Processus posterior tali Fraktur

Symptomatic
non-united fracture of the entire posterior process of the talus. Schematic diagram of pathologies involving the lateral tubercle of the posterior talar process (FHL marked by the orange circle).
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Symptomatic
non-united fracture of the entire posterior process of the talus. PD-W non fat suppressed axial, sagittal and coronal MR of the ankle show the nonunited fracture of the entire posterior talar process (red arrows). Remote navicular fracture and collapse also shown by the yellow arrows.
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Combined
anterior and posterior ankle impingement syndrome with nonunion of Cedell fracture in a 58-year-old female: a case report. The radiographs of right ankle. a Anteroposterior weight-bearing view showing abundant osteophytes below the medial malleolus (arrowhead).b Lateral weight-bearing view showing osteophytes on the dorsal talar neck (white short arrow), anterior tibial plafond (white short arrow), posterior talar process (black short arrow), and the PMTT fracture fragment (star) with preservation of the tibiotalar joint space. c, Valgus stress view showing a talar tilt of 13° angle
bmcmusculoskeletdisord.biomedcentral.com • CC-by-4.0
Combined
anterior and posterior ankle impingement syndrome with nonunion of Cedell fracture in a 58-year-old female: a case report. CT scans. a coronal view showing a nondisplaced, nonunited PMTT fracture fragment (star) and an interface between the fracture fragment and the parent talus (long arrow). b sagittal view showing the anterior and posterior osteophytes of impingement (white and black short arrow). c axial view showing the larger posterolateral tubercle osteophyte (black short arrow), the nonunited PMTT fragment (star) and the interface (long arrow)
bmcmusculoskeletdisord.biomedcentral.com • CC-by-4.0
Combined
anterior and posterior ankle impingement syndrome with nonunion of Cedell fracture in a 58-year-old female: a case report. MRI sagittal PDWI showing the anterior, posterior ankle joint effusion (long arrow) and the “Kissing contusions (sun)” on the posterior aspect of the posterior subtalar articulation
bmcmusculoskeletdisord.biomedcentral.com • CC-by-4.0
Stress
fracture of the posterior talar process in a female long-distance runner treated by osteosynthesis with screw fixation via two-portal hindfoot endoscopy: a case report. Preoperative non-contrast CT scan. a Sagittal and (b) axial views showing the fracture line located just lateral to the groove for flexor hallucis longus (FHL) tendon at a level just proximal to the subtalar joint. Posterior process of the talus comprising the medial (dotted arrow) and lateral (arrow) tubercles, separated by the groove for the FHL tendon. CT, computed tomography
bmcmusculoskeletdisord.biomedcentral.com • CC-by-4.0
Posterior
talar process fracture • Posteromedial tubercle fracture of the talus - Ganzer Fall bei Radiopaedia
Murphy, A. Posteromedial tubercle fracture of the talus. Case study, Radiopaedia.org. (accessed on 24 Oct 2022) https://doi.org/10.53347/rID-45881 • CC by-nc-sa 3.0 (modified)
Posterior
talar process fracture • Complex regional pain syndrome following Cedell fracture - Ganzer Fall bei Radiopaedia
Ling, Y. Complex regional pain syndrome following Cedell fracture. Case study, Radiopaedia.org. (accessed on 24 Oct 2022) https://doi.org/10.53347/rID-69567 • CC by-nc-sa 3.0 (modified)
Lateral talar
process fracture • Talar lateral and posterior process fractures - Ganzer Fall bei Radiopaedia
Hacking, C. Talar lateral and posterior process fractures. Case study, Radiopaedia.org. (accessed on 24 Oct 2022) https://doi.org/10.53347/rID-77140 • CC by-nc-sa 3.0 (modified)
Radiopaedia • CC-by-nc-sa 3.0 • de

Posterior talar process fractures may involve the medial or lateral tubercle of the posterior process of the talus. The posterior talofibular ligament attaches to the lateral tubercle and flexor hallucis longus runs between these two tubercles. The unfused ossification center of the lateral tubercle forms the os trigonum.

Terminology

A Shepherd fracture refers to a fracture of the lateral tubercle of the posterior process. An elongated lateral tubercle of the posterior process of the talus is referred to as a Stieda process, so occasionally these fractures are described as Stieda process fractures.

A Cedell fracture is a fracture of the medial tubercle of the posterior process.

Fractures of the entire posterior process of the talus are extremely rare

Pathology

Mechanism of injury
  • injury to lateral tubercle is caused by inversion or extreme equinus
  • injury to medial tubercle is uncommon and is caused by forced dorsiflexion and pronation

Radiographic features

Plain radiograph

Lateral process fractures are best visualized on lateral projections. The os trigonum may be mistakenly identified as a fracture on plain radiograph.

CT

Best imaging modality for identifying posterior process fractures. CT is indicated when clinical suspicion is high but radiographs are negative.

Treatment and prognosis

Short leg cast or ankle brace is used until signs of union appear. If there is non-union, then excision of the fragment is undertaken.

Siehe auch:
Assoziationen und Differentialdiagnosen zu Processus posterior tali Fraktur:
Os trigonum
 
Wikipedia • CC0
Talusfraktur
 
Wikipedia • CC BY-SA 3.0
Processus
Stieda
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