[Fractures of the lateral process of the talus]

In approximately 1% of all ankle sprains a fracture of the lateral process of the talus can be found. This fracture is probably even more common than this suggests, as it is often missed. We recommend that CT examination be performed in the investigation of ankle sprains when swelling, hematoma, and pain are present, when there is no instability of the ankle ligaments, and when no conclusive findings are yielded by conventional X-ray. Various theories on the best therapy have been propounded in the literature. Our retrospective study involved six patients. In two cases the fracture was treated by surgical operation. The remaining four patients received conservative therapy. Both patients who were operated upon had dislocated fractures sustained shortly before. On follow-up they were found to be completely symptom free. One further patient, who underwent conservative treatment for a fresh undislocated fracture, was also found to be free of all symptoms at follow-up. The late radiological findings in these three patients were incontestable. The three remaining patients, whether they had undergone conservative our functional treatment, reported considerable problems at follow-up, i.e. starting pain and a decreased range of motion in the talo-calcanear joint.