Authors of section

Authors

Richard Buckley, Andrew Sands

Executive Editors

Joseph Schatzker

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Lateral process

Mechanism of the injury

This fracture is often confused with an ankle sprain. The mechanism of injury is forced eversion with a loaded hindfoot. This is often called the “snowboarder’s fracture”.

direct lateral approach to the talus
orif screw fixation

Imaging

A plain x-ray may be diagnostic, but coronal CT scans are often necessary for a complete definition of the injury.
Case by courtesy of Dr. Steven Steinlauf, Florida, USA.

orif screw fixation

Surgical indications

Fractures of the lateral process of the talus always involve the subtalar joint and depending on the size of the fragment may also involve the articulation between the lateral surface of the talus and the lateral malleolus. Because this is an intraarticular fracture, if displaced, anatomic reduction and stable fixation has to be restored to prevent the development of posttraumatic arthritis. If the fracture is comminuted and reduction and fixation is not possible, then one should consider resection. Similarly, if a symptomatic nonunion develops, the fragment should be resected.
If the fracture is completely undisplaced, then immobilization and non-weightbearing is indicated.