Advertisement

Fractures of the Lateral Process of the Talus

  • Matthew P. Sullivan
  • Reza FiroozabadiEmail author
Chapter
  • 42 Downloads

Abstract

The lateral process of the talus plays a critical role in hindfoot function. It is the attachment site for several important ligamentous structures responsible for lateral ankle stability and provides a significant percentage of the talar contribution to the subtalar joint. Lateral process fractures have recently experienced increased attention due to the rise in popularity of snowboarding over the past two decades and the greatly increased rate of lateral process injuries seen in snowboarders as compared to other activities. This rapid rise in incidence has greatly increased our understanding of diagnosis, management, and natural history of the fracture. Historically, these have been an underdiagnosed entity, often being mistaken for an ankle sprain. Though long-term follow-up and a paucity of data exist in regard to management, we advocate operative management in the majority of injuries due to the critical role the lateral process plays in normal hindfoot function. The objective of this chapter is to provide a comprehensive review of lateral process injuries with particular attention paid to operative treatment concepts.

Keywords

Talus fracture Lateral process Technique Subtalar arthritis Talar neck 

References

  1. 1.
    Dimon JH 3rd. Isolated displaced fracture of the posterior facet of the talus. J Bone Joint Surg Am. 1961;43-A:275–81.CrossRefGoogle Scholar
  2. 2.
    Hawkins LG. Fracture of the lateral process of the talus. J Bone Joint Surg Am. 1965;47:1170–5.CrossRefGoogle Scholar
  3. 3.
    Cimmino CV. Fracture of the lateral process of the talus. Am J Roentgenol Radium Therapy, Nucl Med. 1963;90:1277–80.Google Scholar
  4. 4.
    Fjeldborg O. Fracture of the lateral process of the talus. Supination-dorsal flexion fracture. Acta Orthop Scand. 1968;39(3):407–12.CrossRefGoogle Scholar
  5. 5.
    McCrory P, Bladin C. Fractures of the lateral process of the talus: a clinical review. “Snowboarder’s ankle”. Clin J Sport Med. 1996;6(2):124–8.CrossRefGoogle Scholar
  6. 6.
    Boon AJ, Smith J, Zobitz ME, Amrami KM. Snowboarder’s talus fracture. Mechanism of injury. Am J Sports Med. 2001;29(3):333–8.CrossRefGoogle Scholar
  7. 7.
    Bonvin F, Montet X, Copercini M, Martinoli C, Bianchi S. Imaging of fractures of the lateral process of the talus, a frequently missed diagnosis. Eur J Radiol. 2003;47(1):64–70.CrossRefGoogle Scholar
  8. 8.
    Kirkpatrick DP, Hunter RE, Janes PC, Mastrangelo J, Nicholas RA. The snowboarder’s foot and ankle. Am J Sports Med. 1998;26(2):271–7.CrossRefGoogle Scholar
  9. 9.
    Mukherjee SK, Pringle RM, Baxter AD. Fracture of the lateral process of the talus. A report of thirteen cases. J Bone Joint Surg Br. 1974;56(2):263–73.CrossRefGoogle Scholar
  10. 10.
    Langer P, DiGiovanni C. Incidence and pattern types of fractures of the lateral process of the talus. Am J Orthop (Belle Mead NJ). 2008;37(5):257–8.Google Scholar
  11. 11.
    Young KW, Park YU, Kim JS, Cho HK, Choo HS, Park JH. Misdiagnosis of talar body or neck fractures as ankle sprains in low energy traumas. Clin Orthop Surg. 2016;8(3):303–9.CrossRefGoogle Scholar
  12. 12.
    Wang PH, Su WR, Jou IM. Lateral Hindfoot impingement after nonunion of fracture of the lateral process of the talus. J Foot Ankle Surg. 2016;55(2):387–90.CrossRefGoogle Scholar
  13. 13.
    Valderrabano V, Perren T, Ryf C, Rillmann P, Hintermann B. Snowboarder’s talus fracture: treatment outcome of 20 cases after 3.5 years. Am J Sports Med. 2005;33(6):871–80.CrossRefGoogle Scholar
  14. 14.
    Ebraheim NA, Skie MC, Podeszwa DA, Jackson WT. Evaluation of process fractures of the talus using computed tomography. J Orthop Trauma. 1994;8(4):332–7.CrossRefGoogle Scholar
  15. 15.
    Noble J, Royle SG. Fracture of the lateral process of the talus: computed tomographic scan diagnosis. Br J Sports Med. 1992;26(4):245–6.CrossRefGoogle Scholar
  16. 16.
    Mills HJ, Horne G. Fractures of the lateral process of the talus. Aust N Z J Surg. 1987;57(9):643–6.CrossRefGoogle Scholar
  17. 17.
    Wu Y, Jiang H, Wang B, Miao W. Fracture of the lateral process of the talus in children: a kind of ankle injury with frequently missed diagnosis. J Pediatr Orthop. 2016;36(3):289–93.CrossRefGoogle Scholar
  18. 18.
    Heckman JD, McLean MR. Fractures of the lateral process of the talus. Clin Orthop Relat Res. 1985;199:108–13.Google Scholar
  19. 19.
    Perera A, Baker JF, Lui DF, Stephens MM. The management and outcome of lateral process fracture of the talus. Foot Ankle Surg. 2010;16(1):15–20.CrossRefGoogle Scholar
  20. 20.
    von Knoch F, Reckord U, von Knoch M, Sommer C. Fracture of the lateral process of the talus in snowboarders. J Bone Joint Surg Br. 2007;89(6):772–7.CrossRefGoogle Scholar
  21. 21.
    Bali K, Prabhakar S, Gahlot N, Dhillon MS. Neglected lateral process of talus fracture presenting as a loose body in tarsal canal. Chin J Traumatol. 2011;14(6):379–82.PubMedGoogle Scholar
  22. 22.
    Golano P, Vega J, Perez-Carro L, Gotzens V. Ankle anatomy for the arthroscopist. Part II: role of the ankle ligaments in soft tissue impingement. Foot Ankle Clin. 2006;11(2):275–96, v–viCrossRefGoogle Scholar
  23. 23.
    Stephens MM, Sammarco GJ. The stabilizing role of the lateral ligament complex around the ankle and subtalar joints. Foot Ankle. 1992;13(3):130–6.CrossRefGoogle Scholar
  24. 24.
    DiGiovanni CW, Langer PR, Nickisch F, Spenciner D. Proximity of the lateral talar process to the lateral stabilizing ligaments of the ankle and subtalar joint. Foot Ankle Int. 2007;28(2):175–80.CrossRefGoogle Scholar
  25. 25.
    Kjaersgaard-Andersen P, Wethelund JO, Helmig P, Soballe K. The stabilizing effect of the ligamentous structures in the sinus and canalis tarsi on movements in the hindfoot. An experimental study. Am J Sports Med. 1988;16(5):512–6.CrossRefGoogle Scholar
  26. 26.
    Langer P, Nickisch F, Spenciner D, DiGiovanni C. Effect of simulated lateral process talus “fracture excision” on its ligamentous attachments. Am J Orthop (Belle Mead NJ). 2009;38(5):222–6.Google Scholar
  27. 27.
    Funk JR, Srinivasan SC, Crandall JR. Snowboarder’s talus fractures experimentally produced by eversion and dorsiflexion. Am J Sports Med. 2003;31(6):921–8.CrossRefGoogle Scholar
  28. 28.
    Klein SE, Varner KE, Marymont JV. Lateral talar process fracture and peroneal tendon dislocation: a previously unrecognized injury complex. Foot Ankle Int. 2008;29(10):1020–4.CrossRefGoogle Scholar
  29. 29.
    Firoozabadi R, Kramer PA, Benirschke SK. Kirschner wire bending. J Orthop Trauma. 2013;27(11):e260–3.CrossRefGoogle Scholar
  30. 30.
    Romeo NM, Hirschfeld AG, Githens M, Benirschke SK, Firoozabadi R. Significance of lateral process fractures associated with talar neck and body fractures. J Orthop Trauma. 2018;32(12):601–6.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Orthopaedic Trauma ServiceState University of New York, Upstate University HospitalOneidaUSA
  2. 2.Department of Orthopaedics and Sports Medicine, Harborview Medical Center/University of WashingtonSeattleUSA

Personalised recommendations