Talus Fractures in Snowboarders: A Case Series

Abstract

Fractures of the lateral process of the talus have been associated with snowboarding, so much so that they have earned the nickname “snowboarder’s ankle”; these typically occur with relatively low-energy injuries when compared with fractures of the talar head, neck, and body. We have observed that snowboarding portends a higher risk of talus fractures when compared with skiing and can include higher energy injury patterns. This study describes a series of talar head, neck, and body fractures caused by snowboarding, their treatment, and outcomes. A retrospective chart review was performed on all surgical cases collected from 2007 to 2012 to include talar head, neck, body, or lateral process fractures sustained while snowboarding. Radiographs were reviewed and the fractures were characterized. Questionnaires, including the Foot and Ankle Disability Index (FADI), were mailed to the patients. The pre-operative reports, surgical treatments, and outcomes were evaluated. Nine patients were identified with fractures of the talus caused by a snowboarding injury. One patient sustained an isolated talar head fracture, three sustained isolated talar neck fractures, one patient had an isolated talar body fracture, and two patients had isolated lateral process fractures. Two patients had a combination of talar injuries. At 2.5 years mean follow-up (range 6 months to 5 years), none of the patients developed avascular necrosis, nonunion/malunion, or required subsequent surgery. FADI scores indicated good to excellent results post-operatively.

History of the management of talar fractures: from the fall of king Darius to Garibaldi’s bullet and from the earliest to current operative strategies

“…It may be fractured by direct causes, especially by the action of gunshot bullets; but more frequently by indirect causes, as in a fall from height [5][6][7][8]. Unique types of talus fractures are the aviator fracture, described in World War I [9] and caused by a forced dorsiflexion of the foot in the impact with the rudder pedal, and the most recent snowboarder fracture, a lateral process talus fracture that occurs when a snowboarder lands after a jump with dorsiflexion of the ankle and inversion of the hindfoot [10,11].…”