![]() 12 However, Kirkpatrick et al reported a higher incidence of these fractures in snowboarders using hard boots as well. 11 One postulated reason behind their high incidence in snowboarders is the use of soft boots (70%), which results in more flexibility around the ankle joint leading to higher risk of foot and ankle injuries. Hawkins postulated that the avulsion of the lateral process caused by the pull of the lateral talocalcaneal ligament might be another contributing mechanism however, cadaveric and clinical studies do not clearly demonstrate this suggestion. 10 However, there is no disagreement that dorsiflexion plays the key role at the time of injury. 9 Funk et al, in another cadaveric study, suggested that a combined eversion and dorsiflexion might also play an important role resulting in these fractures. 8 Boon et al, in their cadaveric study, proposed that some degree of external rotation is also required to produce this type of injury. 5 This results in a lateral shift of the talar head, an upward shift of the lateral process of the talus on the posterior articular surface of the calcaneum and loss of congruity of the posterior articulation. The suggested mechanism is thought to be a consequence of forced dorsiflexion and inversion of a fixed pronated foot. Lateral process fractures are usually a result of high-energy injuries. 2- 4 This article aims to provide an overview of fractures of the lateral and posterior processes of the talus. 1 Factors that can affect the outcomes of these fractures are the extent of initial articular damage, the accuracy of the reduction and the subtalar joint stability. Delayed diagnosis and treatment can potentially lead to poor outcomes, resulting in long-term pain, disability, nonunion and degenerative changes. Their management depends on the type, size of the fragment, degree of displacement, subtalar joint involvement and the articular surface lesion. They are uncommon and frequently missed due to difficulty in visualizing them on plain radiographs and low level of suspicion. Fractures of the lateral and posterior processes are considered to be peripheral talar fractures. ![]() Skalski, : ).įractures of the talus are uncommon and they comprise 3.4% of foot and ankle fractures and 0.32% of all fractures in the human body. Anatomy of the talus (reproduced courtesy of Dr Matt. ![]()
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