My achin’ feet: Talus fracture

Case presentation

A 14-year-old male is brought to the Emergency Department after being involved in a motor vehicle crash. The patient was a restrained front seat passenger in a vehicle that was struck by another car while stopped at a red light.

The patient did not lose consciousness and has no complaint of head pain, neck pain, back pain, or abdominal pain. He states he feels that his right foot “was twisted” and “slammed into the floorboard” of the car. He complains of pain to the dorsal aspect of the foot. He denies numbness.

His physical examination reveals normal vital signs and is generally unremarkable. He has swelling and pain on palpation of the dorsal-lateral aspect of his right foot. There is no obvious deformity. The joint appears to be stable. He has brisk capillary refill and both the dorsalis pedis and posterior tibial pulses are equal and strong.

Imaging considerations