We undertook a prospective study to determine the type and distributio
n of foot and ankle snowboarding injuries. Reports of 3213 snowboardin
g injuries were collected from 12 Colorado ski resorts between 1988 an
d 1995. Of these, 491 (15.3%) were ankle injuries and 58 (1.8%) were f
oot injuries. Ankle injuries included 216 (44%) fractures and 255 (52%
) sprains. Thirty-three (57%) of the foot injuries were fractures and
16 (28%) were sprains. The remaining injuries were soft tissue injurie
s, contusions, or abrasions. There was no significant correlation betw
een boot type (soft, hybrid, or hard) and overall foot or ankle injury
rate. There were significantly fewer ankle sprains in patients wearin
g hybrid boots and fewer fractures of the lateral process of the talus
in patients wearing soft boots. An unexpectedly high number of fractu
res of the lateral process of the talus were noted. These 74 fractures
represented 2.3% of all snowboarding injuries, 15% of all ankle injur
ies, and 34% of the ankle fractures. Many of these fractures are not v
isible on plain radiographs and require computed tomography imaging to
be diagnosed. Diagnosis of this fracture pattern is paramount; the ph
ysician should be very suspicious of anterolateral ankle pain in the s
nowboarder, where subtle fractures that may require surgical intervent
ion can be confused with anterior talofibular ligament sprains.