Evaluation of talus fractures treated with fixation- correlation of functional outcome with the fracture type and wound condition

Neetin Pralhad Mahajan, Nikhil Dilip Palange, Eknath Pawar, Amit Supe, Prasannakumar G. S.


Background: Fractures of talus are one of the most difficult ones to treat owing to the problems of complicated fracture patterns, wound problems, risk of osteonecrosis etc. This study aims to evaluate the relation of the fracture type and wound with the functional outcome after open reduction and fixation.

Methods: The study was conducted in Sir J. J. Group of Hospitals from June 2014 to March 2018. A consecutive series of 28 patients with displaced fractures of talus were selected after approval from ethical committee. All patients were operated and evaluated at average of 6 months after surgery.

Results: The Hawkins score was used to evaluate the functional outcome. 60% of patients of type II gained good to very good score as compared to 40% of patients of type III and 30% of type IV. With increase in severity of the fracture, percentage of score decreased.

Conclusions: Most precise method of restoring and maintaining the anatomy of talus fracture is open reduction and internal fixation to allow early motion. Surgery for displaced fractures consists of anatomically correct reconstruction to avoid articular surface incongruence and angular deformity as well as preservation and rapid restoration of talar blood supply. This will ensure early mobilization and satisfactory outcome. Open fractures have worse functional outcome than closed fractures owing to lower union rates, higher osteonecrosis rates and higher re-operation and infection rates. 


Talus, Fractures, Hawkins, Osteonecrosis

Full Text:



Fortin PT, Balazsy JE. Talus Fractures: Evaluation and Treatment. J Am Acad Orthop Surg. 2001;9:114-27.

Stirton JB, Ebraheim NA, Ramineni SK. Medial peritalar fracture dislocation of the talar body. Trauma Case Reports. 2015;1(3):32-7.

Santavirta S, Seitsalo S, Kiviluoto O, Myllynen P. Fractures of the talus. J Trauma. 1984;24:986.

Vallier HA. Fractures of the Talus: State of the Art. J Orthop Trauma. 2015;29:385.

Haverkort JJM, Leenen LPH, van Wessem KJP. Diagnosis and treatment of talar dislocation fractures illustrated by 3 case reports and review of literature. Int J Surg Case Rep. 2015;16:106–11.

Marti R. Talus and Calcaneus frakturen. In: Frakturbehandlung bei Kindern und Jugendlichen. Weber BG, Brunner C, Freuler F, eds. New York: Springer, Berlin Heidelberg; 1978:376-87.

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

Metzger MJ, Levin JS, Clancy JT. Talar neck fractures and rates of avascular necrosis. J Foot Ankle Surg. 1999;38:154–62.

Lindvall E, Haidukewych G, DiPasquale T, Herscovici D Jr, Sanders R. Open reduction and stable fixation of isolated, displaced talar neck and body fractures. J Bone Joint Surg (Am). 2004;86:2229–34.

Canale ST. Fractures of the neck of the talus. Orthopedics. 1990;13:1105–15.

Metzger MJ, Levin JS, Clancy JT. Talar neck fractures and rates of avascular necrosis. J Foot Ankle Surg. 1999;38:154–62.

Canale ST, Kelly FB Jr. Fractures of the neck of the talus:Long-term evaluation of seventy-one cases. J Bone Joint Surg Am. 1978;60:143-56.

Vallier HA, Nork SE, Barei DP, Benirschke SK, Sangeorzan BJ. Talar neck fractures:results and outcomes. J Bone Joint Surg (Am). 2004;86:1616– 24.

Weber BG. Brüche von Knöcheln und Talus. Bewährtes und Neues in iagnostik und Therapie. Langenbecks Arch Chir. 1981;355:421-5.

Beck E. Die Talusfraktur. Orthopäde. 1991;20:33-42.

Dávid A, Muhr G, Möllenhoff G. Talusfrakturen – Therapie und Ergebnisse. In: Das obere Sprunggelenk – Angeborene und erworbene Schäden (Ed. Stahl Ch). ecomed. Fortschritte in Orthopädie und Traumatologie, Landsberg/Lech; 1996: 103-104.

Schulze W, Richter J, Klapperich T, Muhr, G. Funktionsergebnisse nach operativer Therapie von Talusfrakturen. Chirurg. 1998;69:1207-13.

Penny JN, Davis LA. Fractures and fracture-dislocation of the neck of the talus. J Trauma. 1980;20:1029-37.

Grob D, Simpson L, Weber BG, Bray T. Operative treatment of displaced talus fractures. Clin Orthop. 1985;199:88-96.

Szyszkowitz R, Reschauer R, Seggl W. Eighty-five talus fractures treated by ORIF with five to eight years of follow-up of 69 patients. Clin Orthop. 1985;199:97-107.

Elgafy H, Ebraheim NA, Tile M, Stephen D, Kase J. Fractures of the talus: experience of two level 1 trauma centers. Foot & Ankle Int. 2000;21:1023.