Talus Fracture

Talar fractures are rare but serious injuries. The talus transmits all body weight between the tibia and the foot and has a precarious blood supply — 60–70% of its surface is covered by articular cartilage, leaving little room for vascular penetration. Talar neck fractures (the most common type) from high-energy dorsiflexion carry a high risk of avascular necrosis (AVN) of the talar body: Hawkins type I (undisplaced, ~0% AVN), type II (subtalar subluxation, ~40% AVN), type III (talar body dislocation, ~90% AVN).

X-rays including lateral, AP, and Canale views for talar neck. CT is mandatory for surgical planning. MRI evaluates AVN and residual vascularity. Hawkins sign — subchondral lucency of the talar dome on 6-8 week X-ray — is a favorable prognostic sign indicating revascularization.

Displaced talar neck fractures require urgent anatomic reduction and fixation to minimize AVN risk. Emergency surgery for dislocated talar body fractures.

External patient-education references and related OSI pages for additional background:

• Britannica — Bone disease (fractures)
• Britannica — Ankle (anatomy)
• AAOS OrthoInfo — patient education library
• OSI glossary — orthopedic terminology in plain language