ICYMI: A Bad Pattern of Talar Neck Fractures to Watch Out For
These injuries may be seeing you — make sure you're seeing them
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Smart Practice: Watch out for talar neck fractures that extend proximally into the talar body; they are badly behaved and are not well captured on the Hawkins classification.
What’s the Claim?
A retrospective, comparative study found that talar neck fractures with proximal extension into the talar body are more likely to:
- Develop osteonecrosis (49% versus 19%), even after controlling for confounding variables like smoking and diabetes (odds ratio for AVN of 3.5 after controlling for those variables)
- Collapse (14% versus 4%)
- Progress to nonunion (26% versus 9%)
A sequence of visuals is presented at the bottom of this post,
How’s It Stack Up?
It’s surprising there isn’t more out there on this. Over 40% of the talar neck fractures in this study extended proximally. This pattern isn’t well captured by the Hawkins classification, and we’ve not seen a study specifically on this before, so we’ll share the author's exact words on how to diagnose it:
