Talar Neck Fracture

Case contributed by Dr Abimbola Sojimi

Presentation

Involved in a road traffic accident. Pain and inability to use left foot afterward.

Patient Data

Age: 40 years
Gender: Female
X-ray

Talar fracture

There is a displaced vertical fracture of the neck of the left talus with dislocation of the tibiotalar and talocalcaneal joints. The talonavicular joint maintains a normal articulation. Small osseous fragments are also noted posterior to the talus.

The tibia, fibula and other tarsal bones appear normal.

There is posteromedial extrusion of the talar body.

Soft tissue swelling of the left ankle noted. No breach of the soft tissue outline noted.

 

CONCLUSION

Hawkins-Canale type III fracture of the neck of the left talus.

Posterior process fracture of the left talus.

Case Discussion

All three of the major sources of blood supply to the talus are commonly injured with type III talar neck fractures.

risk of avascular necrosis (AVN) increases with increasing classification type

  • type I fractures have 0%–15% risk
  • type II fractures have 20%–50% risk
  • type III fractures approach 100% risk
  • type IV fractures have 100% risk
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Case information

rID: 87089
Published: 23rd Feb 2021
Last edited: 23rd Feb 2021
Inclusion in quiz mode: Included
Institution: University College Hospital Ibadan

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