Snowboarder's Talus Fractures Experimentally Produced by Eversion and Dorsiflexion

Abstract

Background: Fracture of the lateral process of the talus is an unusual injury that has received heightened attention in recent years because of its association with snowboarding. The diagnosis is often confused with that of lateral ankle sprain. If left untreated, it can cause long-term impairment, including osteoarthritis and subtalar joint degeneration. It is generally thought to result from dorsiflexion and inversion. However, few experimental studies have been conducted to investigate the injury mechanism. Hypothesis: Eversion of a dorsiflexed ankle is more likely to fracture the lateral process of the talus than inversion of a dorsiflexed ankle. Study Design: Controlled laboratory study. Methods: Ten cadaveric leg specimens were subjected to dynamic inversion or eversion of an axially loaded and dorsiflexed ankle. Results: Inversion failed to produce any fractures in three injured specimens. However, all six specimens subjected to eversion sustained a fracture of the lateral process of the talus. Conclusions: The incidence of fracture of the lateral process of the talus was significantly higher in the eversion group compared with the inversion group. Clinical Relevance: Eversion of an axially loaded and dorsiflexed ankle may be an important injury mechanism for fracture of the lateral process of the talus among snowboarders.