The talus sits at the summit of the foot, transmitting body weight from the tibia to the calcaneus and forefoot. It has a uniquely high proportion of articular surface (about 70% of its surface is cartilage) and no direct muscular attachments. Its blood supply is precarious, making talar fractures prone to avascular necrosis.
| Articulations |
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|---|---|
| Landmarks |
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| Ossification | Endochondral ossification from a single centre present at birth, with the lateral and posterior processes ossifying from the same centre. |
The talus is the second largest tarsal bone and uniquely has no direct muscle attachments. All forces acting on it are transmitted through its ligamentous and articular connections. Two-thirds of its surface is covered by articular cartilage. Its blood supply enters through limited vascular foramina, making it uniquely vulnerable to avascular necrosis after fractures and dislocations that disrupt these entry points. Talar neck fractures (Hawkins classification) carry an AVN risk of 0 to 100 percent depending on the degree of displacement.
Forced dorsiflexion, such as braking hard in a car crash, fractures the talar neck with a high risk of avascular necrosis of the body.
Damage to the cartilage and underlying bone of the talar dome, often after ankle sprains, causing deep ankle pain and catching.
Dorsiflexion and eversion fracture the lateral process; it mimics an ankle sprain and is often missed.
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