Combined ankle and talus fractures--a case report

A 50-year-old male patient sustained a supination-adduction type ankle fracture with an associated sagittal split fracture of the talus. The patient was treated initially in a short leg splint, and upon presentation to an orthopaedic surgeon, an external fixator was applied. After the soft tissue swelling improved enough to permit open reduction and internal fixation, the patient was brought back to the operating room for definitive treatment with removal of the external fixator and open reduction and placement of internal fixation. The patient's postoperative course was uncomplicated. At the 6-week follow-up visit, he was noted to have a radiographic Hawkin's sign in the dome of the talus. At 3 months postoperatively, he was weightbearing as tolerated with radiographic evidence of fracture healing, and his ankle range of motion was from 30° of plantar flexion to 15° of dorsiflexion. At 6 months postoperatively, the patient had no complaints and was ambulating in a regular shoe. His plantar flexion was 35° and his dorsiflexion was 15°. His subtalar motion was from 5° of eversion to 10° of inversion. He returned for his one-year follow-up doing well without complaints, and he had returned to his previous activities.