Northwestern University Feinberg School of Medicine

Orthopedic Teaching

Ankle Case 4 History/Physical Exam

Talar Avulsion Fracture

History and Physical Exam

The mechanism of talar avulsion fractures is similar to that of ankle sprains: an inverion force is applied to the foot when in either dorsiflexion or plantarflexion. Relatively low-energy mechanisms such as falls and sports injuries with significant twisting component may cause talar avulsion fractures, as a ligament pulls a small piece of bone away from its attachment site.

On physical exam, patients will complain of pain over the dorsum of the foot, usually worse with ambulation. They often have mild to moderate swelling with focal tendernes over the dorsal surface of the talar head. Patients typically have preserved ROM at the ankle but may experience pain with inversion and eversion.