Delayed presentation of a loose body in undisplaced paediatric talar neck fracture

Abstract

Fractures of the talus are rare in children. A high index of suspicion is needed to avoid missing such an injury, which is not an uncommon occurrence especially with undisplaced fractures. We present an unusual case of an undisplaced talar neck fracture in a five-year-old child leading to a delayed presentation of a symptomatic osteochondral loose body in the ankle joint. To our knowledge there are no reports in the literature of osteochondral loose bodies occurring in conjunction with an associated undisplaced talar neck fracture in either children or adults. The loose body was removed using anterior ankle arthroscopy. The child had an uneventful post operative recovery and regained full range of movement and function of his ankle joint and was discharged at one year follow-up. We aim to highlight the need to have a low threshold to further evaluate symptomatic children after fracture healing of an undisplaced talar neck fracture for a possible associated loose body in the ankle joint.

Talar Fractures in Children: A Possible Injury After Go-Karting Accidents

“…However, osteonecrosis is rare in children <12 years old, and the outcome might be independent of the method of treatment (6). In the case of a child who remains symptomatic after the initial treatment of a talar fracture, other rarer complications should be considered; for example, nonunion of the fracture (4) or a loose osteochondral body (12) or bone fragments (13) in the ankle. The former can be treated by delayed osteosynthesis and the latter by removal of the fragment using anterior ankle arthroscopy.…”