Journal of Postgraduate Medicine
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CASE REPORT
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Year : 1995  |  Volume : 41  |  Issue : 2  |  Page : 54-5  

Fracture of the entire posterior process of the talus.

TR Jimulia, AN Parekh 
 Department of Orthopaedics, K E M Hospital, Parel, Mumbai.

Correspondence Address:
T R Jimulia
Department of Orthopaedics, K E M Hospital, Parel, Mumbai.

Abstract

A 25 year old, who had sustained a fracture of the entire posterior process of the talus, is presented. THe fracture was successfully managed conservatively.



How to cite this article:
Jimulia T R, Parekh A N. Fracture of the entire posterior process of the talus. J Postgrad Med 1995;41:54-5


How to cite this URL:
Jimulia T R, Parekh A N. Fracture of the entire posterior process of the talus. J Postgrad Med [serial online] 1995 [cited 2020 Nov 24 ];41:54-5
Available from: https://www.jpgmonline.com/text.asp?1995/41/2/54/494


Full Text




  ::   IntroductionTop


Fracture of the entire posterior process of the talus is a rare entity and only one case has been documented before. We report one more such case wherein good results were obtained with conservative treatment.


  ::   Case reportTop


A 25-year-old adult male reported to the hospital within 2 hours of an accidental fall from a height of about 8 feet having landed on his feet. His right foot suffered an inversioncompression injury Xrays revealed an isolated fracture of the entire posterior process of the talus. This was confirmed with the help of oblique views, which satisfied us that this was entirely an extraarticular fracture. [Figure:1] & [Figure:2]

The patient was treated conservatively in a plaster cast for 6 weeks and kept nonweight bearing. Serial Xrays through the plaster were taken to confirm that it had not displaced. The cast was removed at 6 weeks and the patient mobilised with crutch support for a further 4 weeks and allowed to mobilise free after that. [Figure:3] & [Figure:4]

At the end of 3 months postinjury, the patient was painfree and had full, painless movements at the ankle and sub-talar joints with a normal gait.


  ::   DiscussionTop


Two tubercles form the posterior process of talus, both of which are separated by a groove for the tendon of the Flexor Hallucis Longus. Fracture of the lateral tubercle of the posterior process of talus is known as Shepherd's fracture and often presents as an ankle sprain. Fracture of the medial tubercle is rare.

Fracture of the entire posterior process of the talus is extremely rare and only one case has been recorded by Robert R Foster in a personal communication to James D Heckman. The fracture was displaced and compromised the posterior tibial neurovascular bundle and therefore required open reduction and was fixed with two Kirschner wires[1].

The case that we saw was minimally displaced with no neurovascular compromise and the position in plaster was acceptable and thus did well on conservative treatment, as last seen at a oneyear follow-up.

References

1 Rockwood CA, Green DP. Fractures in Adults, 2nd Edition. JB Lipincott Company; 1984.
2Crenshaw AH. Campbell's Operative Orthopaedics, 8th Edition. Mosby Year Book; 1992.
3Wilson JN. WatsonJone Fractures & Joint Injuries, 6th Edition. Churchill Livingstone; 1982.

 
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