Imaging Case of the Week 130

The following left ankle x-rays are from a 25 year old who sustained an ankle injury following a fall from a height. What eponymous fracture can be observed?


Left ankle AP

Left ankle mortise

Left ankle lateral

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The ankle x-ray shows a Snowboarder’s fracture which is a fracture of the lateral process of the talus. This injury is supposedly more common amongst snowboarders who sustain a combined inversion, dorsiflexion and axial-loading injury to the ankle whilst snowboarding.

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Commonly mistaken for an ankle sprain, this injury can cause long term complications of non-union and sub-talar arthritis.

Clinically, the patient will have point tenderness over the lateral process just anterior and inferior to the lateral malleolus.

In this particular patient, the fracture is visible both on AP and Mortise views. However, in most cases, the fracture is best observed on the mortise view. A CT is needed for further characterisation, that is, to assess the size, displacement of the fracture fragment and the involvement of the sub-talar joint.

All patients will need referral to the orthopaedic specialist. Our patient was managed conservatively with below knee cast immobilisation.