Abstract
1. Ten consecutive fractures of the dome of the talus are reported. Six were lateral, three medial and one anterior.
2. The injury is most commonly seen in the second and third decades of life, and with the exception of the rare anterior dome fracture, results from an inversion injury of the ankle. The possibility of a dome fracture associated with strain of the lateral ligament of the ankle joint should therefore always be borne in mind.
3. Antero-posterior views in neutral and in plantar fiexion are helpful in diagnosing medial dome fractures. Lateral fractures are best seen in an antero-posterior view taken in neutral flexion with 10 degrees inward rotation of the limb.
4. A large dome fracture with displacement should be accurately reduced by open operation in order to preserve congruity of the joint surface.
5. A small fracture with no displacement may be treated conservatively until radiographically it appears united.
6. A small fracture with marked displacement is best treated by early excision of the fragment to prevent further damage to the ankle joint.
