Talus fractures

Question 1

Talar head fracture MOI

Answer 1

Longitudinal compression of the FF with the foot in PF

Question 2

Imaging for a Talar head fracture

Answer 2

CT Scan

Question 3

How to treat a non-displaced talar head fracture?

Answer 3

Casting and immobilization 6-8 weeks

Question 4

When to ORIF a talar head fracture?

Answer 4

If the fracture involves >1/3 talar head and/or displaced

Question 5

MOI of talar neck fractures

Answer 5

Hyperdorsiflexion of the foot on the tibia

Question 6

What is the classification for talar neck fractures?

Answer 6

Hawkins

Question 7

Describe Hawkins 1 and give tx

Answer 7

Non-displaced talar neck

Typically tx with NWB and below knee cast

Question 8

Describe Hawkins 2 and give tx

Answer 8

Displaced vertical talar neck fracture with STJ subluxation

Tx with ORIF

Question 9

Describe Hawkins 3 and give tx

Answer 9

Displaced vertical talar neck fracture with STJ and AJ dislocation

Tx with ORIF

Question 10

Describe Hawkins 4 and give tx

Answer 10

Displaced vertical talar neck fracture with subluxation of STJ, AJ, and TNJ

Question 11

What is a Hawkins sign?

Answer 11

Radiolucency of the talar dome typically seen 6 weeks to 3 months is a good indicator that there is no AVN

Question 12

Options for tx AVN before collapse?

Answer 12

Modified WB

PTB cast

Question 13

Options for tx AVN after the collapse

Answer 13

Observation

Blair fusion if symptomatic

Question 14

MOI for Talar body fractures

Answer 14

High energy axial compression with probably plantarflexion at impact

Question 15

What is the classification system for talar body fractures

Answer 15

Sneppen classifcation

Question 16

Sneppen Group 1

Answer 16

Transchondral or compression fracture of the talar dome

Question 17

Sneppen Group 2

Answer 17

Coronal, sagittal, or horizontal shear fracture involving the entire talar body

Question 18

Sneppen Group 3

Answer 18

Posterior tubercle fracture

Question 19

Sneppen Group 4

Answer 19

Lateral process fracture

Question 20

Sneppen Group 5

Answer 20

Crush/Comminuted fracture

Question 21

Treatment option for non-displaced talar body fracture

Answer 21

NWB 6-8 weeks in a cast/boot

Question 22

Treatment for displaced talar body fracture

Answer 22

ORIF and NW

Question 23

What is a Cedell fracture?

Answer 23

Sudden PF and pronation that rupture the PTT ligament and avulsion of the posterior-medial tubercle of the talus

Question 24

What is a Sheperds fracture?

Answer 24

Sudden PF with supination that causes PTF ligament avulsion fracture of the posterior-lateral tubercle

Question 25

MOI of lateral process fractures

Answer 25

Inversion with acute DF

Question 26

McCrory and Bladin is a classification for what fracture?

Answer 26

Lateral talar process fracture

Question 27

McCrory and Bladin type I

Answer 27

Chip fracture

Question 28

McCrory and Bladin type 2

Answer 28

Simple large fragment

Question 29

McCrory and Bladin type III

Answer 29

comminuted fracture

Question 30

Berndt and Hardy is a classification for what type of fracture?

Answer 30

Talar osteochondral defect

Question 31

B and H type I

Answer 31

Small area of sompression

Question 32

B and H type II

Answer 32

Partially detached

Question 33

B and H type III

Answer 33

Fully detached but remains in crater

Question 34

B and H IV

Answer 34

Fully detached and displaced

Question 35

MOI for a posterior medial and anterior lateral OCD

Answer 35

P/M - Inversion and PF

A/L - Inversion and DF

Question 36

What OCD stages require surgical treatment?

Answer 36

Stage 3 anterior/lateral

Stage 4

Question 37

Explain the difference in AVN incidence for the different types of Hawkins fractures

Answer 37

I - 0-13%
II - 20-50%
III - 83-100%
IV - >91%