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A four-year nonrandomized retrospective clinical study was instituted to ascertain the pattern of injuries sustained by participants of snowboarding. One thousand four hundred and fifteen questionnaires representing 1507 physician-seen and diagnosed snowboarding injuries were collected from 1988 through 1992.
Forty-eight participants reported lateral ankle pain and were diagnosed with a fracture of the lateral process of the talus. Twenty-three of the 48 patients participated in a follow-up questionnaire detailing their treatment, current pain level, and function.
All of the fractures were intra-articular and into the posterior facet of the talocalcaneal joint. Diagnosis often required tomograms, computerized tomography (CT), or magnetic resonance imaging (MRI) studies to detail fragment size, displacement, and degree of comminution.
Four patients underwent early open reduction internal fixation (ORIF) with three excellent and one good short-term result. The remaining 19 were treated with casting, splinting or limited weight bearing or both. Fifteen of those treated nonoperatively reported varying degrees of symptoms without complete recovery, including four patients who have been diagnosed with a symptomatic nonunion requiring further treatment. One fracture was diagnosed more than two years after the original injury.
This fracture may be easily missed on X-ray, making diagnosis difficult; thus an aggressive diagnostic approach is recommended. Large or significantly displaced fractures may respond better to more aggressive treatment, including early ORIF or excision.
talus, snowboarder, lateral process talus, talus fracture
Physician assistant, Vail Summit Orthopaedics and Sports Medicine, Vail, CO
orthopedic surgeon, Vail Summit Orthopaedics and Sports Medicine, Vail, CO