Fracture of the lateral process of the talus: appearance at MR imaging and clinical significance

Sanders, Timothy G.; Ptaszek, Amy Jo; Morrison, William B.

doi:10.1007/s002560050508

Cited by 29 publications

(22 citation statements)

References 18 publications

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“…The most common locations for occult fractures are navicular, talus, and calcaneus. Although occult fractures in the talus may have variable appearances, they usually extend through the subtalar joint posteriorly to some degree [18,19].…”

Section: Occult Fracturesmentioning

confidence: 99%

MR imaging of the foot and ankle: patterns of bone marrow signal abnormalities

Weishaupt

Schweitzer

2001

Eur Radiol

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IntroductionMagnetic resonance imaging has demonstrated its usefulness in assessment of normal and abnormal bone marrow. Using MR imaging the continuous change of normal bone marrow composition throughout life and the varied responses of bone marrow to trauma or disease can be monitored [1].Magnetic resonance imaging characterization of location, morphology, distribution, and signal characteristics of a bone marrow abnormality enables diagnosis of a wide range of foot and ankle disorders with a high level of specificity. This pictorial review highlights applications of MR imaging of marrow disorders of the foot and ankle including traumatic and stress-related marrow changes, avascular necrosis, osteochondral defects, arthritic, and neuropathic arthropathies as well as osteomyelitis. Technical considerationsThe MR appearance of bone marrow is influenced by both composition (fat, water, minerals) and the specific imaging sequence used [1]; however, most of the MR imaging signal characteristics of marrow are dependent on the fat content [2,3]. A routine MR evaluation of bone marrow of the foot and ankle should include a T1-weighted spin-echo sequence and a fat-suppressed T2-weighted fast spin-echo or short tau inversion recovery (STIR) sequence. Since cellular infiltration within the fatty marrow may be less conspicuous or entirely obscured on T2-weighted fast spin-echo sequences, use of some form of fat suppression is mandatory on T2-weighted fast spin-echo MR images [4,5]. The most widely used form of fat suppression is frequency-selective presaturation. With this method, however, local field inhomogeneities that arise in areas of significantly varying morphology (e.g., ankle) often result in an uneven fat suppression. The inhomogeneous fat suppres- Eur. Radiol. (2002)

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Section: Occult Fracturesmentioning

confidence: 99%

MR imaging of the foot and ankle: patterns of bone marrow signal abnormalities

Weishaupt

Schweitzer

2001

Eur Radiol

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“…Nevertheless, once a diagnosis is suspected on the basis of sonography, computed tomography or MRI must always be performed for further evaluation of displacement and fragmentation, which influence the choice between medical and surgical treatment. 7,8 In conclusion, because of the rise in popularity of snowboarding, LPT fractures have become frequent traumatic lesions. Patients with fractures of the LPT usually have symptoms that are difficult to distinguish from those of more common lateral ankle sprains.…”

Section: Discussionmentioning

confidence: 99%

Sonographic Diagnosis of Talar Lateral Process Fracture

Copercini

Bonvin

Martinoli

et al. 2003

J of Ultrasound Medicine

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he frequency of fractures of the lateral process of the talus (LPT) has markedly increased because of the expansion of snowboard activity. These lesions are difficult to diagnose, because they have aspecific signs, and standard radiographs do not show the fractures in 50% of cases. Sonography is used more and more in the assessment of ankle trauma, but it is rarely performed for detection of bone fractures. We report a case of a patient in which sonography directly showed an LPT fracture. Case ReportA 32-year-old man was admitted to the Emergency Department for acute right ankle pain that occurred the day before during snowboarding. He had forceful movement of eversion and external rotation of the ankle during a jump landing, followed by inability to bear weight and painful ankle swelling. Clinically, moderate swelling over the lateral malleolar and exquisite inframalleolar local tenderness were evident. Passive inversion and dorsal flexion of the foot were painful. Tests for instability of the ankle joint, including the anterior drawer test, were questionable because of severe pain and reflex muscle activation. Previous routine radiographic findings (anteroposterior [AP] and lateral views) were reported as negative.Because of pain at the external aspect of the ankle, sonography was performed to assess para-articular soft tissues and ligaments. Sonography was performed with commercially available equipment (HDI 5000; Philips Medical Systems, Bothell, WA) working with linear array transducers (frequency band, 5-12 MHz) and no standoff pad. Longitudinal and axial images obtained over the anterior talofibular and calcaneofibular ligaments showed normal aspects of both ligaments and no signs of tears (Fig. 1). A longitudinal image obtained over the

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“…The preservation of the talus after copious lavage is indicated even in the rare case of total talar dislocation, "Luxatio tali totalis." Any soft-tissue insertions to the talus should be carefully preserved as they may serve as blood supply for revascularization [ 62 ].…”

Section: Talar Neck and Body Fracturesmentioning

confidence: 99%

Foot and Ankle Injuries

Rein

Tan

Rammelt

et al. 2014

Bone and Joint Injuries

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Man's foot is all his own. It is unlike any other foot. It is the most distinctly human part of the whole of his anatomical make-up.Wood Jones (1944) [ 1 ]The goal of this chapter is to further the understanding of pathomechanisms, performing diagnostics and reconstructing of injured feet, and to demonstrate ways to treat malunions and nonunions. Regaining anatomic joints if possible and rebuilding the normal shape of the foot, even by fusion of joints, is a safe way to avoid pain and to restore function. Anatomy of the FootThe human foot contains 28 bones and is divided into three parts: the forefoot, the midfoot, and the hindfoot ( Fig. 28.1 ) [ 3 , 4 ]. ForefootThe forefoot contains the fi ve metatarsals and toes with two sesamoids under the fi rst metatarsal head and an inconstant sesamoid beneath the fi rst interphalangeal joint. Six weight-bearing surfaces are located at the metatarsophalangeal level (two sesamoids and four lesser metatarsal heads) and fi ve weight-bearing surfaces are located under the distal phalanges in a normal foot.The metatarsals are short tubular bones with a base, shaft, neck, and head. The heads of the metatarsals are strongly connected by the intermetatarsal ligaments. The fi fth metatarsal has a tuberosity at its base, where the plantar aponeurosis, the peroneus brevis, and the peroneus tertius tendon insert.The fi rst toe has two phalanges and the other four toes have three phalanges. The fi rst metatarsal is slightly shorter, broader, and more mobile than the three middle metatarsals, and normally bears as much as one-third to one-half of the body weight through the forefoot and plays a key role in the gait cycle. The metatarsophalangeal joints are ellipsoidal joints, but only the fi rst and fi fth rays allow fl exion/extension and ab-/adduction. The joint capsules are strengthened by collateral ligaments on either side.The two sesamoids at the fi rst metatarsophalangeal joint are well embedded in the capsuloligamentous complex; the medial (tibial) sesamoid is larger than the lateral (fi bular) sesamoid, corresponding to its more important role in weight bearing within the medial sulcus of the metatarsal head.The sesamoids are held together by the strong intersesamoid ligament and the plantar plate, which is fi rmly attached at the base of the proximal phalanx and loosely attached at the neck of the metatarsal via the capsule. The sesamoids are located within the two slips of the fl exor hallucis brevis tendon. The abductor hallucis tendon inserts at the medial sesamoid, the adductor hallucis tendon at the fi bular sesamoid.

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Fracture of the lateral process of the talus: appearance at MR imaging and clinical significance

Cited by 29 publications

References 18 publications

MR imaging of the foot and ankle: patterns of bone marrow signal abnormalities

MR imaging of the foot and ankle: patterns of bone marrow signal abnormalities

Sonographic Diagnosis of Talar Lateral Process Fracture

Foot and Ankle Injuries

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