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1. Megha varshney Roll no -70

2. Talus anatomy 2 nd largest bone of foot Present on upper surface of anterior two third of calcaneus Connecting link between bone of foot and leg Only bone of foot ,which is devoid of any muscular attachment It present with head, neck, and body Blood supply -from anastomotic ring of blood vessel ,and vessel entering through neck and running posterolateral within bone to supply its body.

3. Talus is supplied by Anterior Tibia artery- Dorsalis Pedis artery Posterior Tibia artery- Posterior tubercle artery- Artery of Tarsal Canal- Deltoid artery Peroneal artery Artery of Tarsal Sinus

4. Mechanism Fracture of neck - due to forced dorsiflexion of ankle. Sustained during aircraft crash where the rubber bar is forcibly hit against the middle of the sole of foot, and neck being weak area gives way. This may be associated with dislocation of body of talus backward. Fracture of head - compression injury due to fall from height These are uncommon

5. Clinical feature Patient present with history of trauma Painful and swollen foot Restriction of movement of ankle i n displaced fracture obvious deformity skin may be tented or split Tenderness over talus and subtalar joint

6. management Diagnosis X-ray - AP, lateral and oblique view is essential CT→ help to identify associated ankle and foot injury Frequently missed (mostly undisplaced fracture)→ because of overlapping of tarsal bones. MRI may be done for soft tissue injury

7. Treatment It depends on the displacement In undisplaced fracture – below knee plater cast for 8-10 weeks is sufficient In displaced fracture- open reduction and internal fixation of the fracture may be required

8. complication Avascular necrosis and non union - during neck fracture avascular fragment fails to unite with the rest of the bone ,leading to deformation of bone Osteoarthritis - patient complaint for pain and stiffness Treatment is mostly by physiotherapy and in severe cases ankle arthrodesis may be required

9. Foot bones comprise- 2 bones in the hindfoot (calcaneus, talus) 5 bones in the midfoot (navicular, cuboid, 3 cuneiforms) 19 bones in the forefoot (5 metatarsals, 14 phalanges)

10. Fracture of metatarsal Mechanism of injury – direct trauma - heavy object falling on the foot martial artists frequently injure the dorsum of their of foot when kicking . Indirect trauma - foot pined and lateral force or twisting motion is applied. Stress injury - due to march fracture

11. Fracture of base of 5 th metatarsal -(jones fracture) This is a fracture at the base of the 5th metatarsal, caused by the pull exerted by the tendon of the peroneus brevis muscle inserted on it.

12. Clinically, there is pain, swelling and tenderness at the outer border of the foot, most marked at the base of the 5th metatarsal. Diagnosis is easily confirmed on X-ray Treatment is by a below-knee walking plaster cast for 3 weeks

13. March fracture It is a 'fatigue' fracture of third metatarsal, resulting from long continued or often repeated stress, particularly from prolonged walking or running in those not accustomed to it. Occurs in army recruit freshly committed to marching. Diagnosis is easily confirmed on X-ray Treatment is by a below-knee walking plaster cast for 3 weeks

14. Chopad fracture The chopart joint refers to the articulation of the hindfoot and the midfoot. It is characterized by the talonavicular joint and calcaneocuboid joint . cause  motor vehicle crash or fall from height  twisting force on a plantar flexed foot . clinical features  pain, swelling and trouble bearing weight .  Deformity may be present, especially in the acute setting Prominent plantar ecchymosis is often present

15. treatment short leg cast for 6-8 weeks . Weight bearing is typically toe touch initially which can be progressed at around 6-8 weeks . Surgical indications include displaced intra-articular fractures, dislocations, intra-articular impaction fractures and other complex injury patterns. treatment comprises early reduction of the dislocation, and  open reduction internal fixation.

16. Lisfranc (midfoot) fracture I t is an  injury   of the  foot in which one or more of the metatarsal bones are   displaced from the  tarsus . the Lisfranc midfoot joint complex has very little motion and is critical in stabilizing the arch for push off during walking  During walking, the midfoot transfers the forces generated by the calf muscles to the front of the foot. If a Lisfranc injury is left untreated, instability of the arch can persist, resulting in the collapse or flattening of the foot . CAUSE - football or soccer injury fall from a height  motor vehicle collision

17. Clinical feature The top of foot may be swollen and painful. There may be bruising on both the top and bottom of the foot. Bruising on the bottom of the foot is highly suggestive of a Lisfranc injury. There may be pain in the midfoot that worsens with standing, walking, or attempting to push off on the affected foot. Treatment nonsurgical treatment -no fractures or dislocations in the joint ,wearing non- weightbearing cast or boot for 6 to 8 weeks . Surgical treatment- Open reduction internal fixation