The following ankle x-rays are from a 62 year old male who was involved in a high speed MVA. His ankle is quite swollen. What can you see?
[peekaboo_link name=”Answer”]Answer[/peekaboo_link] [peekaboo_content name=”Answer”]
Here are the magnified views:
The AP view of the ankle shows a bony fragment with irregular edges medial to the talus.
The mortise view shows talar neck fracture. There is a cortical break involving the medial margin of the talar neck along with sclerosis, which indicates a degree of impaction.
The lateral view shows small fracture fragments posterior to the talus.
Here’s the ankle CT slice:
The Hawkin’s classification of talar neck fractures:
- Type I – non displaced fracture of talar neck without dislocation.
- Type II – displaced fracture of the talar neck with subluxation or dislocation of the subtalar joint.
- Type III – displaced fracture of the talar neck, with the dislocation of the body of the talus from the subtalar and ankle joints.
This patient has a type II injury.
Undisplaced talar neck fractures are easy to miss and the main complication of such a fracture is avascular necrosis.
Thanks to Dr. Rafal Francikiewicz for the images.[/peekaboo_content]