Talar head fractures

 

Talar Head FractureTalar Head Fracture CT

 

Epidemiology

 

< 10% of all talus fractures

Rare and often missed

 

Types

 

1. Compression fracture

- impaction injuries with force through navicular to compress head

- hyperdorsiflexion

- may also produce compression fracture of navicular

 

2. Shear fracture

- inversion injury

- midtarsal adduction

- navicular shears off portion of talar head

 

Issue

 

Disability via involvement articular surface - late talonavicular arthritis

 

Can have subluxation / dislocation of transverse tarsal joints

 

Management

 

Non-displaced 

- cast / NWB

 

Displaced 

- ORIF via medial approach

- if extremely comminuted consider TNJ arthrodesis