Other Foot Fractures
FRACTURES
1. fractures (50%)
Classification
Hawkins "Fractures of the neck of the talus" JBJS 52A:991-1002, 1970
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Type
|
Pathology
|
|
I
|
Undisplaced
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|
II
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Displaced [disloc. subtalar jt.]
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|
III
|
Displaced + dislocation of the body [disloc. ankle jt.]
|
|
IV
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Displaced + dislocation of both body and neck (added by Terry and Canale later) [disloc. T-N jt.]
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Treatment and results
| Hawkins |
Treatment |
AVN |
Non-union |
Subtalar Arthrosis |
Results |
| Type I |
6 weeks non-weight bearing in cast (minimum), weight bearing starts when signs of union present |
10% |
2% |
25% |
90% good results |
| Type II |
Immediate closed reduction in A/E if skin compromise present, ORIF via medial approach with lag screw fixation from anterior - posterior. The screw heads must be countersunk below the articular surface. |
40% |
8% |
65% |
47% unsatisfactory result with healing usually in 8 - 12 weeks |
| Type III |
25% of these are open; ORIF required (via medial malleolus osteotomy) |
90% |
10% |
65% (ankle 70%) |
Malunion 30%; 52% unsatisfactory results and healing occurs in upward of 16 weeks |
| Type IV |
ORIF |
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