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Talus Fracture

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Talus Fracture, Snowboarder's Fracture, Lateral Process Talar Fracture, Talar Stress Fracture

  • Mechanism
  1. Acute Trauma (rare in sports)
    1. High energy foot injury
    2. Severe foot dislocations (associated with talar neck Fracture)
  2. Snowboarder's Fracture
    1. Lateral process Talus Fracture
    2. Often misdiagnosed as Lateral Ankle Sprain
    3. Occurs with acute dorsiflexion and foot inversion under axial load
  3. Stress Fracture (rare)
  • Imaging
  1. Initial imaging
    1. Foot XRay
    2. Ankle XRay
  2. CT Imaging Indications
    1. High index of suspicion for Talus Fracture despite negative XRay
  • Complications
  1. Subtalar Dislocation
  2. Avascular Necrosis
  • Management
  1. Talar body Fractures
    1. Non-displaced talar body Fractures are treated with non-weight bearing and Casting or boot
    2. Displaced talar body Fractures are often surgically managed
  2. Talar neck Fractures
    1. Emergent orthopedic Consultation if displaced talar neck Fracture
  3. Lateral Process Talar Fracture (Snowboarder's Fracture)
    1. Non-displaced Fracture
      1. Non-weight bearing in boot or cast for 6 weeks
    2. Displaced Fracture
      1. Surgery (typically ORIF)
  4. Talar Stress Fracture
    1. Relative rest, support shoe, walking boot (CAM Boot), or non-weight bearing
    2. Resolution may require up to 6 months
    3. Progressive return to weight bearing
    4. Use Ankle Brace after return to activity
  • References
  1. Feden and Kiel (2017) Crit Dec Emerg Med 31(11): 3-10
  2. Koenig and Clanton in Madden et al (2010) Netter's Sports Medicine, Saunders, Philadelphia, p. 469-70