Talar insufficiency fracture complicating ankle cheilectomy

Ankle cheilectomy as surgical treatment for anterior ankle impingement has high rates of procedural success and low rates of complications when performed before the onset of significant osteoarthritis. We present 3 patients who developed insufficiency fractures of the talar neck following cheilectomy for anterior ankle impingement. Due to the high risk of avascular necrosis associated with displaced talar neck fractures, the recognition of talar insufficiency fractures by the radiologist can aid in the timely diagnosis and initiation of intervention. Because radiographic findings of stress fractures often require weeks to manifest, maintaining a high index of suspicion in the postcheilectomy setting allows the radiologist to suggest appropriate further imaging when appropriate.