Fracture of the Posterior Process of Talus with Pilon Fracture: A case report

Abstract

he posterior process of the talus has two tubercles, the medial and lateral, with the groove for the flexor hallucis longus tendon in between. The more prominent of these is the lateral tubercle. The posterior process is an intra articular component to the subtalar and ankle joints and any incongruity to the posterior process can lead to early degenerative arthritis of both joints.Fracture of the entire posterior process of the talus is a very rare injury with only 13 cases reported to date. Case ReportA 29 year-old male expatriate worker was brought to the accident and emergency with history of a heavy sheet falling on his both lower legs. The right ankle and lower leg was grossly swollen. There was mild swelling of the left ankle with tenderness over the lateral malleolus. He didn't have any co-morbid medical illness. He also had a puncture wound over the medial malleolus on the right. There was no distal neurovascular deficit.X-rays performed in the emergency department showed comminuted fracture of the right distal tibia extending to the tibial plafond and the medial malleolus, with suprasyndesmotic fracture of the fibula. (Figs. 1 A and B, and 2) In addition, he so had undisplaced fracture of the right os calcis, navicular and first metatarsal bone. X-rays of the left ankle showed an undisplaced fracture of the lateral malleolus.