2. Pt is a 24 yo WM that
jumped out of a 10 foot
high window trying to
jump into the pool. He
landed on his right foot on
the pavement. He did not
hit anything else and is
now complaining of pain in
his right foot and ankle.
He has been unable to walk
since.
Vitals: T:98.6, HR:112, RR:16,
BP:128/76
Gen: WD, WN, nontoxic male
holding his right ankle
CV: slight tachy, RR
Pulm: CTA bilaterally
MSK: significant edema over
right ankle and dorsum of foot.
Ttp diffusely. No obvious
deformity. Decreased ROM at
ankle. 2+ pulses. Good cap
refill. Neuro intact.
3.
4. A talar fracture can occur at the head, necck, or body. The
neck is the most likely location of a talar fracture (as seen
above)
5. Assess neurovascular status
Reduce if necessary
Splint with posterior leg and stirrups splints.
The ankle should be plantar flexed and everted 15
degrees.
Emergent orthopedic consult
Appropriate pain management
6. Talar Fractures can occur in 3 different spots on the
talus: the body, the head, and the neck.
body fx: accounts for 25% and is further divided into
osteochondral, lateral process, posterior process and
dome(true body) fractures
Head fx: <10% of talar fx
Neck fx: categorized by Hawkins:
1) nondisplaced
2) displaced, body subluxed/dislocated from subtalar joint
3) high energy with subluxed/dislocated ankle or subtalar
joint with displaced talar neck
7. Avascular necrosis is very common with talar
fractures, especially when fracture is displaced
Talar fractures are associated with medial malleolar
fractures in 25% of case.
