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.