$talus fracture$

$talus fracture$

#Talus fracture series#

One was undiagnosed for five months and two were referred with a delayed diagnosis. All were treated at a level-one trauma centre, where the diagnosis was established immediately in all but three patients. 6 We are not aware of any study that provides detailed information on associated injuries and outcome following fractures of the lateral process of the talus sustained while snowboarding.īetween 19, 26 consecutive snow-boarders (23 men, three women) sustained a unilateral fracture of the lateral process of the talus.

#Talus fracture series#

The clinical outcome of fractures of the lateral process of the talus has hitherto been limited to case reports 8, 9 and one formal series (20 cases) of clinical and radiological results in snowboarders. In selected cases, CT may be needed to confirm a suspected fracture. 3 The diagnosis can usually be established by a careful history, clinical examination and standard plain radiographs. 3, 7 The sequelae of missed fractures, particularly types II and III, include malunion, nonunion, long-term disability and degenerative arthritis of the subtalar joint. According to Hawkins, 1 these fractures may be classified as non-articular (type I), a single fragment involving the talofibular articulation and subtalar joint (II), and comminuted fractures, also involving both articulations (III).įracture of the lateral process of the talus has often been misdiagnosed as a lateral ankle sprain. 4 Recent evidence from in vitro biomechanical 5 and clinical 6 studies suggests that dorsiflexion, axial impaction, eversion and external rotation are involved. The mechanism of injury is believed to be dorsiflexion of the ankle with inversion of the foot. 1, 2 With the increasing popularity of snowboarding, fractures of the lateral process of the talus occur more frequently and account for 2.3% of snowboarding injuries. Before the development of this sport, these fractures were rare and generally associated with motor vehicle accidents, falls from a height, or simple inversion injuries. 1 Fracture of the lateral process is seen typically in snowboarders. The lateral process of the body of the talus is a broad-based wedge-shaped prominence that articulates dorsolaterally with the fibula and inferomedially with the os calcis, thereby forming the lateral part of the subtalar joint. The outcome after fracture of the lateral process of the talus in snowboarders is favourable provided an early diagnosis is made and adequate treatment, which is related to the degree of displacement and associated injuries, is undertaken. Subtalar osteoarthritis was present in nine (45%) of the 20 patients available for radiological review, including one late-diagnosed non-operative case and eight operative cases with associated injuries or fracture comminution. All but eight (35%) patients (six operative and two non-operative) regained their pre-injury level of sporting activity. In 88% of operative cases, significant concomitant hindfoot injuries were found at operation. The non-operative group of seven with a minimally-displaced fracture scored higher (98 points) than the operative group of 16 with displaced or unstable fractures (93 points). The mean American Orthopaedic Foot and Ankle Society hindfoot score was 94 (82 to 100). In this consecutive cohort study both operative and non-operative cases were considered. We investigated the clinical and radiological outcome after unilateral fracture of the lateral process of the talus in 23 snowboarders with a mean follow-up of 3.5 years (12 to 76 months).

$talus fracture$