Fracture type	Mechanism of injury	Important physical examination findings*	Best plain radiograph†	Treatment
Talar dome (lateral)	Inversion with dorsiflexion	Tenderness anterior to the lateral malleolus, along the anterior border of the talus	Mortise view: shallow, wafer-shaped lesion	Stage I or II (see Table 3): NWBSLC for six weeks Stage III or IV (see Table 3), or persistent symptoms: surgical Treatment
Talar dome (medial)	Inversion with plantar flexion or atraumatic	Tenderness posterior to the medial malleolus, along the posterior border of the talus	AP view: deep, cup-shaped lesion; initial radiograph can be normal because changes in subchondral bone may not develop for weeks.	Stage I, II, or III (see Table 3): NWBSLC for six weeks Stage IV (see Table 3): surgical treatment
Lateral talar process	Rapid inversion with dorsiflexion	Point tenderness over the lateral process (anterior and inferior to the lateral malleolus)	Mortise view; lateral view may show subtalar effusion	Small fragment with <2 mm Displacement: NWBSLC for four to six weeks Large or displaced fragments: operative treatment
Posterior talar Process (lateral tubercle)	Hyperplantar flexion or forced inversion	Tenderness to deep palpation anterior to the Achilles tendon over posterolateral talus Plantar flexion may reproduce pain.	Lateral radiograph (an accessory ossicle, the os trigonum, may be present)	Minimally displaced fracture: NWBSLC for four to six weeks Large or displaced fragments or persistent symptoms: operative treatment
Posterior talar process (medial tubercle)	Dorsiflexion with pronation	Tenderness to deep palpation between the medial malleolus and the Achilles tendon	Difficult with standard views; an oblique ankle radiograph taken with the foot placed in 40 degrees of external rotation has been successful.	Similar to lateral tubercle Fractures
Anterior process of the calcaneus	Inversion with plantar flexion can lead to an avulsion fracture. Forced dorsiflexion compression fracture.	Point tenderness over the calcanealcuboid joint (approximately 1 cm inferior and 3 to 4 cm anterior to the lateral malleolus)	Lateral radiograph (an accessory ossicle, the calcaneus secondarium, may be present)	Small nondisplaced fracture: nonweight-bearing with compressive dressing or NWBSLC for four to six weeks Large or displaced fractures may require operative treatment.