Talar body fracture
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Synopsis
Causes / typical injury mechanism: Fractures to the talar body are rare and are typically caused by high-energy trauma and axial compression, such as those that occur in a fall or motor vehicle accident. The body of the talus consists of a convex trochlear surface called the talar dome, as well as both medial and lateral processes. The inferior portion of the talar body articulates with the calcaneus. The talar dome articulates with the tibia to form the ankle joint. The medial process of the talar body is most likely to fracture following supination trauma, while lateral process fractures often result from pronation and external rotation.Classic history and presentation: Talar body fractures are commonly accompanied by a fracture in the ipsilateral foot or ankle. It is important to determine the extent of concomitant injuries before planning treatment.
Prevalence: Fractures of the talus constitute less than 1% of all fractures and 3%-6% of all fractures in the foot. The incidence of talar body fractures is reported with significant variability.
Pathophysiology: Approximately 60% of the surface of the talus is covered with cartilage, limiting the blood supply to the talar body. Poor vascular supply contributes to the high risk of osteonecrosis following talar body fractures. Risk for osteonecrosis is elevated in displaced fractures.
Grade / classification system: The Sneppen classification system has been used to describe talar body fractures.
- Sneppen A: Fractures to the talar dome resulting from high-impact trauma. These fractures are more likely to damage subchondral bone and cartilage.
- Sneppen B: Coronal shear fracture due to axial loading on the dorsiflexed foot.
- Sneppen C: Sagittal shear fracture due to axial loading on the dorsiflexed foot.
- Sneppen D: Posterior process fractures due to compression of the posterior process between the tibia and calcaneus.
- Sneppen E: Lateral process fractures, colloquially termed "snowboarder's fracture."
- Sneppen F: Crush injuries due to high-energy impact. Commonly, these are open fractures.
Codes
ICD10CM:S92.126A – Nondisplaced fracture of body of unspecified talus, initial encounter for closed fracture
S92.126B – Nondisplaced fracture of body of unspecified talus, initial encounter for open fracture
SNOMEDCT:
208686005 – Closed fracture talus, body
208698000 – Open fracture talus, body
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Talar neck fracture
- Ankle sprain
- Ankle fracture
- Calcaneus fracture
- Subtalar dislocation
- Os trigonum
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Last Reviewed:02/28/2023
Last Updated:04/03/2023
Last Updated:04/03/2023