Many lateral process fractures of the talus are displaced or unstable enough to require surgical fixation. If the fracture is such that the piece of broken bone is displaced less than 2mm, it can be treated with immobilization in a short leg cast or boot for 6 weeks, with no weight bearing for at least 4 weeks. In the early stages of treatment, ice packs and pain-relieving medications can be beneficial in controlling pain and reducing swelling. As the fracture can involve the articular surfaces of the ankle and subtalar joint, it is important to start appropriate treatment promptly to avoid further degeneration of the joint. The pieces that break away can either be shifted away from their normal position (displaced) or remain in place (non-displaced). The piece(s) of bone that breaks off the lateral process of the talus can vary in size and number. X-rays and CT scans not only confirm the diagnosis, but help determine the treatment course. Ultrasound can be useful for detection of cortical disruption and ankle joint space effusion however follow-up CT or MRI is often used to visualise the fracture line more clearly and provide information to fully appreciate the extent of the injury. It may be possible to identify the fracture on a plain x-ray, but the fracture line is often quite subtle and difficult to see due to overlapping bony structures. On physical examination, tenderness will be induced over the outside of the ankle and towards the front and outer border of the foot. There is usually also difficulty in walking and an inability to bear weight. There is typically pain behind the lateral malleolus of the fibula, with accompanying swelling and bruising. The symptoms experienced with a fracture of the lateral process of the talus often resemble those of a severe ankle sprain. If this occurs with enough force, the lateral process of the talus will fracture.
If a person has their foot in a dorsiflexed position and rolls their ankle outwards, the lateral process of the talus gets compressed in between the calcaneus and the lateral malleolus of the fibula.
When the ankle is dorsiflexed, the talus is locked into position by the surrounding bones. The injury is acute and typically occurs when the outside of the talus is jammed heavily against the fibula. Injury:Ī lateral process fracture of the talus occurs most frequently when the foot is dorsiflexed and eversion. As the lateral process is involved in both the ankle and subtalar joints, it is important in almost all foot movements. The bottom of the lateral process forms the anterior portion of the posterior subtalar joint. The top of the lateral process articulates with the fibula and forms part of the lateral gutter of the ankle joint. The lateral process of the talus is a wedge-shaped prominence of the talar body. The talus also articulates with a bone in front of it called the navicular, allowing for subtle movements of the midfoot that play an important role when walking on uneven ground. This joint allows for inversion and eversion of the foot. The underneath aspect of the talus articulates with the calcaneus, giving rise to the subtalar joint. The ankle joint allows for dorsiflexion and plantarflexion of the foot. The talus forms the lower part of the ankle joint, and articulates with the medial malleolus of the tibia and the lateral malleolus of the fibula. The talus is one of seven articulating foot bones that are located between the tibia and fibula of the leg and the metatarsal bones of the midfoot.
A fracture of the lateral process is rare in the general population and is fifteen times more common in the snowboarder population. The talus is a bone in the ankle that sits between the lower leg bones and the heel bone. “Snowboarder’s fracture” is a colloquialism commonly used to describe a fracture of the lateral process of the talus. Home » Patient Info » Conditions and Procedures » Foot & Ankle » Lateral Process Fractures of the Talus: The Snowboarder's Fracture Lateral Process Fractures of the Talus: The Snowboarder's Fracture Matthew Peters, BSc Brian Gilmer, MD Introduction:
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