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This Article Full Text Full Text (PDF) All Versions of this Article: 33/6/871    most recent 0363546504271001v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (5) Citing Articles via Google Scholar Google Scholar Articles by Valderrabano, V. Articles by Hintermann, B. Search for Related Content PubMed PubMed Citation Articles by Valderrabano, V. Articles by Hintermann, B. Related Collections Fracture Skiing/snowboarding

Snowboarder’s Talus Fracture

Treatment Outcome of 20 Cases After 3.5 Years

Victor Valderrabano, MD^*,,, Thomas Perren, MD, Christian Ryf, MD, Paavo Rillmann, MD and Beat Hintermann, MD

From the Orthopaedic Traumatology Clinic, Hospital of Davos, Davos, Switzerland, and the Orthopaedic Department, University Hospital of Basel, Basel, Switzerland

^* Address correspondence to Victor Valderrabano, MD, Orthopaedic Traumatology Clinic, Hospital of Davos, 7270 Davos Platz, Switzerland (e-mail: v.valderrabano{at}bluewin.ch).

Background: Fracture of the lateral process of the talus is a typical snowboarding injury. Basic data are limited, particularly with respect to treatment and outcome.

Hypothesis: As the axial-loaded dorsiflexed foot becomes externally rotated and/or everted, fracture of the lateral process of the talus occurs. Primary surgical treatment may improve the outcome of this injury, reducing the risk of secondary subtalar joint osteoarthritis.

Study Design: Cohort study; Level of evidence, 2.

Methods: We recorded details of the treatment and evaluation of 20 patients (8 female and 12 male; age at trauma, 29 years [range, 17–48 years]) who sustained a lateral process of the talus fracture while snowboarding. The injury pathomechanism was documented. The patients were treated either nonsurgically or surgically based on a fracture-type treatment algorithm. The evaluation at most recent follow-up (mean, 42 months [range, 26–53 months]) included clinical and functional examination, follow-up of sport activity, and radiological assessment (radiograph, computed tomography scan).

Results: The injury mechanism included axial impact (100%), dorsiflexion (95%), external rotation (80%), and eversion (45%). Using the American Orthopaedic Foot and Ankle Society hindfoot score, the patients obtained a mean of 93 points; the surgically treated group (n = 14) scored higher (97 points) than did the nonoperative group (n = 6; 85 points) (P < .05). Degenerative disease of the subtalar joint was found in 3 patients (15%; operative, 1 patient; nonoperative, 2 patients). All but 4 (20%, all after nonsurgical treatment) patients reached the same sport activity level as before injury.

Conclusion: The snowboarding-related lateral process of the talus fracture represents a complex hindfoot injury. In type II fractures, primary surgical treatment has led to achieving better outcomes, reducing sequelae, and allowing patients to regain the same sports activity level as before injury.

Key Words: snowboarding • fracture • talus • lateral process of the talus (LPT) • sport injury

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