Geriatric 'Snowboarder' fracture - Lateral talar process + fibula fracture
Score and Comment on this Case
Clinical Details
Clinical and radiological findings: A unique injury of a dorsiflexed 'brake foot' injury sustained by an 85yo F in a motor vehicle accident. Whilst the classical 'snowboarder' fracture is seen in the dorsiflexed foot under high axial load and external rotation, a similar load constellation may be experienced by a dorsiflexed foot on a brake pedal under heavy breaking prior to frontal collision where a peak axial impulse force occurs.
Preoperative Plan
Planning remarks: Initial consideration was given to simple cannulated screw fixation, however given the osteoporotic nature of the bone and the low pull-out strength of individual screws , this was considered insufficient. Instead we chose to anchor the LTP with a small 2.0mm locking plate, utilising divergent locked screws in the plate to prevent failure of fixation and loss of reduction under load.
Surgical Discussion
Patient positioning: Supine
Anatomical surgical approach: Single curved incision over the distal fibula curving anteriorly over the LTP and extending distally in line with the 4th MT Ray
Operative remarks:coming
Postoperative protocol: NWB/TWB 8W in an ankle Orthosis. ROM exercise out of the Orthosis allowed
Orthopaedic implants used: Stryker 2.0mm Minifragment plate (Talus) Synthes 3.5/2.7mm LCP distal locking fibula plate
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Dr Ed Oates
- Germany , Schleswig Holstein
- Area of Specialty - General Trauma
- Position - Specialist Consultant
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Article viewed 775 times
21 Apr 2023
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Full Citation
Cite this article:
Oates, E.J. (2023). Geriatric 'Snowboarder' fracture - Lateral talar process + fibula fracture. Journal of Orthopaedic Surgery and Traumatology. Case Report 20610898 Published Online Apr 21 2023.