Fracture of the Talus

Dr. W. H. Harris: A 12-year-old boy was admitted to the emergency ward of Massachusetts General Hospital 30 min. after he had fallen 5 flights of stairs from a fire escape, landing on his feet. His chief complaint was pain in the left ankle. He had not lost consciousness nor sustained any other injury. He had no prior history of injury to his extremities. General physical examination of the patient was within normal limits. There was no pain or tenderness in the spine. Examination of the left ankle showed marked swelling both medially and laterally. The skin was intact. There was marked tenderness over the talus when palpated from any position. The dorsalis pedis pulse could be palpated, but the posterior tibial pulse could not. Sensation and motor power in the foot were intact. Routine admission laboratory data were not remarkable. Roentgenograms were obtained (Fig. 1), and the patient was