Talus fractures Flashcards
Talar head fracture MOI
Longitudinal compression of the FF with the foot in PF
Imaging for a Talar head fracture
CT Scan
How to treat a non-displaced talar head fracture?
Casting and immobilization 6-8 weeks
When to ORIF a talar head fracture?
If the fracture involves >1/3 talar head and/or displaced
MOI of talar neck fractures
Hyperdorsiflexion of the foot on the tibia
What is the classification for talar neck fractures?
Hawkins
Describe Hawkins 1 and give tx
Non-displaced talar neck
Typically tx with NWB and below knee cast
Describe Hawkins 2 and give tx
Displaced vertical talar neck fracture with STJ subluxation
Tx with ORIF
Describe Hawkins 3 and give tx
Displaced vertical talar neck fracture with STJ and AJ dislocation
Tx with ORIF
Describe Hawkins 4 and give tx
Displaced vertical talar neck fracture with subluxation of STJ, AJ, and TNJ
What is a Hawkins sign?
Radiolucency of the talar dome typically seen 6 weeks to 3 months is a good indicator that there is no AVN
Options for tx AVN before collapse?
Modified WB
PTB cast
Options for tx AVN after the collapse
Observation
Blair fusion if symptomatic
MOI for Talar body fractures
High energy axial compression with probably plantarflexion at impact
What is the classification system for talar body fractures
Sneppen classifcation
Sneppen Group 1
Transchondral or compression fracture of the talar dome
Sneppen Group 2
Coronal, sagittal, or horizontal shear fracture involving the entire talar body
Sneppen Group 3
Posterior tubercle fracture
Sneppen Group 4
Lateral process fracture
Sneppen Group 5
Crush/Comminuted fracture
Treatment option for non-displaced talar body fracture
NWB 6-8 weeks in a cast/boot
Treatment for displaced talar body fracture
ORIF and NW
What is a Cedell fracture?
Sudden PF and pronation that rupture the PTT ligament and avulsion of the posterior-medial tubercle of the talus
What is a Sheperds fracture?
Sudden PF with supination that causes PTF ligament avulsion fracture of the posterior-lateral tubercle
MOI of lateral process fractures
Inversion with acute DF
McCrory and Bladin is a classification for what fracture?
Lateral talar process fracture
McCrory and Bladin type I
Chip fracture
McCrory and Bladin type 2
Simple large fragment
McCrory and Bladin type III
comminuted fracture
Berndt and Hardy is a classification for what type of fracture?
Talar osteochondral defect
B and H type I
Small area of sompression
B and H type II
Partially detached
B and H type III
Fully detached but remains in crater
B and H IV
Fully detached and displaced
MOI for a posterior medial and anterior lateral OCD
P/M - Inversion and PF
A/L - Inversion and DF
What OCD stages require surgical treatment?
Stage 3 anterior/lateral
Stage 4
Explain the difference in AVN incidence for the different types of Hawkins fractures
I - 0-13%
II - 20-50%
III - 83-100%
IV - >91%
