Case Reports and Series| Volume 56, ISSUE 6, P1298-1304, November 2017

Traumatic Complex Hawkins Type IV Talar Fracture: A Case Report


      Fracture-dislocations of the talus are one of the most complex injuries involving the foot and ankle. These injuries are often accompanied by additional traumatic orthopedic injuries, avascular necrosis, and infection. When approaching limb reconstruction and salvage, the overall prognosis and functionality of the limb are key factors to consider. In the present report, we draw attention to the importance of a multidisciplinary team approach for formulating a treatment plan that incorporates the talar injury and associated injuries or pathologic features. We also reviewed the published data related to avascular necrosis of the talus, open talar fracture management, and treatment outcomes.

      Level of Clinical Evidence


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to The Journal of Foot and Ankle Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Archdeacon M.
        • Wilber R.
        Fractures of the talar neck.
        Orthop Clin North Am. 2002; 33: 247-261
        • Hawkins L.G.
        Fractures of the neck of the talus.
        J Bone Joint Surg Am. 1970; 52: 991-1002
        • Canale S.T.
        • Kelly F.B.
        Fractures of the neck of the talus: long term evaluation of 71 cases.
        J Bone Joint Surg Am. 1978; 60: 143-156
        • Adelaar R.S.
        • Madrian J.R.
        Avascular necrosis of the talus.
        Orthop Clin North Am. 2004; 35: 383-395
        • Adelaar R.S.
        Complex fractures of the talus.
        Instr Course Lect. 1997; 46: 323-338
        • Mindell E.R.
        Late results of injuries to the talus: analysis of forty cases.
        J Bone Joint Surg Am. 1963; 45: 221-245
        • Sanders R.
        • Pappas J.
        • Mast J.
        • Helfet D.
        The salvage of open grade IIIB ankle and talus fractures.
        J Orthop Trauma. 1992; 6: 201-208
        • Gustillo R.B.
        • Anderson J.T.
        Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: retrospective and prospective analysis.
        J Bone Joint Surg Am. 1976; 58: 453-458
        • Blair H.C.
        Comminuted fractures and fracture dislocations of the body of the astragalus: operative treatment.
        Am J Surg. 1943; 59: 37-43
        • Dennis M.D.
        • Tullos H.S.
        Blair tibiotalar arthrodesis for injuries to the talus.
        J Bone Joint Surg Am. 1980; 62: 103-107
        • Morris H.D.
        • Hand W.L.
        • Dunn A.W.
        Modified Blair fusion for fractures off the talus.
        J Bone Joint Surg Am. 1971; 53: 1289-1297
        • McKeever F.M.
        Treatment of complications of fractures and dislocations of the talus.
        Clin Orthop. 1963; 30: 45-62
        • Pennal G.F.
        Fractures of the talus.
        Clin Orthop. 1963; 30: 53-63