Fracture of the lateral process of the talus associated with snowboarding

Snowboarding is one of the fastest-growing winter sports and is associated with a relatively high rate of ankle injuries. Presented is a patient who, after falling while snowboarding, complained of lateral ankle pain and was misdiagnosed with an ankle sprain. Further workup revealed a lateral process of the talus fracture, an injury that is rare outside of snowboarding. A lateral process of the talus fracture should be suspected when there is a history of inversion with dorsiflexion and there is tenderness over the lateral process of the talus. Results of plain films are negative up to 40% of the time, and therefore a computed tomographic scan is the imaging modality of choice. Treatment includes immobilization and not bearing weight for 4 to 6 weeks for nondisplaced fractures or open reduction and fixation for displaced fractures. Up to two thirds of patients with lateral process of the talus fractures report chronic pain. Early recognition may decrease this relatively high rate of morbidity. [Ann Emerg Med. 2003;41:854-858.]