Lateral talar fracture


Description of patient (type of occupation, indication of age, intensity of sport):

25 year old man, fall from a great height, with knee dislocation and lateral talar fracture with loose body.

History and previous treatment:

Undergone a ligament reconstruction for the knee. The ankle is in a cast.

Current complaints:

Painful and stiff ankle joint.

Physical examination:

Painful and stiff ankle joint.


Non displaced lateral talar process.

Additional investigation (CT/MRI):
[Picture 1 - 5]
The lateral fragment is running from anterior to posterior. There is 2 loose bodies, the articular surface is not so displace (step less than 2mm). There is also a fracture on the medial side in front of the sustentaculum tali.


Case summary:

25 year old man with lateral talar fracture with loose body.

Question(s) to this case:

What treatment do you recommend?
-Conservative first, to let the fracture a chance to consolidate in this position and then if necessary AS for extraction of the loose bodies and evaluated the cartilage?
-ORIF or AS: The lateral fracture will be difficult to stabilize and fixe! combine anterior and posterior AS should be an option? If open do you suggest a fibular osteotomy?


Conservative is probably best option since the posterior fragments are difficult to reach and do not seem to be dislocated. There seems to be a good contact area between the fragments and the talus. No weight bearing for 6 weeks. Active ROM is allowed.