Unusual ankle fracture: A case report and literature review

Abstract

Fractures of the talus are uncommon, and talar body fractures in the sagittal plane are still rarer. The aim of its treatment is urgent anatomic reduction to restore congruency of the ankle and to reduce the risk of avascular necrosis by preserving any remaining blood supply. We report the case of a body talar fracture in sagittal plane associated with fracture of the medial malleolus in a young adult; the mechanism of the fracture was plantar hyperflexion, internal rotation and axial compression. We perform an open reduction and stabilization with two screws for the talus and screw the medial malleolus. At 14 months following the injury patient had good range of movement with little pain. The mechanism is discussed along with a literature review.

Keywords: Medial malleolus; Sagittal fracture; Screw; Talar body.

Fig. 1

(a) Anterior-posterior and (b) lateral radiographs at time of presentation.

Fig. 2

Per operative view through medial approach.

Fig. 3

Anterior-posterior and lateral radiographs post reduction.

Fig. 4

Hawkins sign: decreased subchondral bone density in the dome of talus.

Fig. 5

Lateral (a) and anterior-posterior (b) X-ray after removal of the screw fixation.