are divided into different ones Classes a. These classes are determined by the root cause the fracture, the Mechanism of origin, the Degree the interruption of continuity, the course of the Fracture line as well as the number of Fracture pieces. One distinguishes Bend, crack, compression, shear, twist and comminuted fractures. A further distinction is made between open and closed fractures. From one open fracture one speaks when part of the bone protrudes from the skin.

Duration

How long it takes to heal or how long it takes to put weight on the foot again depends, among other things, on the bone affected by the fracture. For example, if the ankle bone fractures, the foot must be used for eight weeks be immobilized and must not be loaded, because the talus is of extraordinary importance for the Function of the footas it is the entire body weight wears with every step. The treatment always takes place in combination with physiotherapy in order to maintain the mobility of the foot. If there is a fracture of the smaller tarsal bones, such as the cuboid bone, the healing time is a little shorter. It usually lies between six and eight weeks.

Treatment (conservative)

Usually when a tarsal bone breaks, a plaster applied and possibly healing by wearing one rail supported. The cast must then be worn for several weeks. Depending on the severity of the injury, it may still be during the healing process Movement exercises be performed. The foot must be completely relieved, so that only movements are carried out and no weight is exerted on the foot. In some cases, however, the fracture should heal first completed before the foot is exercised. It is then immobilized using plaster of paris. After the foot has been immobilized in the cast, a Rear foot relief boots used, which primarily relieves the heel area and distributes the weight more on the forefoot. In the process, the rear foot can then continue to be loaded. This relief is depending on the type of break for eight to twelve weeks recommended.

OP tarsus fracture

In complicated In some cases it may be necessary to break the break operational must provide. This is the case when it is a postponed There is a fracture or, for example, there are bone fragments in the upper ankle. Fractures of the heel bone and the ankle bone in particular are often operated on, as precise repositioning is particularly important for them. In the case of a fracture of the remaining tarsal bones, an operation is only necessary in the event of very severe displacement or severe destruction the bone in question. The operation can be carried out openly or, as is now almost usually the case, as a minimally invasive procedure via arthroscopy. For surgery, the fracture is either with Drill wires or with Screws stabilized. In contrast to other bone fractures, the materials are usually not removed again. If there is a dislocation at the same time, this can also be corrected as part of the operation. After an operation, the foot is usually in one plaster quiet, but this is not always necessary. Depending on the type of intervention, the foot is stable enough after the operation so that you can focus Exercises to strengthen can perform. However, this is only about Movements. It's important, that no burden in the sense of weight being exerted on the foot. That is why the patient should keep getting up until the final healing Crutches to use. Similar to the conservative treatment with plaster of paris, the foot can also be used for approx. eight weeks not be charged.

Complications

Sometimes it happens that by immobilizing the foot during the healing process, it becomes one muscular dystrophy comes. Furthermore, a fracture can lead to premature osteoarthritis of the bone. With osteoarthritis, there is one Cartilage lossso that bones rub against bones. This happens when it comes through healing to one unevenness of the articular surfaces. If an exact reconstruction is not possible, this can become too strong, especially if the heel bone is affected Pain come. Sometimes there is one stiffening of the affected joints needed to alleviate this discomfort.