The neck is the site of 50% of talus fractures.
Severity of fracture determines the probability of osteonecrosis complicating the fracture1: Hawkins Type I (undisplaced) up to 13%; Type II (displaced, with the body fragment subluxed or dislocated from the subtalar joint) 20-50%; Type III (subluxation or dislocation of the subtalar or ankle joint) up to 100% probability.
Nonunion and delayed union are rare.
Following fractured neck of talus, post-traumatic osteoarthritis develops in the subtalar joint in a half of patient, in the ankle joint in a third, and in both joints in a quarter2.
Fractures of the head account for 34-105% of fractures of the talus. They are often difficult to see on routine radiographs and may need Computed Tomography (CT) to identify them. For displaced fractures and those causing instability of the talonavicular joint, Open Reduction and Internal Fixation (ORIF) may be necessary.
Simple closed fractures of the lateral process of the talus are generally considered "minor" and are initially treated by 6 weeks' immobilisation in a cast6, particularly if the fracture is undisplaced or minimally displaced 7.
However, they should always be followed up by an orthopedic surgeon7. Fragments larger than 5 mm may need to be excised 6.
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