Injuries Associated with Talus Fractures: A Retrospective Cohort Study in a Major Trauma Centre.
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Yusuf B.S.
Pradhan A.
Vris A.
Haider Z.
Jeyaseelan L.
Patel, A.
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2026
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IntroductionTalus fractures are rare, representing 0.5% of all fractures and 3% of foot fractures, and typically result from high-energy mechanisms. They compromise the biomechanics of the ankle, subtalar and transverse tarsal joints, and are often accompanied by additional skeletal injuries. This study aimed to characterise the frequency and distribution of associated injuries in patients with talus fractures and to identify recurring injury patterns.MethodsA retrospective cohort study was conducted of consecutive adult patients with radiologically confirmed talus fractures treated at a UK level 1 major trauma centre between 2015 and 2020. Patients with isolated lateral or posterior process avulsion fractures were excluded. Demographics, mechanisms of injury, Injury Severity Scores (ISS), fracture morphology, and associated injuries were obtained from clinical records and imaging. Fractures were classified as isolated or combined (neck, head, and/or body). Statistical analysis was performed using ANOVA with a significance level of p < 0.05.Results113 patients met inclusion criteria (mean age 35.4 years, 78% male, mean ISS 16.5). Isolated talar body fractures were most frequent (54%), followed by neck (24%) and head (5%) fractures; combined fractures accounted for 17%. Overall, 79% of patients sustained additional injuries. The most common were ipsilateral calcaneal (26%), ankle (26%), and distal tibial plafond fractures (15%). Navicular and cuboid fractures occurred in 17% and 11% respectively. Lumbosacral spine fractures were identified in 18% and pelvic fractures in 8%. Combined talar head-and-neck fractures had the highest rate of associated injuries (100%), whereas isolated body fractures had the lowest (75%).ConclusionTalar fractures rarely occur in isolation and are frequently accompanied by ipsilateral lower-limb or spinal injuries. Talar body fractures were the most common subtype, often associated with distal tibial and ankle fractures, while talar neck fractures were linked to calcaneal, cuboid, and navicular injuries. Comprehensive imaging and a high index of suspicion are essential to avoid missed injuries. Early recognition and multidisciplinary management remain key to improving long-term outcomes in this predominantly young, working-age cohort. Copyright © 2026, The Authors. All rights reserved.
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