Management and classification of the fracture of lateral process of talus: An overview and literature update

Figure 1 Basic anatomy of the talus. A: Superior view; B: Front view; C: Inferior view; D: Lateral view. 1: Lateral process of the talus; 2: Lateral tubercle of posterior process of the talus; 3: Medial tubercle ot posterior process of the talus; 4: Articular surface with distal end of tibia; 5: Head of talus; 6: Neck of talus; 7: Articular surface with fibula (talofibular joint); 8: Tarsal sinus; 9: Posterior part of subtalar joint; 10: Sulcus tali.

Figure 2 Hawkins classification of the fracture of the lateral process of the talus. A: Hawkins type 1, simple fracture with involvement of both the talofibular and posterior subtalar articular surfaces; B: Hawkins type 2, comminuted fracture; C: Hawkins type 3, the so-called chip fracture, no articular surface injured.

Figure 3 McCrory-Bladin classification of the fracture of the lateral process of the talus. A: McCrory-Bladin type 1, chip fracture; B: McCrory-Bladin type 2A, undisplaced simple intraarticular fracture; C: McCrory-Bladin type 2B, displaced simple intraarticular fracture; D: McCrory-Bladin type 3, comminuted fracture with involvement of both the talofibular and posterior subtalar articular surfaces.

Figure 4 Boack's classification of the fracture of talar process. A: Boack's type 1a, extra-articular fracture of lateral process; B: Boack's type 1b, isolated fracture of the medial tubercle of the posterior talar process; C: Boack's type 1c, intra-articular fracture of the lateral process; D: Boack's type 2a, fracture of the lateral process of talus involving only the subtalar joint but not the talofibular joint; E: Boack's type 2b, fracture of the lateral tuberosity of the posterior talar process; F: Boack's type 3a, a simple fracture of the lateral talar process with involvement of both the talofibular and posterior subtalar articular surfaces; G: Boack's type 3b, comminuted fracture of the lateral talar process; H: Boack's type 3c, comminuted fracture of the posterior talar process with involvement of both lateral and medial tuberosity; I: Boack's type 4, comminuted fracture of the lateral talar process combined with luxation of the subtalar joint; J: Boack's type 4, comminuted fracture of the posterior talar process with luxation of the subtalar joint.

Figure 5 Tinner-Sommer's classification of the fracture of the lateral process of the talus. A: Tinner-Sommer type 1, chip fracture; B: Tinner-Sommer type 1, a posterolateral view; C: Tinner-Sommer type 2a, undisplaced simple intraarticular fracture; D: Tinner-Sommer type 2a, a posterolateral view; E: Tinner-Sommer type 2b, displaced simple intraarticular fracture; F: Tinner-Sommer type 2b, a posterolateral view; G: Tinner-Sommer type 3a, simple fracture of the lateral talar process combined with 1 medium-sized fragment originating from the posterior subtalar articular surface; H: Tinner-Sommer type 3a, a posterolateral view; I: Tinner-Sommer type 3b, comminuted fracture of the lateral talar process on the basis of type 3a; J: Tinner-Sommer type 3b, a posterolateral view; K: Tinner-Sommer type 3c, severely comminuted fracture without chance of full reconstruction; L: Tinner-Sommer type 3c, a posterolateral view.

Figure 6 Wijers's classification of the fracture of the lateral process of the talus. A: Wijers type 1A fracture of the lateral process of the talus (FLPT), extra-articular fracture with a small fragment; B: Wijers type 1B FLPT, intra-articular fracture with a small fragment; C: Wijers type 2 FLPT, intra-articular fracture with an intermediate fragment; D: Wijers type 3 FLPT, comminuted intra-articular fracture; E: Wijers type 4A, FLPT combined with a sustentaculum tali fracture of the calcaneus but without joint dislocation; F: Wijers type 4B, FLPT combined with subtalar or peritalar dislocation.

Figure 7 Zhang's classification of the fracture of the lateral process of the talus. A: Zhang's type 1a fracture of the lateral process of the talus (FLPT), chip fracture without involvement of the talofibular joint; B: Zhang's type 1b FLPT, simple fracture with involvement of both the talofibular and subtalar joints; C: Zhang's type 1c FLPT, comminuted fracture; D: Zhang's type 2a, FLPT combined with a fracture of talar head; E: Zhang's type 2b, FLPT combined with a fracture of talar neck; F: Zhang's type 2c, FLPT combined with a fracture of talar body; G: Zhang's type 2d, FLPT combined with a fracture of the posterior talar process; H: Zhang's type 2e, two or more fractures of other part of the ipsilateral talus besides FLPT.