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Current Concepts in Talar Neck Fracture Management

  • Foot and Ankle Trauma (G Moloney, section editor)
  • Published:
Current Reviews in Musculoskeletal Medicine Aims and scope Submit manuscript

Abstract

Purpose of the review

Talar neck fractures are a rare but potentially devastating injury, which require a comprehensive understanding of the unique osteology, vasculature, and surrounding anatomy to recognize pathology and treat correctly. The purpose of this article is to describe both classic and current literature to better understand the evolution of talar neck fracture management.

Recent findings

Urgent reduction of displaced fractures and dislocations remains the standard of care to protect the soft tissue envelope and neurovascular structures. Delayed definitive fixation has proven to be safe. CT is the imaging modality of choice to fully identify the fracture pattern and associated injuries. Anatomic reduction and restoration of the peritalar articular surfaces are the pillars of talar neck fracture treatment. Dual incision approach with plate and screw fixation has become the modern surgical strategy of choice to accomplish these goals. Although complications such as osteonecrosis (ON) and posttraumatic arthritis (PTA) can still occur at high rates, treatment should be dictated by patient symptoms.

Summary

Talar neck fractures pose treatment challenges with both initial injury and potential sequelae. Future research will determine whether modern treatment algorithms will decrease complication rate and improve patient outcome.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major Importance

  1. Santavirta S, Seitsalo S, Kiliuoto O, Myllynen P. Fracture of the talus. J Trauma. 1984;24(11):986–9.

    Article  PubMed  CAS  Google Scholar 

  2. Hawkins L. Fractures of the neck of the talus. J Bone Joint Surg Am. 1970;52(5):991–1002.

    Article  PubMed  CAS  Google Scholar 

  3. Kenwright J, Taylor RG. Major injuries of the talus. J Bone Joint Surg Br. 1970;52(1):36–48. Available from: http://www.ncbi.nlm.nih.gov/pubmed/5436204

    Article  PubMed  CAS  Google Scholar 

  4. Lorentzen JE, Christensen SB, Krogsøe O, Sneppen O. Fractures of the neck of the talus. Acta Orthop Scand. 1977;48(1):115–20. Available from: http://www.tandfonline.com/doi/full/10.3109/17453677708985121

    Article  PubMed  CAS  Google Scholar 

  5. Canale ST, Kelly FB. Fractures of the neck of the talus. Long-term evaluation of seventy-one cases. J Bone Joint Surg Am. 1978;60(2):143–56. Available from: http://www.ncbi.nlm.nih.gov/pubmed/417084

    Article  PubMed  CAS  Google Scholar 

  6. Vallier HA, Nork SE, Barei DP, Benirschke SK, Sangeorzan BJ. Talar neck fractures: results and outcomes. J Bone Joint Surg Am. 2004;86–A(8):1616–24. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15292407

    Article  PubMed  Google Scholar 

  7. Ebraheim NA, Patil V, Owens C, Kandimalla Y. Clinical outcome of fractures of the talar body. Int Orthop. 2008;32(6):773–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17583811

    Article  PubMed  Google Scholar 

  8. Gomes de Sousa RJ, Teixeira de Oliveira Massada MM, Gonçalves Pereira MANP, Gonçalves Costa IM, da Costa e Castro JFS. Long-term results of body and neck talus fractures. Rev Bras Ortop. 2009;44(5):432–6. Available from: http://linkinghub.elsevier.com/retrieve/pii/S2255497115302755

    Article  PubMed  Google Scholar 

  9. Fournier A, Barba N, Steiger V, Lourdais A, Frin J-M, Williams T, et al. Total talar fracture - long-term results of internal fixation of talar fractures. A multicentric study of 114 cases. Orthop Traumatol Surg Res. 2012;98(4 Suppl):S48–55. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22621831

    Article  PubMed  CAS  Google Scholar 

  10. Junge T, Bellamy J, Dowd T, Osborn P. Outcomes of talus fractures associated with high-energy combat trauma. Foot Ankle Int. 2017;38(12):1357–61.

    Article  PubMed  Google Scholar 

  11. Halvorson JJ, Winter SB, Teasdall RD, Scott AT. Talar neck fractures: a systematic review of the literature. J Foot Ankle Surg. 2013;52(1):56–61. Only one of 3 systematic reviews on talar neck fractures published within the last 5 years.

    Article  PubMed  Google Scholar 

  12. Dodd A, Lefaivre KA. Outcomes of talar neck fractures: a systematic review and meta-analysis. J Orthop Trauma. 2015;29(5):210–5. Only one of 3 systematic reviews on talar neck fractures published within the last 5 years—separates literature based on treatment paradigm shift that occurred in 2000s.

    Article  PubMed  Google Scholar 

  13. Vallier HA. Fractures of the talus: State of the art. J Orthop Trauma. 2015;29(9):385–92. One of 3 review papers within the last 3 years which discusses classic and modern literature.

    Article  PubMed  Google Scholar 

  14. Buza JA, Leucht P. Fractures of the talus: current concepts and new developments. Foot Ankle Surg. 2017. Available from: http://www.ncbi.nlm.nih.gov/pubmed/29409210. One of 3 review papers within the last 3 years which discusses classic and modern literature.

  15. Maher MH, Chauhan A, Altman GT, Westrick ER. The acute management and associated complications of major injuries of the talus. JBJS Rev. 2017;5(7):1–11. One of 3 review papers within the last 3 years which discusses classic and modern literature.

    Article  Google Scholar 

  16. Jordan RK, Bafna KR, Liu J, Ebraheim NA. Complications of talar neck fractures by Hawkins classification: a systematic review. J Foot Ankle Surg. 2017;56(4):817–21. Only one of 3 systematic reviews on talar neck fractures published within the last 5 years. Only systematic review to focus on the outcomes of talus fractures treated with open reduction and internal fixation stratified by the Hawkins classification.

    Article  PubMed  Google Scholar 

  17. Shakked RJ, Tejwani NC. Surgical treatment of talus fractures. Orthop Clin North Am. 2013;44(4):521–8.

    Article  PubMed  Google Scholar 

  18. Fortin PT, Balazsy JE. Talus fractures: evaluation and treatment. J Am Acad Orthop Surg. 2001;9(2):114–27.

    Article  PubMed  CAS  Google Scholar 

  19. Mulfinger GL, Trueta J. The blood supply of the talus. J Bone Joint Surg Br. 1970;52(1):160–7.

    Article  PubMed  CAS  Google Scholar 

  20. Peterson L, Goldie IF. The arterial supply of the talus: a study on the relationship to experimental talar fractures. Acta Orthop Scand. 1975;46(6):1026–34. Available from: http://www.tandfonline.com/doi/full/10.3109/17453677508989293

    Article  PubMed  CAS  Google Scholar 

  21. Prasarn ML, Miller AN, Dyke JP, Helfet DL, Lorich DG. Arterial anatomy of the talus: a cadaver and gadolinium-enhanced MRI study. Foot Ankle Int. 2010;31(11):987–93. Available from: http://journals.sagepub.com/doi/10.3113/FAI.2010.0987

    Article  PubMed  Google Scholar 

  22. Miller AN, Prasarn ML, Dyke JP, Helfet DL, Lorich DG. Quantitative assessment of the vascularity of the talus with gadolinium-enhanced magnetic resonance imaging. J Bone Joint Surg. 2011;93(12):1116–21. Available from: http://insights.ovid.com/crossref?an=00004623-201106150-00004

    Article  PubMed  Google Scholar 

  23. Ebraheim NA, Sabry FF, Nadim Y. Internal architecture of the talus: implication for talar fracture. Foot Ankle Int. 1999;20(12):794–6. Available from: http://journals.sagepub.com/doi/10.1177/107110079902001207

    Article  PubMed  CAS  Google Scholar 

  24. Peterson L, Romanus B, Dahlberg E. Fracture of the collum tali—an experimental study. J Biomech. 1976;9(4):277–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/1262363

    Article  PubMed  CAS  Google Scholar 

  25. Sproule JA, Glazebrook MA, Younger AS. Varus hindfoot deformity after talar fracture. Foot Ankle Clin. 2012;17(1):117–25. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22284556

    Article  PubMed  Google Scholar 

  26. Elgafy H, Ebraheim N, Tile M, Stephen D, Kase J. Fractures of the talus: experience of two level 1 trauma centers. Foot Ankle Int. 2000;21(12):1023–9.

    Article  PubMed  CAS  Google Scholar 

  27. Vallier HA, Reichard SG, Boyd AJ, Moore TA. A new look at the Hawkins classification for talar neck fractures: which features of injury and treatment are predictive of osteonecrosis? J Bone Joint Surg Surg Am. 2014;96(3):192–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24500580

    Article  Google Scholar 

  28. Thomas JL, Boyce BM. Radiographic analysis of the Canale view for displaced talar neck fractures. J Foot Ankle Surg. 2012;51(2):187–90. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22154058

    Article  PubMed  Google Scholar 

  29. Haapamaki VV, Kiuru MJ, Koskinen SK. Ankle and foot injuries: analysis of MDCT findings. Am J Roentgenol. 2004;183(3):615–22.

    Article  Google Scholar 

  30. Chan G, Sanders DW, Yuan X, Jenkinson RJ, Willits K. Clinical accuracy of imaging techniques for talar neck malunion. J Orthop Trauma. 2008;22(6):415–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18594307

    Article  PubMed  Google Scholar 

  31. Williams T, Barba N, Noailles T, Steiger V, Pineau V, Carvalhana G, et al. Total talar fracture—inter- and intra-observer reproducibility of two classification systems (Hawkins and AO) for central talar fractures. Orthop Traumatol Surg Res. 2012;98(4 SUPPL):S56–65.

    Article  PubMed  CAS  Google Scholar 

  32. Dale JD, Ha AS, Chew FS. Update on talar fracture patterns: a large level I trauma center study. Am J Roentgenol. 2013;201(5):1087–92.

    Article  Google Scholar 

  33. Sangeorzan BJ, Wagner UA, Harrington RM, Tencer AF. Contact characteristics of the subtalar joint: the effect of talar neck misalignment. J Orthop Res. 1992;10(4):544–51. Available from: http://www.ncbi.nlm.nih.gov/pubmed/1613628

    Article  PubMed  CAS  Google Scholar 

  34. Marsh JL, Saltzman CL, Iverson M, Shapiro DS. Major open injuries of the talus. J Orthop Trauma. 1995;9(5):371–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8537838

    Article  PubMed  CAS  Google Scholar 

  35. Ohl X, Harisboure A, Hemery X, Dehoux E. Long-term follow-up after surgical treatment of talar fractures: twenty cases with an average follow-up of 7.5 years. Int Orthop. 2011;35(1):93–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20033158

    Article  PubMed  Google Scholar 

  36. Penny J, Davis L. Fractures and fracture-dislocations of the neck of the talus. J Trauma. 1980;20(12):1029–37.

    Article  PubMed  CAS  Google Scholar 

  37. Tyllianakis M, Karageorgos A, Papadopoulos AX, Lambiris E. Surgical treatment of talar neck fractures. Eur J Trauma. 2004;30(2):98–103. Available from: http://link.springer.com/10.1007/s00068-004-1329-5

    Article  Google Scholar 

  38. Frawley PA, Hart JAL, Young DA. Treatment outcome of major fractures of the talus. Foot Ankle Int. 1995;16(6):339–45. Available from: http://journals.sagepub.com/doi/10.1177/107110079501600605

    Article  PubMed  CAS  Google Scholar 

  39. Grob D, Simpson LA, Weber BG, Bray T. Operative treatment of displaced talus fractures. Clin Orthop Relat Res. 1985;(199):88–96. Available from: http://www.ncbi.nlm.nih.gov/pubmed/4042501.

  40. Comfort TH, Behrens F, Gaither DW, Denis F, Sigmond M. Long-term results of displaced talar neck fractures. Clin Orthop Relat Res. 1985;(199):81–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/4042500.

  41. Schulze W, Richter J, Russe O, Ingelfinger P, Muhr G. Surgical treatment of talus fractures: a retrospective study of 80 cases followed for 1–15 years. Acta Orthop Scand. 2002;73(3):344–51. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12143985

    Article  PubMed  Google Scholar 

  42. Smith PN, Ziran BH. Fractures of the talus. Oper Tech Orthop. 1999;9(3):229–38. Available from: http://linkinghub.elsevier.com/retrieve/pii/S1048666699800214

    Article  Google Scholar 

  43. Berlet GC, Lee TH, Massa EG. Talar neck fractures. Orthop Clin North Am. 2001;32(1):53–64. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11465133

    Article  PubMed  CAS  Google Scholar 

  44. Pajenda G, Vécsei V, Reddy B, Heinz T. Treatment of talar neck fractures: clinical results of 50 patients. J Foot Ankle Surg. 39(6):365–75. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11131473

  45. Buckwalter V JA, Westermann R, Mooers B, Karam M, Wolf B. Timing of surgical reduction and stabilization of talus fracture-dislocations. Am J Orthop (Belle Mead NJ). 46(6):E408–13. Available from: http://www.ncbi.nlm.nih.gov/pubmed/29309454

  46. Grear BJ. Review of talus fractures and surgical timing. Orthop Clin North Am. 2016;47(3):625–37.

    Article  PubMed  Google Scholar 

  47. Lindvall E, Haidukewych G, DiPasquale T, Herscovici D, Sanders R. Open reduction and stable fixation of isolated, displaced talar neck and body fractures. J Bone Joint Surg Am. 2004;86–A(10):2229–34. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15466732

    Article  PubMed  Google Scholar 

  48. Sanders DW, Busam M, Hattwick E, Edwards JR, McAndrew MP, Johnson KD. Functional outcomes following displaced talar neck fractures. J Orthop Trauma. 2004;18(5):265–70.

    Article  PubMed  Google Scholar 

  49. Bellamy JL, Keeling JJ, Wenke J, Hsu JR. Does a longer delay in fixation of talus fractures cause osteonecrosis? J Surg Orthop Adv. 2011;20(1):34–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21477531

    PubMed  Google Scholar 

  50. Babu N, Schuberth JM. Partial avascular necrosis after talar neck fracture. Foot ankle Int. 2010;31(9):777–80. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20880480

    Article  PubMed  Google Scholar 

  51. Patel R, Van Bergeyk A, Pinney S. Are displaced talar neck fractures surgical emergencies? A survey of orthopaedic trauma experts. Foot Ankle Int. 2005;26(5):378–81. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15913522

    Article  PubMed  Google Scholar 

  52. Xue Y, Zhang H, Pei F, Tu C, Song Y, Fang Y, et al. Treatment of displaced talar neck fractures using delayed procedures of plate fixation through dual approaches. Int Orthop. 2014;38(1):149–54.

    Article  PubMed  Google Scholar 

  53. Fleuriau Chateau PB, Brokaw DS, Jelen BA, Scheid DK, Weber TG. Plate fixation of talar neck fractures: preliminary review of a new technique in twenty-three patients. J Orthop Trauma. 2002;16(4):213–9.

    Article  PubMed  CAS  Google Scholar 

  54. Maceroli MA, Wong C, Sanders RW, Ketz JP. Treatment of comminuted talar neck fractures with use of minifragment plating. J Orthop Trauma. 2016;30(10):572–8.

    Article  PubMed  Google Scholar 

  55. Ziran BH, Abidi NA, Scheel MJ. Medial malleolar osteotomy for exposure of complex talar body fractures. J Orthop Trauma. 2001;15(7):513–8.

    Article  PubMed  CAS  Google Scholar 

  56. Gonzalez A, Stern R, Assal M. Reduction of irreducible Hawkins III talar neck fracture by means of a medial malleolar osteotomy: a report of three cases with a 4-year mean follow-up. J Orthop Trauma. 2011;25(5):e47–50. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21464743

    Article  PubMed  Google Scholar 

  57. van Bergen CJA, Tuijthof GJM, Sierevelt IN, van Dijk CN. Direction of the oblique medial malleolar osteotomy for exposure of the talus. Arch Orthop Trauma Surg. 2011;131(7):893–901. Available from: http://link.springer.com/10.1007/s00402-010-1227-8

    Article  PubMed  Google Scholar 

  58. Prewitt E, Alexander IJ, Perrine D, Junko JT. Bimalleolar osteotomy for the surgical approach to a talar body fracture: case report. Foot Ankle Int. 2012;33(5):436–40. Available from: http://journals.sagepub.com/doi/10.3113/FAI.2012.0436

    Article  PubMed  Google Scholar 

  59. Muir D, Saltzman CL, Tochigi Y, Amendola N. Talar dome access for osteochondral lesions. Am J Sports Med. 2006;34(9):1457–63. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16636351

    Article  PubMed  Google Scholar 

  60. Simpson RB, Auston DA. Open reduction for AO/OTA 81-B3 (Hawkins 3) talar neck fractures: the natural delivery method. J Orthop Trauma. 2016;30(3):e106–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26709817

    Article  PubMed  CAS  Google Scholar 

  61. Patel NG, Wansbrough G. Achieving exposure and distraction through medial malleolar osteotomy for fractures of the talus. Tech Orthop. 2016;31(3):207–8.

    Article  Google Scholar 

  62. Liu H, Chen Z, Zeng W, Xiong Y, Lin Y, Zhong H, et al. Surgical management of Hawkins type III talar neck fracture through the approach of medial malleolar osteotomy and mini-plate for fixation. J Orthop Surg Res. 2017;12(1):1–9.

    Article  Google Scholar 

  63. Draper SD, Fallat LM. Autogenous bone grafting for the treatment of talar dome lesions. J Foot Ankle Surg. 39(1):15–23. Available from: http://www.ncbi.nlm.nih.gov/pubmed/10658946

  64. Wu K, Zhou Z, Huang J, Lin J, Wang Q, Tao J. Talar neck fractures treated using a highly selective incision: a case-control study and review of the literature. J Foot Ankle Surg. 2016;55(3):450–5. https://doi.org/10.1053/j.jfas.2016.02.002.

    Article  PubMed  Google Scholar 

  65. Mayo KA. Fractures of the talus: principles of management and techniques of treatment. Tech Orthop. 1987;2(3):42–54. Available from: https://insights.ovid.com/crossref?an=00013611-198710000-00008

    Article  Google Scholar 

  66. Kubiak EN, Nickisch F. Posteromedial approach for talar body fractures. Tech Foot Ankle Surg. 2009;8(2):65–9. Available from: https://insights.ovid.com/crossref?an=00132587-200906000-00006

    Article  Google Scholar 

  67. Bonasia DE, Rossi R, Saltzman CL, Amendola A. The role of arthroscopy in the management of fractures about the ankle. J Am Acad Orthop Surg. 2011;19(4):226–35. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21464216

    Article  PubMed  Google Scholar 

  68. Wajsfisz A, Makridis KG, Guillou R, Pujol N, Boisrenoult P, Beaufils P. Arthroscopic treatment of a talar neck fracture: a case report. Knee Surg Sports Traumatol Arthrosc. 2012;20(9):1850–3. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22048748

    Article  PubMed  Google Scholar 

  69. Pyle C, Harris TG. Arthroscopically assisted percutaneous fixation of a talar neck fracture via posterior approach. Tech Foot Ankle Surg. 2018. Available from: http://insights.ovid.com/crossref?an=00132587-900000000-99863

  70. Sanders DW, Busam M, Hattwick E, Edwards JR, McAndrew MP, Johnson KD. Functional outcomes following displaced talar neck fractures. J Orthop Trauma. 18(5):265–70. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15105747

  71. Swanson TV, Bray TJ, Holmes GB. Fractures of the talar neck. A mechanical study of fixation. J Bone Joint Surg Am. 1992;74(4):544–51. Available from: http://www.ncbi.nlm.nih.gov/pubmed/1583049

    Article  PubMed  CAS  Google Scholar 

  72. Attiah M, Sanders DW, Valdivia G, Cooper I, Ferreira L, MacLeod MD, et al. Comminuted talar neck fractures: a mechanical comparison of fixation techniques. J Orthop Trauma. 2007;21(1):47–51. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17211269

    Article  PubMed  Google Scholar 

  73. Abdelkafy A, Imam MA, Sokkar S, Hirschmann M. Antegrade-retrograde opposing lag screws for internal fixation of simple displaced talar neck fractures. J Foot Ankle Surg. 2015;54(1):23–8.

    Article  PubMed  Google Scholar 

  74. Beltran MJ, Mitchell PM, Collinge CA. Posterior to anteriorly directed screws for management of talar neck fractures. Foot Ankle Int. 2016;37(10):1130–6.

    Article  PubMed  Google Scholar 

  75. Capelle JH, Couch CG, Wells KM, Morris RP, Buford WL, Merriman DJ, et al. Fixation strength of anteriorly inserted headless screws for talar neck fractures. Foot ankle Int. 2013;34(7):1012–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23456083

    Article  PubMed  Google Scholar 

  76. Charlson MD, Parks BG, Weber TG, Guyton GP. Comparison of plate and screw fixation and screw fixation alone in a comminuted talar neck fracture model. Foot ankle Int. 2006;27(5):340–3. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16701054

    Article  PubMed  Google Scholar 

  77. Yilmaz BKB, Kati YA, Turan A, Kilicaslan OF, Kose O. Fracture of the entire posterior process of the talus: a case report and review of the literature. Int J Orthop Sci. 2017. 1;3(1j):640–4. Available from: http://www.orthopaper.com/archives/?year=2017&vol=3&issue=1&part=J&articleid=259

  78. Marsh JL, Slongo TF, Agel J, Broderick JS, Creevey W, DeCoster TA, et al. Fracture and dislocation classification compendium—2007: Orthopaedic Trauma Association classification, database and outcomes committee. J Orthop Trauma. 21(10 Suppl):S1–133.

  79. Haykal S, Roy M, Patel A. Meta-analysis of timing for microsurgical free-flap reconstruction for lower limb injury: evaluation of the Godina principles. J Reconstr Microsurg. 2018. Available from: http://www.ncbi.nlm.nih.gov/pubmed/29536455

  80. Cherubino M, Valdatta L, Tos P, D’Arpa S, Troisi L, Igor P, et al. Role of negative pressure therapy as damage control in soft tissue reconstruction for open tibial fractures. J Reconstr Microsurg. 2017;33(S 01):S08–13. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28985633

    Article  PubMed  Google Scholar 

  81. Sanders R, Pappas J, Mast J, Helfet D. The salvage of open grade IIIB ankle and talus fractures. J Orthop Trauma. 1992;6(2):201–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/1602342

    Article  PubMed  CAS  Google Scholar 

  82. Gillquist J, Oretorp N, Stenström A, Rieger Å, Wennberg E. Late results after vertical fracture of the talus. Injury. 1974;6(2):173–9. Available from: http://linkinghub.elsevier.com/retrieve/pii/0020138374900102

    Article  Google Scholar 

  83. Henderson RC. Posttraumatic necrosis of the talus: the Hawkins sign versus magnetic resonance imaging. J Orthop Trauma. 1991;5(1):96–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/2023054

    Article  PubMed  CAS  Google Scholar 

  84. Tezval M, Dumont C, Stürmer KM. Prognostic reliability of the Hawkins sign in fractures of the talus. J Orthop Trauma. 2007;21(8):538–43. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17805020

    Article  PubMed  Google Scholar 

  85. Gerken N, Yalamanchili R, Yalamanchili S, Penagaluru P, Md EM, Cox G. Talar revascularization after a complete talar extrusion. J Orthop Trauma. 2011;25(11):e107–10. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21577150

    Article  PubMed  Google Scholar 

  86. Chen H, Liu W, Deng L, Song W. The prognostic value of the hawkins sign and diagnostic value of MRI after talar neck fractures. Foot Ankle Int. 2014;35(12):1255–61. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25116131

    Article  PubMed  Google Scholar 

  87. Gross CE, Sershon RA, Frank JM, Easley ME, Holmes GB. Treatment of osteonecrosis of the talus. JBJS Rev. 2016;4(7):1–9.

    Article  Google Scholar 

  88. Daniels TR, Smith JW, Ross TI. Varus malalignment of the talar neck. Its effect on the position of the foot and on subtalar motion. J Bone Joint Surg Am. 1996;78(10):1559–67. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8876585

    Article  PubMed  CAS  Google Scholar 

  89. Monroe MT, Manoli A. Osteotomy for malunion of a talar neck fracture: a case report. Foot Ankle Int. 1999;20(3):192–5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/10195299

    Article  PubMed  CAS  Google Scholar 

  90. Rammelt S, Winkler J, Heineck J, Zwipp H. Anatomical reconstruction of malunited talus fractures: a prospective study of 10 patients followed for 4 years. Acta Orthop. 2005;76(4):588–96. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16195078

    Article  PubMed  Google Scholar 

  91. Huang P-J, Cheng Y-M. Delayed surgical treatment for neglected or mal-reduced talar fractures. Int Orthop. 2005;29(5):326–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16094539

    Article  PubMed  PubMed Central  Google Scholar 

  92. Suter T, Barg A, Knupp M, Henninger H, Hintermann B. Surgical technique: talar neck osteotomy to lengthen the medial column after a malunited talar neck fracture. Clin Orthop Relat Res. 2013;471(4):1356–64. Available from: http://link.springer.com/10.1007/s11999-012-2649-0

    Article  PubMed  Google Scholar 

  93. Button G, Pinney S. A meta-analysis of outcome rating scales in foot and ankle surgery: is there a valid, reliable, and responsive system? Foot Ankle Int. 2004;25(8):521–5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15363371

    Article  PubMed  Google Scholar 

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Whitaker, C., Turvey, B. & Illical, E.M. Current Concepts in Talar Neck Fracture Management. Curr Rev Musculoskelet Med 11, 456–474 (2018). https://doi.org/10.1007/s12178-018-9509-9

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