Distal Talar Avulsion Fracture Consistent With Chopart Ligament Injury – Soccer

Authors

• Xavier Smith, University of Louisville HealthFollow
• Justin Chu, University of LouisvilleFollow
• Andreas Stamatis, University of LouisvilleFollow

Abstract

CASE HISTORY: A 12-year-old male soccer athlete sustained an acute left midfoot injury after a tackle from behind at practice, reporting an immediate “crack,” antalgic gait, and next-day inability to bear weight. PHYSICAL EXAM: Initial exam showed dorsal midfoot/talar bony tenderness, pain with ankle rotation, preserved toe motion, no Achilles tenderness, no malleolar tenderness, intact capillary refill, and no gross deformity. At orthopaedic follow-up, fading ecchymosis over the dorsal distal talus was present; neurovascular status remained intact. DIFFERENTIAL DIAGNOSES: Distal talar avulsion fracture/Chopart injury; talonavicular sprain; occult midfoot fracture; Lisfranc injury; ankle sprain. TESTS & RESULTS: Nonweightbearing AP/lateral/oblique radiographs of the left foot and ankle demonstrated an anterior superior/dorsal distal talus avulsion fracture consistent with Chopart ligament injury, with maintained tibiotalar and talonavicular alignment in a skeletally immature athlete. FINAL DIAGNOSIS: Left distal talus avulsion fracture consistent with Chopart ligament injury. DISCUSSION: This case highlights a soccer-related rotational midfoot injury pattern that can mimic a benign sprain despite inability to bear weight. Early radiographic recognition and protected immobilization are critical to avoid under-treatment, recurrent pain, or osseous/soft-tissue impingement. In this case, preserved joint congruity and favorable interval symptom improvement supported nonoperative management. OUTCOME OF THE CASE: Pain improved substantially after 2 weeks in a CAM boot, with successful weight bearing in immobilization and no indication for surgery. RETURN TO ACTIVITY AND FURTHER FOLLOW-UP: Continued CAM boot x2 additional weeks, followed by staged boot wean over 2 weeks, avoidance of impact/loading until asymptomatic, then gradual unrestricted return, including soccer, approximately 4 weeks later; repeat radiographs only if symptoms persisted beyond 4 weeks.

Recommended Citation

Smith, Xavier; Chu, Justin; and Stamatis, Andreas (2026) "Distal Talar Avulsion Fracture Consistent With Chopart Ligament Injury – Soccer," International Journal of Exercise Science: Conference Proceedings: Vol. 15: Iss. 8, Article 25.
Available at: https://digitalcommons.wku.edu/ijesab/vol15/iss8/25