What is a talar dome injury?
To best understand a talar dome injury, we need to take a look at the anatomy of the area affected.
The anatomy of the foot is a very complex and talar dome injuries are often overlooked due to their close proximity to the ankle joint.
The talar dome is the top area of the talus bone. The talus bone forms part of the ankle joint, known as the mortise. And this connects to the heel bone underneath. This joint is extremely important for proper ankle and foot function and can assist movement through both the ankle and rearfoot joints.
The talar dome is protected by a layer of cartilage that acts as a shock absorber. When the talar dome is injured it can be this cartilage or the bone itself that is damaged.
Severe talar dome injuries can result in a fracture of the talus bone.
What does a talar dome injury feel like?
Talar dome injuries can feel like a deep aching pain through the subtalar joint and the ankle.
People suffering from a talar dome injury might also experience swelling and stiffness within the ankle joint.
Pain generally increases with weight bearing, when changing direction and when walking up and down stairs.
What causes talar dome injuries?
A talar dome injury can occur due to a variety of reasons, some of which include:
- An acute ankle sprain, where the leg bones (tibia and fibula) grind against the talar dome.
- Displacement or malalignment of the talus due to natural foot and ankle alignment. The talus may sit more anterior/towards the foot, or may be tilted in those with very low or very high arches.
- Chronic damage due to repetitive stresses or repeated mild moderate ankle sprains.
Who can be affected by a talar dome injury?
Talar dome injuries can occur in the general adult population, however, they are more common in those playing sports where ankle sprains can occur.
How are talar dome injuries diagnosed?
Talar dome injuries may be suspected by your podiatrist during palpation and movement of the talus and the ankle joint. A referral for an X-ray or MRI will help to confirm diagnosis.
How is a talar dome injury treated?
- RICE
Rest, ice, compression, and elevation is very important during the early stages of injury management and healing. This will help to manage your pain and inflammation.
- Taping and bracing
Taping and bracing can assist in a mild to moderate talar dome injuries to help protect the talus and the ankle mortise. It provides stability and reduces movement to help to facilitate healing and prevent further injury and pain.
- Moon boot
In moderate to severe talar dome injuries, including those where a fracture may be present, a moon boot/CAM walker may be necessary. This allows the ankle and subtalar joints to be immobilised completely, with a graduated pressure system allowing the forces when walking to be redistributed up the leg and away from the injury. Moon boots are generally required for 6-8 weeks depending on the severity of the injury.
- Orthotics
Orthotics can assist in the alignment of the foot and ankle. They can be used to help avoid recurrent ankle injuries, by supporting the foot and ankle and providing stability in footwear. They can also be used following a severe injury or surgery.
- Rehabilitation program
Following a talar dome injury and/or ankle sprain, rehabilitation will involve regaining movement and strength through the ankle joint. This will involve range of motion exercises, balance exercises, and strengthening exercises. A rehabilitation program will be developed specifically for you depending on the extent of your injury and your baseline strength and motion.
- Surgery (for severe cases)
In severe talar dome injuries, surgery may be required and the extent of surgery will depend on the severity of the injury. Fixation of the ankle joint or talus may be required if there is a fracture. An arthroscope of the ankle joint may be required to repair the damaged cartilage.
If you’re experiencing any pain or discomfort similar to what we’ve discussed today, or in your feet or lower limbs, come see one of our superstar podiatrists here at Watsonia Podiatry. Book online or call us on (03) 9432 2689 to book your appointment!
