TALAR BODY FRACTURES
Section snippets
OSTEOCHONDRAL FRACTURES OF THE TALAR DOME
The term osteochondral fracture suggests an acute mechanism of injury. Most osteochondral fractures of the dome of the talus occur in two distinct locations—anterolateral and posteromedial. Anterolateral injuries generally are associated with trauma; posteromedial lesions can occur with acute trauma, although they frequently are believed to be nontraumatic or due to cumulative trauma.3, 14
In a classic article, Berndt and Harty2 noted that 88% of patients with osteochondral lesions had a history
SHEAR FRACTURES OF THE TALAR BODY
Shear fractures of the body of the talus are subdivided into coronal, sagittal, and horizontal fractures. These fractures are uncommon and occur frequently in combination. A shear fracture to the body of the talus is defined as one that has its dorsal fracture line extending into the articular surface of the dome of the talus. A coronal fracture is essentially a more posterior location of a talar neck fracture. Most series describing these fractures are small, but it is accepted that the
FRACTURES OF THE POSTERIOR TUBEROSITY
Fractures of the posterior tuberosity of the talus usually involve the more prominent posterolateral tubercle, which provides an insertion for the posterior talofibular ligament. Its inferior surface is in continuity with the posterior facet of the talus. The os trigonum, an accessory bone, frequently is found in association with the posterolateral tubercle. It is believed to arise from a failure of fusion of a secondary center of ossification.
The posterior tuberosity can be fractured by two
FRACTURES OF THE LATERAL PROCESS OF THE TALUS
Fractures of the lateral process of the talus account for approximately one fourth of all fractures of the body of the talus.4 The fracture involves the lateral process of the talus and involves the talofibular articulation of the ankle joint and posterior facet of the subtalar joint. The lateral talocalcaneal, cervical, bifurcate, and anterior talofibular ligaments have attachments to this process. The usual mechanism of injury is acute dorsiflexion and inversion of the foot. The injury
COMMINUTED BODY FRACTURES
Comminuted body fractures have the worst prognosis of all talar body injuries. They generally are due to high-energy injuries and frequently are open injuries. Their treatment is the same as that for the shear-type fractures; however bone loss frequently is encountered during the operative reduction, leading to nonanatomic reduction and a high incidence of avascular necrosis of the various segments. These injuries are extremely rare. In the author's experience, the results are uniformly poor in
References (20)
- et al.
Step cut osteotomy of the medial malleolus for exposure of the medial ankle joints base
Foot Ankle Int
(1991) - et al.
Transchondral fractures (osteochondritis desiccans of the talus)
J Bone Joint Surg Am
(1959) - et al.
Osteochondral lesions of the talus
J Bone Joint Surg Am
(1980) Fractures and dislocations of the foot
- et al.
Arthroscopic treatment of osteochondral fractures of the talus: Long-term results
Trans Orthop Res Soc
(1990) - et al.
Osteochondritis desiccans of the talus: Review of the literature and new surgical approach for medial dome lesions
Foot Ankle Int
(1985) - et al.
Fractures and dislocations of the foot
- et al.
Treatment of osteochondritis desiccans of the talus: Use of the mosaicplasty technique—a preliminary report
Foot Ankle Int
(1997) - et al.
Osteochondral lesions of the talus: A revised classification
Foot Ankle Int
(1999) - et al.
Long-term follow up of talus fractures
Orthopaedics
(1996)
Cited by (72)
Fractures of the talus: where are we now?
2023, Orthopaedics and TraumaBiomechanical behavior of bone. Fractures in Charcot neuroarthropathy
2022, The Essentials of Charcot Neuroarthropathy: Biomechanics, Pathophysiology, and MRI FindingsThe lateral transligamentous approach to the talar dome
2021, Foot and Ankle SurgeryEarly stage and small medial osteochondral lesions of the talus in the presence of chronic lateral ankle instability: A retrospective study
2020, Journal of Orthopaedic ScienceTraumatic Injury to the Subtalar Joint
2018, Foot and Ankle Clinics
Address reprint requests to David B. Thordarson, MD, Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, 2025 Zonal Avenue, GNH 3900, Los Angeles, CA 90033, e-mail: [email protected]
- *
Divisions of Foot and Ankle Trauma and Reconstructive Surgery, Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California