1.To review incidence and mechanism of injury of lateral process fractures. 2. To understand why these fractures are commonly missed, and why missed fractures had a high morbidity. 3. To recognize subtle plain radiographic findings of lateral process fracture. 4. To facilitate optimal use of advanced imaging in diagnosis.
Lateral process of talus fractures are reportedly rare. However, the prevalence of patients presenting with late sequelae of missed fracture suggests a higher prevalence. Several large retrospective studies have reported a 40-50% rate of missed diagnosis. The fracture occurs with inversion and dorsiflexion injury. It represents 15% of ankle injuries sustained by snowboarders, and also occurs in skiers, climbers, jumpers, and with ground level falls on uneven ground. The lateral process of the talus is incompletely seen on AP and mortise views of the ankle, and diagnostic sensitivity depends on recognition of fracture on lateral radiograph. Diagnostic criteria which we have developed are discussed. Accuracy of criteria are shown with results of a prospective study of 30 lateral process fractures. CT scan findings will also be shown, as CT is essential for evaluation of degree of comminution and extent of articular involvement, and planning surgical management.
Crim, J,
Hale, W,
Fractures of the Lateral Process of the Talus: A Diagnostic Challenge. Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL.
http://archive.rsna.org/2004/4410262.html