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Talus fracture

70 citationsUpdated Sep 2026

Overview

Fractures of the lateral and posterior processes of the talus are uncommon but clinically significant injuries that may result in substantial disability if diagnosis is missed or treatment is delayed or inadequate [1]. Optimal management requires a thorough understanding of osseous anatomy and vascular supply, as definitive treatment involves direct reduction of articular surfaces and restoration of talar shape, with preoperative planning mandatory to match the exposure to the fracture pattern [3, 4]. Talus fractures with significant displacement or associated dislocation require urgent reduction to afford the best outcome [4]. In pediatric populations, foot fractures generally carry a good prognosis and are typically treated nonoperatively [2], although avascular necrosis complicating undisplaced or minimally displaced talar neck fractures is rare but not unique, with a calculated incidence of 16% in children compared to adults [13].

The goals of treatment for ankle fractures are a healed fracture and an ankle that moves and functions normally without pain [14]. Despite advances in treatment techniques such as dual anterior incisions and vascularized autografts, osteonecrosis and osteoarthritis remain common complications of talus fractures, and functional outcomes remain poor in a subset of severely injured patients [9]. Osteochondral lesions are frequently seen in patients with ankle fractures, with rates of 45–47% when assessed directly after and at least 12 months after initial trauma, respectively, with the vast majority located in the talus [5]. Most patients with symptomatic or unstable osteochondral lesions of the talus require surgery, and while many reasonable operative techniques exist, most lead to similar and satisfactory results [7].

Epidemiological data from Finland indicate that the incidence of talar fractures has increased during the last decades, while the incidence of performed operations has remained stable [15]. Surgical treatment yields a good long-term result for transchondral fractures of the talar dome, with no deterioration in functional capacity noted in patients followed for up to eighteen years [11]. In type II snowboarder's talus fractures, primary surgical treatment has led to achieving better outcomes, reducing sequelae, and allowing patients to regain the same sports activity level as before injury [27]. Limb preservation after limb-threatening trauma with hindfoot injury and multiple fractures of the lower extremity is recommended as the method of choice with reasonable clinical results [34].

Anatomy & Pathophysiology

Bony Anatomy

The posterior process of the talus consists of medial and lateral tubercles separated by a groove that accommodates the flexor hallucis longus tendon [112]. This posterior process covers approximately 25% of the posterior articular facet of the subtalar joint [112]. In talar osteochondral lesions, the subchondral bone is often yellowish and hard, while the "floating" osteochondral fragment is frequently a loose fragment turned upside down within the crater [41]. For medial malleolar osteotomy, an optimal location exists at the medial ankle edge that involves minimal cartilage damage [83].

Fracture Mechanisms

Talar body fractures result from axial compression of the talus between the tibial plafond and the calcaneus [44]. When a combined medial malleolar fracture is present, an additional inversion torque distributes force to medial structures, producing a vertical split of the talar body and medial malleolar fracture [44]. A lateral side talar body fracture can be produced by pronation-external rotation [44]. Fracture of the lateral process of the talus in snowboarders occurs when axial loading in dorsiflexion and inversion is combined with external rotation [105]. Axial loading in dorsiflexion and inversion without external rotation does not produce lateral process fractures of the talus [105]. Fracture of the larger posterolateral tubercle of the talus is caused by inversion or extreme equinus [112]. Fracture of the smaller posteromedial tubercle of the talus is caused by excessive dorsiflexion and pronation [112].

Pathophysiology & Complications

Fractures of the lateral and posterior processes of the talus may result in significant disability in cases of missed diagnosis or delayed or inadequate treatment [1]. Misdiagnosis of lateral process fractures can lead to long-term morbidity and severe degeneration of the subtalar joint [105]. Fracture of the posterior medial talar tubercle (Cedell fracture) is associated with morbidities such as tarsal tunnel syndrome, flexor hallucis longus tendon interposition, and posteromedial ankle impingement [112]. Disrupted and intermittent contact of the articular surface in posterior malleolar fractures leads to degenerative changes and traumatic arthritis [76]. Restoring the integrity of the lateral malleolus establishes stability of the ankle and prevents late degenerative arthritis [53]. The dynamic congruency of the joint, influenced by ligamentous integrity, is the main anatomical component in mechanical ankle instability [40]. Three-dimensional talar shape is not a factor in chronic mechanical ankle instability [40]. Abnormal internal rotation of the talus in patients with mechanical ankle instability is decreased after ankle lateral stabilization surgery [73]. Ligament injury leading to loss of stability of the bone structure can cause talus dislocation [89].

Classification

Berndt and Harty: This radiographic staging system for osteochondral lesions has been cited in virtually every subsequent publication on the topic since 1959 [47]. The criteria define four stages: stage I is a small compression fracture, stage II is incomplete avulsion of a fragment, stage III is complete avulsion without displacement, and stage IV is an avulsed fragment displaced within the joint [47]. An increase in the radiographic stage does not necessarily predict increasing fragmentation or loosening of the lesion [47]. For example, of eight radiographic stage IV lesions, four were considered grade I arthroscopically [47].

Other Considerations: Osteochondral lesions (OCLs) are frequently seen in patients with ankle fractures when assessed both directly after and at least 12 months after initial trauma (45–47%, respectively), with the vast majority located in the talus [5]. In patients with chronic lateral ankle instability, the most common location for cartilage lesions was the talus (85%), with most lesions located on the medial talar dome (68%) [18]. An international consensus derived from leaders in the field assists clinicians with the appropriate terminology for osteochondral lesions of the ankle [108].

Fractures with significant displacement or associated dislocation require urgent reduction to afford the best outcome [4]. Definitive treatment involves direct reduction of articular surfaces and restoration of talus shape, with preoperative planning mandatory as the fracture pattern dictates the exposure [3]. Isolated displaced fractures of the posterior facet of the talus do occur and they pose problems in diagnosis and treatment [8]. High-energy injuries resulting in fractures of the medial tubercle of the posterior process of the talus are very different to the previously described sporting avulsion fractures [25]. Arthroscopic reduction and internal fixation for a type I fracture of the lateral process of the talus can be easily accomplished, and precise anatomic reduction can be obtained [29].

Despite advances in treatment techniques such as dual anterior incisions and vascularized autografts, osteonecrosis and osteoarthritis remain common complications of talus fractures, and functional outcomes remain poor in a subset of severely injured patients [9]. Reduction of the talus after severe injury is thought to be fruitless in most cases, leading to months or years of disability because of the frequency of infection and loss of vascular supply to the talus [19]. Avascular necrosis complicating undisplaced or minimally displaced fracture of the neck of talus in a child is rare, but by no means unique, with a calculated incidence of 16% in children compared to adults [13].

Most patients with symptomatic or unstable osteochondral lesions of the talus require surgery, and while many reasonable operative techniques exist, most lead to similar and satisfactory results [7]. The management of OLT by foot and ankle surgeons from around the world remains extremely varied [21]. Fixation of the lesion fragment, regardless of size and/or chronicity, appears to be appropriate in cases of an osteochondral talar lesion [63].

Clinical Presentation

Associated Injuries and Pathologies

Osteochondral lesions are frequently identified in patients with ankle fractures, occurring in 45–47% of cases when assessed directly after trauma and at least 12 months post-injury, with the vast majority located in the talus [5]. In patients presenting with chronic lateral ankle instability, the talus is the most common site for cartilage lesions (85%), predominantly affecting the medial talar dome (68%) [18]. Acute ankle fractures are commonly concomitant with multiple soft-tissue injuries, a context in which arthroscopy may serve as a method for accurate diagnosis and appropriate treatment [51].

Diagnostic Challenges and Imaging

Plain radiographs may miss up to 50% of osteochondral lesions even when combined with history taking and physical examination [45]. Computed tomography lacks the ability to assess cartilage, although it is useful in obtaining greater detail about the bony injury [45]. MRI has been shown to detect chondral and subchondral bone integrity accurately, can delineate the size and location of osteochondral lesions, and correlates closely with arthroscopic findings [45].

Specific Fracture Patterns and Mechanisms

Talar body fractures are produced by an axial compression of the talus between the tibial plafond and calcaneus [44]. An inverted osteochondral fracture of the lateral talus (LIFT lesion) can occur after a twisting injury to the ankle; clinical suspicion should be high, especially in the younger athletic patient population [96].

Red-Flag Patterns and Special Views

The association of a swollen hindfoot, talar tilt, and a flake fracture of the lateral malleolus must alert clinicians to this injury [20]. In cases of symptomatic posterior ankle impingement, a PIM view is advised to be used instead of or in addition to the standard lateral view for detection of posterior talar pathologic conditions [52].

Investigations

Plain radiography: Application of the Ottawa ankle rule is highly sensitive and correctly predicts the likelihood of ankle fractures when present, although lower specificity rates increase the likelihood of false positives [24]. Exorotated radiographic views provide additional diagnostic value in detecting an osseous impediment in patients with posterior ankle impingement instead of, or in addition to, the standard lateral view [117].

MRI: Magnetic resonance imaging is a highly sensitive and specific tool for the diagnosis of sports-related injuries and can aid in decision making regarding treatment [114]. MRI detected a posterior syndesmosis injury in 93.5% of patients acutely but became less reliable with time [106].

CT: Weight-bearing CT scans better demonstrate the true orientation of bones and joints during loading compared to standard imaging, aiding in the diagnosis and preoperative planning of complex foot and ankle pathologies [48]. The technique of transverse CT scan of the syndesmosis can be useful in assessing the degree of malreduction of the ankle mortice and potential incongruency [115].

Other Considerations: A Delphi consensus was reached on specific imaging techniques, anatomical aspects, and fracture reduction parameters for evaluating wrist and ankle fractures [59].

Treatment

Non-Operative

Conservative management is first-line and effective for most cases of os trigonum fractures [97]. In patients with isolated stable Weber-B type ankle fractures, immobilization for 3 weeks with a cast or orthosis was noninferior to cast immobilization for 6 weeks for symptoms and clinical outcomes at 1 year [111].

Operative

Indications: Definitive treatment involves direct reduction of articular surfaces and restoration of talus shape [3]. Preoperative planning is mandatory for talus fractures as the fracture pattern dictates the exposure [3]. Posterior talar fractures are frequently ignored acutely, and primary immobilisation until fracture union or surgical stabilisation/excision would prevent many later problems [98].

Surgical Approach / Technique: Surgical treatment of Hawkins type III talar neck fracture through the approach of medial malleolar osteotomy and mini-plate for fixation resulted in decreased soft tissue trauma, adequate exposure of talar neck, satisfactory performance of daily life activities, and quality of life following surgery and restoration of anatomy of injured talus [38]. The PAMELA (Posterior to anterior malleolar extended lateral approach to the ankle) opens a new perspective in the optimal management of complex fractures of the ankle [36]. Temporary external and percutaneous k-wire fixations could be a good alternative treatment option for ankle fracture-dislocations [107].

Osteochondral Lesions: The technique of osteochondral transplantation of autologous talar graft for osteochondral lesions of talus after failure of primary treatment with bone marrow stimulation can be safely and successfully used [28]. This case study shows good clinical and radiographic results with autologous bone peg fixation in patients with acute osteochondral fractures of the talus [37]. Both debridement and microfracture yield good functional outcomes in the second year of the treatment for acute talar osteochondral lesions [60]. Future management should aim for primary preventive interventions and an individualised approach focusing on optimal tissue engineering requirements to improve outcomes for osteochondral lesions of the talus [101].

Salvage Procedures and Complications: External fixation and bone-grafting was effective for ankles that had evidence of osteonecrosis of the body of the talus [57]. TC (tibiocalcaneal) arthrodesis is a promising and effective method for the treatment of severe ankle deformities with talus luxation [100]. Results suggest that satisfactory outcomes can be achieved by tibiotalocalcaneal arthrodesis using intramedullary nailing [109].

Complications

Osteonecrosis and Arthrosis

Osteonecrosis and osteoarthritis remain common complications of talus fractures despite advances in treatment techniques such as dual anterior incisions and vascularized autografts [9]. Avascular necrosis complicating undisplaced or minimally displaced fracture of the neck of talus in a child is rare, with a calculated incidence of 16% in children compared to adults [13].

Osteochondral Lesions

Osteochondral lesions are frequently seen in patients with ankle fractures when assessed both directly after and at least 12 months after initial trauma, with rates of 45–47% respectively, and the vast majority are located in the talus [5]. In patients with chronic lateral ankle instability, the most common location for cartilage lesions is the talus (85%), with most lesions located on the medial talar dome (68%) [18]. The management of osteochondral lesions of the talus by foot and ankle surgeons from around the world remains extremely varied [21]. Addressing chronic lateral ankle instability simultaneously with osteochondral lesion of the talus treatment may positively impact the long-term health of the ankle joint by protecting repaired cartilage and stopping the cascade of cartilage damage [55].

Soft Tissue and Ligamentous Complications

Approximately one-third of patients who underwent internal fixation for a fracture of the talus had peroneal tendon dislocation, which was associated with a fleck sign [10].

Post-traumatic Arthroplasty Complications

Compared with primary osteoarthritis, fracture posttraumatic osteoarthritis was associated with a markedly higher complication rate after total ankle arthroplasty and was at higher risk of failure requiring prosthesis explant [110].

Other Considerations

Obese patients have significantly worse long-term outcomes after an operatively treated ankle fracture, including increased pain, poorer function, and greater impairment in everyday life [50].

Recovery

General Prognosis and Complications: Osteonecrosis and osteoarthritis remain common complications of talus fractures, and functional outcomes remain poor in a subset of severely injured patients [9]. Obese patients experience significantly worse long-term outcomes, including increased pain, poorer function, and greater impairment in everyday life after operatively treated ankle fractures [50].

Osteochondral Lesions: Autologous chondrocyte implantation of the talus yields significant functional improvement; however, further investigation is necessary to determine the long-term structural and biomechanical properties of the repair tissue [54].

Specific Fracture Patterns and Outcomes: Surgical treatment of Hawkins type III talar neck fractures through medial malleolar osteotomy and mini-plate fixation resulted in decreased soft tissue trauma, adequate exposure of the talar neck, satisfactory performance of daily life activities and quality of life following surgery, and restoration of the anatomy of the injured talus [38]. A staged procedure using an antibiotic cement spacer and femoral head allograft for complete talar extrusion resulted in fair outcomes in terms of AOFAS ankle-hindfoot score and allowed the patient to continue with activities of daily living without complications of infection or collapse requiring additional unplanned procedures [61]. Although excessive talar tilt persisted radiologically in some cases following plication of the anterolateral capsule with extensor digitorum brevis transfer, functional instability did not recur and no serious complications were encountered [26]. Stress X-ray films at follow-up examination revealed no talar tilt in 15 patients, and 10 had a tilt which was significantly less than that before treatment [62].

Key Evidence

  • [L4] Fractures of the lateral and posterior processes of the talus are uncommon but important injuries that may result in significant disability in cases of missed diagnosis or delayed or inadequate treatment. [1] (10.1302/2058-5241.3.170040)
  • [L4] Fractures of the foot in children usually have a good prognosis and generally are treated nonoperatively. [2] (10.1097/01.blo.0000156451.40395.fc)
  • [L5] Definitive treatment involves direct reduction of articular surfaces and restoration of talus shape, with preoperative planning mandatory as the fracture pattern dictates the exposure. [3] (10.5435/jaaos-d-20-01348)
  • [L5] Optimal diagnosis and management of talus fractures require a thorough understanding of osseous anatomy and vascular supply; fractures with significant displacement or associated dislocation require urgent reduction to afford the best outcome. [4] (10.5435/00124635-200103000-00005)
  • [L4] OCLs are frequently seen in patients with ankle fractures when assessed both directly after and at least 12 months after initial trauma (45–47%, respectively), with the vast majority located in the talus. [5] (10.1007/s00167-020-06187-y)
  • [L5] Only a small fracture of the talus is visible via an open approach, which could warrant arthroscopic evaluation. [6] (10.1177/23259671211066856)
  • [L5] Most patients with symptomatic or unstable osteochondral lesions of the talus require surgery, and while many reasonable operative techniques exist, most lead to similar and satisfactory results. [7] (10.1530/eor-22-0024)
  • [L4] [8] (10.2106/00004623-196143020-00016)
  • [L5] Despite advances in treatment techniques such as dual anterior incisions and vascularized autografts, osteonecrosis and osteoarthritis remain common complications of talus fractures, and functional outcomes remain poor in a subset of severely injured patients. [9] (10.5435/jaaos-d-20-00116)
  • [L4] Approximately one-third of the patients who underwent internal fixation for a fracture of the talus had peroneal tendon dislocation, which was associated with a fleck sign. [10] (10.1302/0301-620x.99b4.bjj-2016-0641.r1)
  • [L4] Surgical treatment yields a good long-term result for transchondral fractures of the talar dome, with no deterioration in functional capacity noted in patients followed for up to eighteen years. [11] (10.2106/00004623-198062040-00020)
  • [L4] Multiple factors must be considered in deciding whether to address the posterior malleolus fracture surgically, although current indications are unclear. [12] (10.5435/00124635-201402000-00001)
  • [L4] Avascular necrosis complicating undisplaced or minimally displaced fracture of the neck of talus in a child is rare, but by no means unique, with a calculated incidence of 16% in children compared to adults. [13] (10.1016/j.injury.2004.02.016)
  • [L5] The goals of treatment for ankle fractures are a healed fracture and an ankle that moves and functions normally without pain. [14] (10.2106/00004623-199611000-00021)
  • [L3] While the incidence of performed operations had remained stable, the incidence of talar fractures in Finland has increased during the last decades. [15] (10.1186/s12891-024-08141-2)
  • [L4] The most common location was the talus (85%), with most lesions located on the medial talar dome (68%). [18] (10.1177/03635465221084365)
  • [L4] Reduction of the talus after severe injury is thought to be fruitless in most cases, leading to months or years of disability because of the frequency of infection and loss of vascular supply to the talus. [19] (10.2106/00004623-195032020-00022)
  • [L4] The association of a swollen hindfoot, talar tilt and a flake fracture of the lateral malleolus must alert clinicians to this injury. [20] (10.1016/0020-1383(93)90200-p)
  • [L4] The management of OLT by foot and ankle surgeons from around the world remains extremely varied. [21] (10.1007/s00167-020-06370-1)
  • [L1] Application of the OAR is highly sensitive and can correctly predict the likelihood of ankle fractures when present, however, lower specificity rates increase the likelihood of false positives. [24] (10.1186/s12891-022-05831-7)
  • [L5] High-energy injuries resulting in fractures of the medial tubercle of the posterior process of the talus are very different to the previously described sporting avulsion fractures. [25] (10.1016/s0020-1383(97)00060-0)
  • [L4] Although excessive talar tilt persisted radiologically in some cases, functional instability did not recur and no serious complications were encountered. [26] (10.1016/0020-1383(88)90073-3)
  • [L2] In type II fractures, primary surgical treatment has led to achieving better outcomes, reducing sequelae, and allowing patients to regain the same sports activity level as before injury. [27] (10.1177/0363546504271001)
  • [L4] The midterm results suggest that the technique of osteochondral transplantation of autologous talar graft for osteochondral lesions of talus after failure of primary treatment with bone marrow stimulation can be safely and successfully used. [28] (10.1007/s00167-014-3389-3)
  • [Paper] Arthroscopic reduction and internal fixation for a type I fracture of the lateral process of the talus can be easily accomplished, and precise anatomic reduction can be obtained. [29] (10.1016/j.eats.2014.11.011)
  • [L4] Limb preservation after limb threatening trauma with hindfoot injury and multiple fractures of the lower extremity is recommended as the method of choice with reasonable clinical results. [34] (10.1016/j.injury.2017.03.045)
  • [L5] The best and most cost-effective treatment of lateral malleolar fractures without talar displacement on presenting radiographs remains controversial, but it is not controversial that they do not all need an operation. [35] (10.2106/jbjs.16.01416)
  • [L5] The PAMELA opens a new perspective in the optimal management of complex fractures of the ankle. [36] (10.1007/s00402-020-03507-2)
  • [L5] This case study shows good clinical and radiographic results with autologous bone peg fixation in patients with acute osteochondral fractures of the talus. [37] (10.1007/s00402-018-3066-y)
  • [L4] This surgical treatment resulted in decreased soft tissue trauma, adequate exposure of talar neck, satisfactory performance of daily life activities, and quality of life following surgery and restoration of anatomy of injured talus. [38] (10.1186/s13018-017-0610-3)
  • [L4] Prosthetic talar replacement is a useful procedure for patients with osteonecrosis of the talus as it maintains ankle function. [39] (10.2106/jbjs.n.01272)
  • [L3] This supports the interpretation that the dynamic congruency of the joint, which is influenced by ligamentous integrity remains the main anatomical component in mechanical ankle instability. [40] (10.1186/s12891-025-09458-2)
  • [L4] [44] (10.1007/s00402-007-0475-8)
  • [L3] [45] (10.1016/j.injury.2015.10.029)
  • [L5] [47] (10.5435/00124635-199603000-00001)
  • [L5] Weight-bearing CT scans better demonstrate the true orientation of bones and joints during loading compared to standard imaging, aiding in the diagnosis and preoperative planning of complex foot and ankle pathologies. [48] (10.5435/jaaos-d-19-00700)
  • [L3] Obese patients have significant worse long-term outcomes, namely increased pain, poorer function, and greater impairment in everyday life after an operatively treated ankle fracture. [50] (10.1186/s12891-022-05247-3)
  • [L4] Acute ankle fractures are commonly concomitant with multiple soft-tissue injuries in which arthroscopy may serve as a method for accurate diagnosis and appropriate treatment. [51] (10.1016/j.arthro.2015.03.043)
  • [L2] In cases of symptomatic posterior ankle impingement, we advise that a PIM view be used instead of or in addition to the standard lateral view for detection of posterior talar pathologic conditions. [52] (10.1016/j.arthro.2014.05.006)
  • [L4] Restoring the integrity of the lateral malleolus establishes stability of the ankle and prevents late degenerative arthritis. [53] (10.2106/00004623-197759020-00005)
  • [L4] Autologous chondrocyte implantation of the talus yields significant functional improvement; however, further investigation is necessary to determine the long-term structural and biomechanical properties of the repair tissue. [54] (10.1177/0363546508325670)
  • [L5] Addressing chronic lateral ankle instability simultaneously with osteochondral lesion of the talus treatment may positively impact the long-term health of the ankle joint by protecting repaired cartilage and stopping the cascade of cartilage damage. [55] (10.1016/j.arthro.2025.02.005)
  • [L4] The results indicate that external fixation and bone-grafting was effective for ankles that had evidence of osteonecrosis of the body of the talus. [57] (10.2106/00004623-199803000-00010)
  • [L4] Arthroscopically assisted percutaneous talar osteosynthesis is a reliable and feasible technique that yields good clinical outcomes. [58] (10.1186/s12891-022-05991-6)
  • [L5] A Delphi consensus was reached on specific imaging techniques, anatomical aspects, and fracture reduction parameters for evaluating wrist and ankle fractures. [59] (10.1007/s00402-010-1198-9)
  • [L3] Both debridement and microfracture yield good functional outcomes in the second year of the treatment. [60] (10.1007/s00167-018-4963-x)
  • [L5] This unique staged procedure resulted in fair outcomes in terms of AOFAS ankle-hindfoot score and allowed the patient to continue with activities of daily living without complications of infection or collapse requiring additional unplanned procedures. [61] (10.5435/jaaos-d-16-00748)
  • [L4] Stress X-ray films at the follow-up examination revealed no talar tilt in 15, and 10 had a tilt which was significantly less than that before treatment. [62] (10.1016/s0020-1383(74)80041-0)
  • [L4] Fixation of the lesion fragment, regardless of size and/or chronicity, appears to be appropriate in cases of an osteochondral talar lesion. [63] (10.1007/s00167-019-05716-8)
  • [L3] Abnormal internal rotation of the talus in patients with mechanical ankle instability was decreased after ankle lateral stabilization surgery. [73] (10.1177/23259671211023447)
  • [L5] [76] (10.1186/s13018-023-04432-x)
  • [L4] Anatomically, there is an optimal location for the medial malleolar osteotomy at the medial ankle edge involving minimal cartilage damage. [83] (10.1007/s00167-015-3591-y)
  • [L5] Transected mice in the CL+ATFL and CL+DL groups displayed mechanical instability of the ankle-subtalar joint complex, and some mice in the CL+DL group also suffered from talus dislocation due to ligament injury leading to loss of stability of the bone structure. [89] (10.1186/s13018-021-02683-0)
  • [L4] An inverted osteochondral fracture of the lateral talus (LIFT lesion) can occur after a twisting injury to the ankle and clinical suspicion should be high, especially in the younger athletic patient population. [96] (10.1016/j.arthro.2013.08.012)
  • [L5] [97] (10.5435/jaaosglobal-d-23-00237)
  • [L4] These injuries are frequently ignored acutely, and primary immobilisation until fracture union or surgical stabilisation/excision would prevent many later problems. [98] (10.1016/s0020-1383(99)00224-7)
  • [L4] TC arthrodesis is a promising and effective method for the treatment of severe ankle deformities with talus luxation. [100] (10.1007/s00402-016-2420-1)
  • [L5] Future management should aim for primary preventive interventions and an individualised approach focusing on optimal tissue engineering requirements to improve outcomes for osteochondral lesions of the talus. [101] (10.1007/s00167-019-05647-4)
  • [L5] [105] (10.1177/03635465010290031401)
  • [L3] MRI detected a posterior syndesmosis injury in 93.5% of patients acutely but became less reliable with time. [106] (10.1007/s00167-019-05581-5)
  • [L3] This method could be a good alternative treatment option for ankle fracture-dislocations. [107] (10.1186/s12891-023-07020-6)
  • [L5] This international consensus derived from leaders in the field will assist clinicians with the appropriate terminology for osteochondral lesions of the ankle. [108] (10.1016/j.jisako.2021.12.001)
  • [L4] Results suggest that satisfactory outcomes can be achieved by tibiotalocalcaneal arthrodesis using intramedullary nailing. [109] (10.1007/s00167-015-3548-1)
  • [L3] Compared with primary osteoarthritis, fracture posttraumatic osteoarthritis was associated with a markedly higher complication rate after total ankle arthroplasty and was at higher risk of failure requiring prosthesis explant. [110] (10.5435/jaaos-d-22-01192)
  • [L1] In patients with isolated stable Weber-B type ankle fractures, immobilization for 3 weeks with a cast or orthosis was noninferior to cast immobilization for 6 weeks for symptoms and clinical outcomes at 1 year. [111] (10.2106/jbjs.19.00512)
  • [Case_report] [112] (10.1186/s12891-020-03584-9)
  • [Paper] Magnetic resonance imaging is a highly sensitive and specific tool for the diagnosis of sports-related injuries and can aid in decision making regarding treatment, while arthroscopy is a safe and effective technique for the treatment of many sports-related injuries in the foot and ankle. [114] (10.1016/j.csm.2013.03.007)
  • [L4] The technique of transverse CT scan of the syndesmosis can be useful in assessing the degree of malreduction of the ankle mortice and potential incongruency. [115] (10.1016/s0020-1383(97)00167-8)
  • [L3] This study underlines the additional diagnostic value of exorotated views instead of, or in addition to the standard lateral view in detecting an osseous impediment. [117] (10.1136/jisakos-2019-000272)

See Also

References

[1] Talar process fractures. EFORT Open Reviews. 2018. DOI: 10.1302/2058-5241.3.170040

[2] Pediatric Foot Fractures. Clinical Orthopaedics & Related Research. 2005. DOI: 10.1097/01.blo.0000156451.40395.fc

[3] Talus Fractures: An Update on Current Concepts in Surgical Management. Journal of the American Academy of Orthopaedic Surgeons. 2022. DOI: 10.5435/jaaos-d-20-01348

[4] Talus Fractures: Evaluation and Treatment. Journal of the American Academy of Orthopaedic Surgeons. 2001. DOI: 10.5435/00124635-200103000-00005

[5] High incidence of (osteo)chondral lesions in ankle fractures. Knee Surgery, Sports Traumatology, Arthroscopy. 2020. DOI: 10.1007/s00167-020-06187-y

[6] Talus Visualization in Ankle Fractures: How Much Are We Really Seeing?. Orthopaedic Journal of Sports Medicine. 2022. DOI: 10.1177/23259671211066856

[7] Osteochondral lesion of the talus: still a problem?. EFORT Open Reviews. 2022. DOI: 10.1530/eor-22-0024

[8] Isolated Displaced Fracture of the Posterior Facet of the Talus. The Journal of Bone & Joint Surgery. 1961. DOI: 10.2106/00004623-196143020-00016

[9] Talus Fractures: Evaluation and Treatment. Journal of the American Academy of Orthopaedic Surgeons. 2020. DOI: 10.5435/jaaos-d-20-00116

[10] The recognition and incidence of peroneal tendon dislocation associated with a fracture of the talus. The Bone & Joint Journal. 2017. DOI: 10.1302/0301-620x.99b4.bjj-2016-0641.r1

[11] Surgical treatment of transchondral talar-dome fractures (osteochondritis dissecans). Long-term follow-up.. The Journal of Bone & Joint Surgery. 1980. DOI: 10.2106/00004623-198062040-00020

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[13] Avascular necrosis of the talus after a minimally displaced neck of talus fracture in a 6-year-old child [Injury 31 (2000) 63–65]. Injury. 2004. DOI: 10.1016/j.injury.2004.02.016

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