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 .


Comments

Popular posts from this blog

Outline of Treatment of Spinal Tuberculosis

COXA VARA

Paediatric Supracondylar Humerus Fracture

Timing and Outcome of Surgery in Hip Fractures

Hind Foot amputation

Management of Nerve Injuries