Lateral talar process fracture and peroneal tendon dislocation: a previously unrecognized injury complex

Area of Science:

• Orthopedic surgery
• Traumatology
• Sports medicine

Background:

• Lateral talar process fractures are often missed injuries.
• Hawkins classification categorizes these fractures into three types.
• Type II fractures involve comminution of talofibular and talocalcaneal surfaces.

Purpose of the Study:

• To describe an injury complex of Type II lateral talar process fracture with peroneal tendon dislocation.
• To analyze the characteristics and outcomes of this specific injury pattern.

Main Methods:

• Retrospective chart review of 13 patients with lateral talar process fractures (January 1995 - December 2006).
• Fracture classification, injury mechanism, radiographic studies, and treatment were reviewed.
• Concurrent peroneal tendon dislocations were identified.

Main Results:

• All 13 patients had Hawkins Type II lateral talar process fractures.
• Six patients (46%) presented with simultaneous peroneal tendon dislocation.
• Patients with the combined injury were more likely to require additional surgery and develop subtalar arthritis.
• Return to previous activity level was lower in the injury complex group (33%) compared to isolated fractures (71%).

Conclusions:

• A distinct injury complex of Hawkins Type II lateral talar process fractures and peroneal tendon dislocation exists.
• High-energy injuries causing comminuted lateral talar process fractures warrant evaluation for concurrent peroneal tendon dislocation.
• Early recognition and management are crucial for optimizing patient outcomes.