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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