Snowboarder's Ankle

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Original Editor - Puja Gaikwad

Top Contributors - Puja Gaikwad and Kim Jackson  

Introduction

In recent times snowboarding has increased in popularity dramatically, with this increase in popularity comes an increase in a distinct ankle injury which has been aptly termed ‘snowboarder’s ankle’. Snowboarding is a popular winter sport that includes riding a single board down a ski slope or on a half-pipe snow ramp. Snowboarder's Ankle is the common term for a fracture of the lateral process of the Talus (LPT), often overlooked initially and misdiagnosed as a severe ankle sprain. The term snowboarder’s ankle comes from this fracture being 15x more likely amongst snowboarding associated ankle injuries than any other ankle injuries. Ankles are involved in 12-17% of snowboarding-related injuries. A fracture to the lateral process of the talus in snowboarders can account for one-third of ankle fractures in this population. Various types of snowboard equipment, rider stance, and snowboarding activity tend to result in several types of injury. Soft boots give the snowboarder nearly twice the risk of ankle injury compared with hard boots. Sideways motion, soft (non-hard shell) boots, and being strapped to the board are all factors that influence the higher rate.

Anatomy

The talus is one of seven articulating foot bones that are situated between the tibia and fibula of the lower leg and the metatarsal bones of the midfoot. The talus constitutes the lower part of the ankle joint and articulates with the medial malleolus of the tibia and the lateral malleolus of the fibula. The ankle joint permits dorsiflexion and plantarflexion of the foot. The underneath aspect of the talus articulates with the calcaneus forming a subtalar joint. This joint enables inversion and eversion of the foot. The talus also articulates navicular bone allowing for subtle movements of the midfoot that play a vital role when walking on uneven ground. The lateral process of the talus is a wedge-shaped projection of the talar body. The top of the lateral process articulates with the fibula and makes a part of the lateral gutter of the ankle joint. The bottom of the lateral process forms the anterior part of the posterior subtalar joint. As the lateral process is involved in both the ankle and subtalar joints, it is significant in almost all foot movements.

Mechanism of Injury

The mechanism of injury is likely that the injured ankle was the leading foot at the time of the fall. Recent research indicates that forced ankle joint dorsiflexion, inversion, and external tibial rotation causes the LPT to shear away as it compresses against the calcaneus. It can occur during a landing from an aerial maneuver or a jump, especially when the landing has been over-rotated.