International Journal of Education and Research in Health Sciences
(Official Publication of Sai Amrut Educational and Medical Research Foundation, Aurangabad)
 
Vol.1, Issue 3 (2018)


Fracture Neck of Talus: Intervene Early and Avoid Complications

Kunal A Shah



Abstract

Fracture talus is an uncommon fracture with incidence of less than 1% of all fractures. Here, I describe a case of closed talar neck fracture Hawkins type II with comminution in a 25-year-old male following a road traffic accident. Patient presented to the emergency 1 hour after injury. X-ray and computed tomography (CT) scan revealed talar neck fracture with subtalar joint dislocation. Patient was operated within 5 hours of trauma. The patient underwent open reduction and internal fixation with medial malleolus osteotomy with 4 mm partially threaded cannulated cancellous screws. In the postoperative period, the patient was given below-knee slab for 2 weeks. The patient was kept nonweight-bearing for 6 weeks followed by partial weightbearing for 6 weeks followed by full weight-bearing mobilization with gradual return to full activity. At 6 months follow-up, the patient had no complaints and functional range of motion of ankle and subtalar joint was maintained. On radiological examination, fracture had united with subchondral lucency (Hawkin’s sign) under talar dome, suggestive of intact vascularity. Fracture talar neck fixed within 6 hours can preserve vascularity and possibly avoid avascular necrosis (AVN). Complications like malunion and arthritis can be avoided by open reduction and internal fixation with acceptable anatomic reduction.


Keywords

Keywords: Avascular necrosis of talus, Talus fixation, Talus fracture


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International Journal of Education and Research in Health Sciences






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