talar fracture

Question 1

what causes talar fractures?

Answer 1

usually after high energy trauma where the ankle is forced into dorsiflexion

Question 2

why is the talus at high risk of avascular necrosis post fracture?

Answer 2

talus is reliant on an extraosseous arterial supply, which is highly susceptible to interruption in the context of fractures.

Question 3

what are the clinical features of talar fractures?

Answer 3

• history of high impact trauma
• immediate pain
• swelling
• clear deformity if talus dislocated
• unable to dorsiflex or plantarflex
• check if skin is intact
• check distal NV status

Question 4

what investigations are done for talar fractures?

Answer 4

• plain film radiographs, AP and lateral

- CT if complex

Question 5

how are talar fractures classified?

Answer 5

type 1-4, classfied by the Hawkins classification system as to how dislocated they are

1 = undisplaced
4 = dislocated and so area neighbouring structures

Question 6

how are talar fractures managed?

Answer 6

depends on classification

undisplaced are managed conservitavely in non weight bearing orthosis,

displaced require immediate reduction in ED and then surgical repair

Question 7

what are the complications of talar fractures?

Answer 7

• avascular necrosis

- OA secondary to avascular necrosis or malunion