Talar body fracture

 

talar bodyTalar bodyTalar Dome ORIF AP

 

Epidemiology

 

10-20% of all talus fractures

 

Patterns

 

Coronal plane / Sagittal plane

+/- Crush fractures

+/- talar neck

 

Involve both the tibiotalar and the subtalar joint

 

Xray

 

Talar body fractureTalar body

 

CT

 

talar bodyTalar bodyTalar body

 

CT Talar Dome FractureCT Talar Dome Fracture 2

 

Operative Management

 

Indications

 

Displaced / intra-articular fractures

 

Approach

 

Anteromedial / anterolateral approach +/- medial or lateral malleolar osteotomy

 

AO surgery reference anteromedial approach talus

 

AO surgery reference anterolateral approach talus

 

AO surgery reference medial malleolar osteotomy

 

Talar Dome ORIF APTalar Dome ORIF Lateral

ORIF talar body utilizing medial malleolar osteotomy

 

Posterior fractures

- posteromedial approach +/- distraction with external fixation

- posterolateral approach +/- distraction with external fixation

- posterior ankle arthroscopy

 

Talar Dome ORIF APTalar Dome ORIF LateralTalar Dome ORIF Non Union

 

Results

 

Ebraheim et al Int Orthop 2008

- 19 talar body fractures treated with ORIF

- 52% (10/19) good outcomes

 

Vallier et al JBJS Am 2003

- 26 talar body fractures treated with ORIF

- 65% (17/26) ankle OA

- 35% (9/26) subtalar OA

- 38% (10/26) AVN

 

Complications

 

Nonunion

 

Talus Body Nonunion CTTalus Body Nonunion CT2Talus Body Nonunion MRI

Non / malunion of nonoperatively treated talar fracture

 

Talus Body Nonunion ORIF 1Talus Body Nonunion ORIF 2

Post ORIF of the nonunion utilizing a medial malleolar osteotomy

 

Malunion / AVN

 

Talar malunionTalar malunion