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Other Foot Fractures

FRACTURES

1. fractures (50%)

Classification

Hawkins "Fractures of the neck of the talus" JBJS 52A:991-1002, 1970

Type

Pathology

I

Undisplaced

II

Displaced [disloc. subtalar jt.]

III

Displaced + dislocation of the body [disloc. ankle jt.]

IV

Displaced + dislocation of both body and neck (added by Terry and Canale later) [disloc. T-N jt.]

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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