Medial malleolar and lateral talar dome fractures

Case contributed by Craig Hacking


Fall from 2 meters.

Patient Data

Age: 25 years
Gender: Male

Mildly displaced oblique fracture through the medial malleolus. Irregularity of the superior lateral corner of the left talar dome may represent a osteochondral defect. No intra-articular fracture fragment is identified. The talocrural joint and syndesmosis are anatomically aligned. Significant soft tissue edema surrounding the medial malleolus fracture.

A moderately displaced fracture through the base of the medial malleolus is confirmed with mild widening of the ankle mortise.

A fracture involves the lateral aspect of the talar dome extending into the lateral aspect of the talus, adjacent to the lateral malleolus. The fracture is mild comminuted with mildly depress in the lateral aspect and the largest fracture fragment measures up to 20mm. The region of mild depression of the weightbearing articular surface measures 6mm in width in the coronal plane and 8mm in width in the sagittal plane with 2mm depression.

The medial malleolar and lateral talar dome screws are well positioned with no evidence of orthopedic hardware complication. Fracture alignment is satisfactory.

Case Discussion

The talar dome is a check area for patients with malleolar fractures.

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