Treatment for 15mm Bone Fragment Along the Medial Aspect of the Talus

Initial Evaluation

Initial assessment should include standard three-view ankle radiographs to evaluate the fracture fragment and overall ankle alignment, as recommended by the American College of Radiology 2, 3
CT scan is essential to determine the exact extent, displacement, comminution, and any intra-articular extension of the fragment, according to the American College of Radiology 1, 4
MRI may be beneficial to assess for associated soft tissue injuries, including ligamentous damage and cartilage abnormalities, as suggested by the American College of Radiology 5, 4

A 15mm bone fragment is considered large enough to warrant surgical fixation to restore joint congruity and prevent instability, as recommended by the American College of Radiology 1

Non-weight bearing for 6-8 weeks in a cast or fixed-ankle walker device is recommended, as suggested by the American Academy of Family Physicians 6, 7
Progressive weight bearing and physical therapy after adequate healing is confirmed radiographically, as recommended by the American Academy of Family Physicians 6

Weight-bearing radiographs during follow-up provide important information about stability, with a medial clear space of <4mm confirming stability, as recommended by the American College of Radiology 2

Inadequate fixation may result in fragment displacement and persistent instability, as warned by the American College of Radiology 1
Failure to recognize associated ligamentous injuries can compromise surgical outcomes, as noted by the American College of Radiology 5
Overly aggressive rehabilitation before adequate healing can lead to fixation failure, as cautioned by the American Academy of Family Physicians 6