In briefOsteochondral fractures of the talar dome are often overlooked because the symptoms are similar to ankle sprains. The most common site of fracture is on either the superolateral or superomedial margin of the dome. Lateral lesions are caused by inversion and dorsiflexion of the ankle, while medial lesions result from inversion and plantar flexion. Careful inspection of x-ray films is the only way to diagnose an acute injury. Surgical treatment is usually required to avoid a long period of immobilization.