Snowboarding Injuries:Focus on Talus

The Physician and Sports Medicine

Volume 27, Number 4 (April 1999)

Andrea J. Boon, MD; Jay Smith, MD; Edward R. Laskowski, MD

Injuries in snowboarders differ from those of skiers. Snowboarders usually have fewer knee and thumb problems than skiers, but more upper-extremity injuries or trauma, general fractures, and ankle injuries. The most particular concern of injury in snowboarders is the fracture of the lateral proccess of the talus (LPT), which is often misdiagnosed as an inversion ankle sprain and often missed and can lead to significant disability. The signs are typically similar to inversion sprains , yet, pain during palpation of the lateral proccess can be very helpful in diagnosis. Regular radiographs often do not show the fracture, so a CT, or lateral tomography may be required. The leased harmed, nondisplaced LPT injuries may heal with casting and rehabilitation, but the most severe fractures will require surjury. Fractures of the talus carry a risk of avascular necrosis and nonunion. These fractures commonly involve the articular surface of the talus. In severe injuries, sometimes seen in snowboarding accidents, there may also be a chondral defect of the posterior calcaneal articular surface. It is unsure as to what the mechanism of an LPT fracture is. Many believe sudden and severe dorsiflexion with the hindfoot in inversion causes the fracture. This would occur after preforming an aerial meneuver. Examination shows swelling over and anterior to the lateral malleolus and pain with ankle dorsiflexion and plantar flexion and/or with subtalar inversion and eversion.

Abstract written by: Sarah Gurnard