Management of Avulsion Fracture of the Talus Over 1 Month

Diagnostic Evaluation

For patients with persistent ankle pain after trauma, especially with point tenderness over the talus, radiographic evaluation is indicated, according to the American College of Radiology 1, 2
Weight-bearing radiographs provide important information about fracture stability, as recommended by the American College of Radiology 2
Standard radiographic protocol should include anteroposterior, lateral, and mortise views, as suggested by the American College of Radiology 2
CT without IV contrast is recommended to determine extent, displacement, comminution, and intra-articular extension of avulsion fractures of the talus that are over 1 month old, according to the American College of Radiology 3, 4
MRI without IV contrast is particularly valuable for assessing associated bone marrow contusions 5 and associated soft-tissue abnormalities, as recommended by the American College of Radiology 5, 6

The Broden view may be useful for specific evaluation of lateral process fractures of the talus, as suggested by the American College of Radiology 4
Avulsion fractures may be overlooked on routine radiographs; special attention to areas of tenderness is recommended, according to the American College of Radiology 2
Untreated avulsion fractures can lead to functional limitations, as noted by the American College of Radiology 4