The snowboarders' ankle - etiology, diagnostics, therapy

The ankle is at high risk for injuries in snowboarding. The fracture of the lateral processus of the talus, an extremely rare lesion before the spreading of snowboarding as a mass sport, represents 15% of all ankle injuries in general and 34% of all ankle fractures. The typical pattern of injury is a powerful dorsal extension of the ancle, combined with an inversion of the hindfoot and axial load. The diagnosis of this lesion is easily to miss, as it can be mixed up with a trivial ankle sprain. Many of the fractures are not visible on plain radiographs and consequently require MRI or computed tomography imaging to be diagnosed. Diagnosis of the fracture is paramount as dislocated fractures need to treated operatively to prevent the snowboarder from developing an early osteoarthritis of the talo-calcanear joint. The physician should be therefore very suspicious of anterolateral ankle pain in the snowboarder.