Talar fractures associated with ipsilateral femoral shaft fractures: report of three cases.

Talar fractures associated with ipsilateral femoral shaft fractures have been occasionally reported, but an unexpectedly high potential for simultaneous occurrence of the fractures in head-on collisions has not been well documented. We treated three patients with ipsilateral femoral shaft and talar fractures in a 2-year period starting in 2000. The patients were male, aged 25, 34 and 40 years, polytraumatized with other injuries. In all cases, the fractures occurred in the right lower extremities of drivers involved in head-on collisions. The talar fractures were not detected at the initial diagnosis. We considered that the feet had been dorsiflexed and exposed to an axial load from the front when the drivers pushed the brake pedals. This condition was considered to cause both fractures. Careful examination should be carried out to rule out talar fractures in swollen feet associated with femoral shaft fractures in head-on collisions.