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