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Purpose The aim of the current study was to describe long-term gait changes after talus fractures, identify patterns associated
with poor outcome and discuss possible treatment options based on dynamic gait analysis.
Methods Twenty-seven patients were followed-up clinically and via gait analysis after talus fracture osteosynthesis. Continuous
dynamic pedobarography with a gait analysis insole was performed on a standardized parcours consisting of different gait tasks
and matched to the outcome.
Results Mean follow-up was 78.3 months (range 21–150), mean AOFAS and Olerud-Molander scores 66 (range 20–100) and 54
(range 15–100). Significant correlations between fracture classification and osteoarthritis (Hawkins: rs = 0.67 / Marti-Weber: rs =
0.5) as well as several gait differences between injured and healthy foot with correlations to outcome were seen: decreased step
load-integra l/maximum-loa d; assoc iations between centre-of-pressu re displacemen t and outcome as well as between
temporospatial measures and outcome. Overall, pressure-distribution was lateralized in patients with subtalar joint injury (Δ:
0.5765 N/cm², p =0 .0475).
Conclusions Talus fractures lead to chronic gait changes and restricted function. Dynamic pedobarography can identify patterns
associated with poor results. The observed gait patterns suggest that changes can be addressed by physical therapy and custom-
ized orthoses to improve overall outcome. The presented insole and measurement protocol are immediately feasible as a
diagnostic and rehabilitation aid.

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