Talar neck fracture - Hawkins type 3

Vertical fracture through the talar neck with posterior translation and anterior rotation of the talar dome fracture fragment, which effaces Kagers fat pad. There is associated dislocation of the talocrural and subtalar articulations.

Transverse fractures through the proximal shaft of the 1st metatarsal and the base of the 2nd metatarsal.

Comminuted markedly displaced fracture through the neck of the talus with complete disruption of the ankle articulation. The talar dome is situated posterior to the tibia, effacing Kager's fat pad.

Further displaced transverse fracture through the distal fibula, below the level of the syndesmosis - distal fragment located posterior to the talar dome fragment.

Oblique fracture through the proximal shaft of the 1st metatarsal and the base of the 2nd metatarsal. Injury to the Lisfranc joint cannot be excluded.

Impression

1. Comminuted displaced fracture through the neck of the right talus with complete disruption of the ankle articulation. Talar dome situated posterior to the distal tibia. Hawkins type 3 fracture.
2. Displaced transverse right distal fibula fracture.
3. Oblique fracture through the proximal shaft of the 1st metatarsal and the base of the 2nd metatarsal.

Overlying plaster backslab obscures bony fine detail. Comminuted fracture involving the talus with a large fracture fragment displaced posteriorly to the distal tibia.The position of the fracture fragments are similar to that seen on the earlier study.

X-ray taken through a plaster cast which obscures bony detail. Internal fixation of the fracture of the neck of the talus has been achieved by means of medial screw and a lateral curved plate and screws. Single screw internal fixation of the distal fibular fracture.