Fractures of the lateral process of the talus: a clinical review. "Snowboarder's ankle".

OBJECTIVE: This is a review article discussing the incidence, aetiology, investigation, and management of fractures of the lateral process of the talus, an uncommon but increasingly recognised complication of snowboarding.

DATA SOURCES: The data regarding aetiology, investigation, and management of these fractures were obtained through a comprehensive literature review utilising the Medline, Sport discus, Medline Orthopaedic, and Cinahl databases. Injury data were obtained through published prospective epidemiological studies of snowboarding injuries.

STUDY SELECTION: All studies of talar fractures, particularly of the lateral process, were included in the review. All prospective and retrospective studies of snowboarding injuries were reviewed.

DATA SYNTHESIS: The mechanism of this injury appears to be a combination of dorsiflexion and inversion of the ankle. The combination of soft-shell snowboarding boots and aerial maneuvers increase the likelihood of injury. Clinically these injuries resemble severe ligamentous ankle sprains and are commonly misdiagnosed. The fractures can be classified into three subtypes based on the severity of the bony injury. The management of each injury subtype differs and although no prospective treatment trials have been performed the published risk of long term degenerative subtalar joint damage warrant aggressive early management of this injury.

CONCLUSIONS: With the increasing popularity of snowboarding, the possibility of this injury should be considered in all ankle injuries related to this sport. Once diagnosed, management guidelines should be followed in order to minimise long term problems.