Tae Jung Bang; Sun-Kyu Kim; Hyung-Jin Chung

doi:10.12671/jkfs.2016.29.3.213

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Fracture of the Talus: Tae Jung Bang, M.D., Sun-Kyu Kim, M.D., Hyung-Jin Chung, M.D.; Journal of the Korean Fracture Society 2016;29(3):213-220.
DOI: https://doi.org/10.12671/jkfs.2016.29.3.213
Published online: July 21, 2016

Department of Orthopedic Surgery, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.

Address reprint requests to: Hyung-Jin Chung, M.D. Department of Orthopedic Surgery, Inje University Sanggye Paik Hospital, 1342 Dongil-ro, Nowon-gu, Seoul 01757, Korea. Tel: 82-2-950-1399, Fax: 82-2-950-1398, orthoman@paik.ac.kr

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract
NOTES
REFERENCES

Abstract

Although talus fractures are uncommon, proper management is important because they are often associated with severe complications. Talar neck and body fractures occupy most of the talar fractures. It remains controversial whether talar neck fractures require emergent or elective treatment. Elective definitive fixation, however, may reduce risks of wound complications. Many surgeons recommend dual surgical approaches—anteromedial and anterolateral—to allow accurate visualization and anatomic reduction. Although there are various methods of fixation, the use of plates is necessary in comminuted talar fractures. Outcomes may vary and will be dependent on the degree of the initial fracture displacement. It is necessary to restore articular congruency and axial alignment for normalizing hindfoot function. Common complications include posttraumatic arthritis, avascular necrosis, malunion, and nonunion.
Key words: Talus, Neck, Body, Fracture, Complications

None.

REFERENCES

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Fig. 1

Hawkins classification of talar neck fractures.6)

Fig. 2

Classification of talar body fractures.11)

Fig. 3

(A, B) Preopertive radiographs show a comminuted talar neck and body fracture (A: anteroposterior view; B: lateral view). (C, D) Postoperative radiographs show a fixation using multiple screws and lateral plate with dual (anteromedial & anterolateral) surgical exposures and medial malleolar osteotomy (C: anteroposterior view; D: lateral view).

Fig. 4

(A, B) Preopertive radiographs show a comminuted talar neck fracture with subtalar joint subluxation (A: anteroposterior view; B: lateral view). (C, D) Postoperative radiographs show fixation using one anteroposterior screw, one posteroanterior screw, and one lateral plate with screws (C: anteroposterior view; D: lateral view).

Fig. 5

(A) Postoperative radiograph shows a subcondral sclerosis ten weeks after screw fixation of comminuted talar neck fracture. Hawkins sign is absent. (B, C) These T2-weighted magnetic resonance imaging scans were obtained ten weeks after a talar neck fracture and demonstrate focal osteonecrosis of talar body (B: coronal section; C: sagittal section).

Table 1

Hawkins Classification of Talar Neck Fractures6)

Type I: nondisplaced fracture without subluxation; risk of avascular necrosis 0% to 13%

Type II: displaced vertical talar neck fracture with subtalar joint; risk of avascular necrosis 20% to 50%

Type III: displaced vertical talar neck fracture with subluxation of the subtalar and tibiotalar joint; risk of avascular necrosis 75% to 100%

Type IV: displaced vertical talar neck fracture with subluxation of the subtalar, ankle, and talonavicular joint; risk of avascular necrosis 100%

Figure & Data

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Fracture of the Talus

J Korean Fract Soc. 2016;29(3):213-220. Published online July 31, 2016

DOI: https://doi.org/10.12671/jkfs.2016.29.3.213

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Fracture of the Talus

Fig. 1 Hawkins classification of talar neck fractures.6)

Fig. 2 Classification of talar body fractures.11)

Fig. 3 (A, B) Preopertive radiographs show a comminuted talar neck and body fracture (A: anteroposterior view; B: lateral view). (C, D) Postoperative radiographs show a fixation using multiple screws and lateral plate with dual (anteromedial & anterolateral) surgical exposures and medial malleolar osteotomy (C: anteroposterior view; D: lateral view).

Fig. 4 (A, B) Preopertive radiographs show a comminuted talar neck fracture with subtalar joint subluxation (A: anteroposterior view; B: lateral view). (C, D) Postoperative radiographs show fixation using one anteroposterior screw, one posteroanterior screw, and one lateral plate with screws (C: anteroposterior view; D: lateral view).

Fig. 5 (A) Postoperative radiograph shows a subcondral sclerosis ten weeks after screw fixation of comminuted talar neck fracture. Hawkins sign is absent. (B, C) These T2-weighted magnetic resonance imaging scans were obtained ten weeks after a talar neck fracture and demonstrate focal osteonecrosis of talar body (B: coronal section; C: sagittal section).

Fig. 1

Fig. 2

Fig. 3

Fig. 4

Fig. 5

Fracture of the Talus

Table 1

Hawkins Classification of Talar Neck Fractures6)

Type I: nondisplaced fracture without subluxation; risk of avascular necrosis 0% to 13%

Type II: displaced vertical talar neck fracture with subtalar joint; risk of avascular necrosis 20% to 50%

Type III: displaced vertical talar neck fracture with subluxation of the subtalar and tibiotalar joint; risk of avascular necrosis 75% to 100%

Type IV: displaced vertical talar neck fracture with subluxation of the subtalar, ankle, and talonavicular joint; risk of avascular necrosis 100%

Table 1 Hawkins Classification of Talar Neck Fractures6)