Published online Jul 18, 2014. doi: 10.5312/wjo.v5.i3.398
Revised: April 15, 2014
Accepted: June 10, 2014
Published online: July 18, 2014
Fractures of the talus are rare in children. A high index of suspicion is needed to avoid missing such an injury, which is not an uncommon occurrence especially with undisplaced fractures. We present an unusual case of an undisplaced talar neck fracture in a five-year-old child leading to a delayed presentation of a symptomatic osteochondral loose body in the ankle joint. To our knowledge there are no reports in the literature of osteochondral loose bodies occurring in conjunction with an associated undisplaced talar neck fracture in either children or adults. The loose body was removed using anterior ankle arthroscopy. The child had an uneventful post operative recovery and regained full range of movement and function of his ankle joint and was discharged at one year follow-up. We aim to highlight the need to have a low threshold to further evaluate symptomatic children after fracture healing of an undisplaced talar neck fracture for a possible associated loose body in the ankle joint.
Core tip: Undisplaced talar neck fractures in children rarely present with an associated osteochondral loose body. If a child remains symptomatic after fracture healing we would advocate further evaluation with magnetic resonance imaging (MRI) scan to exclude an associated loose body. If a loose body or an osteochondral lesion is identified on MRI scan it can be safely treated with anterior ankle arthroscopy.