Fracture of the Lateral Process of Talus

AP view of the foot shows a small avulsion fracture (arrow) of the lateral process of the talus.

Facts: Lateral Process of Talus

• Lateral process is a broad-based, wedge-shaped prominence of the lateral talar body that articulates with the fibula and posterior facet of talus
• Anchor point for lateral talocalcaneal, anterior and posterior talofibular ligaments

Facts: Fracture of the Lateral Process of Talus

• Axial loading with elements of dorsiflexion and eversion or external rotation
• High incidence among snowboarders, sometimes called "snowboarder fracture"
• Can be difficult to diagnose clinically, easily confused with ankle sprain
• Pain localized anteroinferior to the distal end of fibula

Imaging

• Important to look specifically at this area in patients presenting with lateral ankle pain following trauma
• Small, nondisplaced fracture can be overlooked. CT may be warranted if suspicion persists in a normal-looking x-ray series
• Hawkins classified this fracture into 3 types: 1) large single fragment, 2) large comminuted fragment, 3) small, extra-articular fragment

Reference:

Browner BD, Levine AM, Jupiter JB, et al. Skeletal Trauma: Basic Science, Management, and Reconstruction, 2009.