Talar Neck Fracture
https://litfl.com/hawkins-classification/
Hawkins's Classification
I - Talar Neck Fracture
II - Talar Neck Fracture with Subtalar Dislocation
III - Talar Neck Fracture with Subtalar and Tibiotalar Dislocation
IV - Talar Neck Fracture with Subtalar , Tibiotalar and Talonavicular Dislocation
What other information would you like to know ?
status of patients , high velocity injury
other injuries
open or closed fracture
NV status of foot
X-ray foot/ankle and CT scan if available
What is the standard treatment ?
Reduction and fixation with cannulated compression screws.
AM approach - for neck of talus
to openly reduce and fix fracture from anterior to posterior
What complications are anticipated ?
early - compartment syndrome of foot
nine compartments
decompress - two dorsal incisions - over 2nd and 4th
one medial
Mid long term complications of this fracture
Infection
Malunion
Non-union
AVN
Osteoarthritis
Risks of AVN in neck of talus fracture
25 %
look for increased density of talar body, subchondral collapse and talar dome fragmentation.
Hawkin's sign- presence of subchondral lucency seen radiographically around 2 months after fracture .
Blood supply of talus
via an anastomosis formed by 3 main vessels and their branches
1. Predominant supply - from posterior tibial via branch of tarsal canal
2. Head and Neck - supplied by dorsalis pedis
artery of sinus tarsi , a branch of peroneal artery .
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