In brief People who sprain their ankles brief may sustain osteochondral fractures of the talar dome. If unrecognized, these fractures can cause chronic pain and disability. The history and physical examination may be nonspecific, but a physician who has a high index of suspicion can identify these lesions with targeted imaging procedures. Identifying the stage of the lesion will suggest a conservative or surgical treatment approach. Prognosis for either option is generally good; however, osteoarthrosis may develop.