Retrospective cohort of 100 patients with 102 operatively treated talar neck fractures at a level-1 trauma center. The study examines rates of osteonecrosis, posttraumatic arthritis, and functional outcomes, and directly tests whether timing of surgical fixation influences osteonecrosis development.
When you see a talar neck fracture with comminution or an open wound, counsel the patient that osteonecrosis and arthritis rates exceed 50% regardless of how fast you get to the OR — injury energy, not surgical delay, drives the prognosis.
Prioritize urgent closed reduction of any dislocation and open wound management, then proceed to definitive ORIF once soft tissues allow rather than rushing through compromised tissue planes.
Retrospective cohort of 100 patients with 102 operatively treated talar neck fractures at a level-1 trauma center. The study examines rates of osteonecrosis, posttraumatic arthritis, and functional outcomes, and directly tests whether timing of surgical fixation influences osteonecrosis development.
When you see a talar neck fracture with comminution or an open wound, counsel the patient that osteonecrosis and arthritis rates exceed 50% regardless of how fast you get to the OR — injury energy, not surgical delay, drives the prognosis.
Prioritize urgent closed reduction of any dislocation and open wound management, then proceed to definitive ORIF once soft tissues allow rather than rushing through compromised tissue planes.